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���� ����� ������cs� ��� ��� ��;�c������� i �.����c��� <br /> Address/PID/Legal: �� ��� �� '�n �� j'�_ <br /> Description of work: 6cx=1'✓�� �t-`�--- � � 2 <br /> �- <br /> Septic �evi��r by: Date�pproved: ��,� -- f � <br /> Zor�ing revievv by: , � � � �-- Date tapproved: �t' � � �' <br /> Bu�lding ceview bY� �ate Appraved: ��� '�- Z.ar 2. <br /> G�c�ing r�view bY= !� Da�e Approvecf: �' a id <br /> Zoning File#: ��^�� Resolution#: � Resolution Date� .� '(� ' �. <br /> Zor�oa� Distric� �6re De ar��rnent Post Office School District <br /> - <br /> Zoning: Lot Area: _SF/AC Wid#h: Depth: <br /> Survey Submitted: Yes � No Date of Survey: �'�d'�� <br /> Pro osed Setbacks: <br /> ont(L�k�) �(Stree�� l � �� W ) ( N� �j�� l�d � Other Builciirt�s Vilet�anc� <br /> `'�d <br /> 3�` � e .3° � <br /> , � <br /> Building Defined Height: Building Peak Height: � #of�tories Ok?: YES <br /> � <br /> FOR A BUILDiNG 1MTH A BASEMEN�'OR CRkVKL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: <br /> START WITH the distance between the basement floor/crawl START the distance between the slab and the highes <br /> space floor and the highest roof peak,the top of WITH roof peak,the top of the comice of a fla#roof, <br /> the.comice of a flat roof,the deck line of a the deck line of a mansard roof,or the <br /> mansard roof,or the upperm�st point on a round upperrnDst point an a round or other�rch-typ� <br /> or other arch- e roof roof <br /> SUBTRACT half the distance between the highest winiiow and �U�TRACI` half the distance beiween the highes�window <br /> hi i�est roof eak pf a itched roof and hi hest roof eak of a itched,roof <br /> SUBTRACT the distance hetween the basement flood crawl ADD . the distancebe#ween the slab and the highes <br /> space floor arttl the highest exist�ng grade within ercistin rade within the foundation <br /> the fqundation or 10 feet,whichever is less. EQUALS Defned buildin hei ht <br /> EQUALS f�efined buildin hei ht <br /> Lot Coverage: SF % <br /> Sharei�nc�Distr�ct ft�C�D Peern@t Received Avera e Lake�hore Setback Bt�ff <br /> / 0 Yes � No 0 N/A � Yes No <br /> � Yes � No �Yes C] No CE N! — <br /> Permit Number: � Setback: <br /> Hardcover Zones Existir� Pro osed Vari cE Re �ired CWP I�e uieed <br /> 0-75' � es t� No � Yes 0 No <br /> 75-250' Z . � � �� TYPe(S)� c Type(s): <br /> 250-500' 4 . �'� � <br /> 500-1000' ' ' <br /> REMARKS (in-house): j <br /> Updated: U9/11/2009 <br /> z:\forms�plan review checklist.docx <br />