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������ ������ ��������� ��'� ���� ���������� � ��������� <br /> Address: �l 2O tv'O/L-Yl`4 �+lL+-c� lLcd �DlZ <br /> Perm6t F�o.. <br /> Description of wrQrk: /`/ 1/ or� �oa I en�fL��dll �- A� i�o� Date Rec'd• <br /> Seplic review b�r: N/A Date Approvecl:' <br /> Zoning r�eiew b�: /l�- Date l�pproved: <br /> Building review by: Date Approved: �/ �- 20�S' <br /> Crading review lsy: N /l� Date Approv�d• <br /> Zoning District: Zor�ing File#: Reso#: f2eso Date: <br /> �o 'ng: Lot�,rea; SF/AC Width: Lot CoveraSe: SF % <br /> Surve utamifted: � Yes � No Dat�of Survey: __ Revised date{��,;, <br /> Pro osed tbacks: ` <br /> Front(Lake� Rear(Street) ( N � E VV ) ( h� S E tN � <br /> ) Ofher Bui n"gs lN�tiand <br /> Side Sic4e <br /> De#ined lieight: E��ak I�efght: FFE: FFE min 6 feet=�(Existtng Contou <br /> , Perimeter(iinear feetj= 50%0= �� ' ; �.E. belovv grade #of Stories - <br /> FOR A BUILDING WITH I!BASEMENT OR CRA SPAGE: FOR A BUJL'b1kG Otd A SLAB�OUNDATIOhE: <br /> Tfie distance betw tNe lowest proposetl s�a' The dfstance bett�yeen.the top of <br /> START tM1IITH floor(of the baseme crawl space)and START WITH slab and the 6ighest point of the: <br /> the highest point of the roof. <br /> ; If you have a... �; If you have a... <br /> • GABLH OR HIPPED ROO no • . GABLE OR HIPPEp ROOF <br /> - windows): Subtract haff the nce (no windows): SubYra�t h8ff <br /> bet�nreen tfae hfghe�t pofnt of the t#�e dfstanoe beM�een the. <br /> � to Ehe loW polnt of the dorres `" • ' highe&t poiiiCof the rooFto <br /> SIiBTRACTION gabie or hfpped roof .s the low polnt of ttie <br /> EBASED ON . � cotrespontling gable or <br /> • GA$LE pR HIPPEA ROO,F(with SUBTRACTION hipped tpof � <br /> ' ROOF TYPE) windows}: Subtract haH,ifie disfance (BASED qN . GABL�-0R HIPPED}�OOF <br /> befweer�the top of th 1i(ghest ROOP TYPE) (with windowsj". Subti�ct <br /> �f ow and the hi��st'point of the lialf the distance 6elw'sen <br /> � the top of the hfghest " <br /> • ALt OTHER R6QF TYPES(flat, windd�nra�d the,highesl. <br /> mansard,eyr)<>No subtracUon, � pofnC bf tlie rtlbi" <br /> SUBTRAC7'ION ' Subtract the d' nae between the • ALL OTli��t ROOF TYPES . ,. <br /> (BASfD ON ` baser�enU wl space floor and the ' {flat,madsard,ete):No = <br /> �XISTING highest e 'ng prade adJacent to the su tracllora. <br /> GRADES) ' founda n OR 10 feet DITION Add tFre diatanee between the top <br /> • (whicheuer is less). ( ED ON of stab and!he high�stexisting <br /> EQWILS Defl building hetgM EXiS G gratle adJeCent to the foundatfo�. <br /> 'CyW#dE <br /> �QUALS Deflned buliding heigfit + <br /> Shoreland Dtstrict ' MCEND Permit `average i.akeshore Sefback' 8{uff <br /> Met? � <br /> � Yes No Permit Number. Q Yes � No E3 N/A ;G 's � No <br /> i7 WA-see attached Setback: , <br /> Stormwater uaiity Exfsting liardcover Proposed <br /> O�eria istrict ���o and s� ��rdco�rer Variance Required CUP Rec�uire <br /> Tter ircle one %and s <br /> � Yes 0 No � Yes 0 No <br /> 1 2 3 4 5 TYP�(S)= TYPe(S). <br /> Updated: January 2045 <br /> z:\formslplan review checklist 2015.docx �f� C(-(� � � <br /> � <br />