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� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> dddress: Y� �� Permit No.: ��7 '�'t'L� <br /> Description of work: l - � � v.Jv �"� Date Rec'd: � Lr ' �� <br /> Septic review by: Date Approved: � L <br /> Zoning review by: Date Approved: ' � ` <br /> Building review by: Date Approved: � l r <br /> Grading review by: Date Approved: ��Q(JL /iZ- <br /> Zoning District: ' Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolutio /NA <br /> Zoning: Lot Area: Z 4' SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: �es � No Date of Survey: �Z� '� 7 Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: ��� (�Vl., bul��� � No/None proposed <br /> Pro osed Setbacks: <br /> Front(L,�.(�ce) Rear(S et) ( N S�W ) ( N S E V�) Other Buildings Wetland <br /> � Si Side <br /> 254�' Z ' � <br /> Buildinp Hei�ht Analvsis: <br /> Distance Between First Floor and defined Top of �a� � <br /> Roo�` See "buildin hei ht" defin' ' n : <br /> First•Floor Elevation from b ' in lans : (b) �� <br /> Highest Existing grou evel (per survey) or 10' ��� <br /> above lowest ro level, whichever is lower: <br /> Difference be een b and c : (d) <br /> Defined Buildin Hei ht(a - d : � <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> �Yes 0 No Permit Number: � _ '13 � Yes 0 No �/A � Ye No <br /> � N/A-see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and s % and s <br /> �b.Gf1'7,� `().�Ql� O Yes No � Yes No <br /> 1 2 � 4 5 � 6� Type(s): Type(s): <br /> �Z(�2 �'S <br /> Updated: October 2016 <br /> v:\fortns�plan review checklist 10-2016.docx <br />