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(o'!b-o'ry <br /> '�f�f�e`� , ��17����1� �C�;����IJ� E ��� E���'E% ���1��4r 6 �b["'��e:� � �����i���`�� <br /> AddresslPere�€t Fdumber:_ 3(.SS N�c�27"H Sf-�02c: �!Z <br /> Description of e�sQ�fc: �!E{�.1 ��-p ,ls <br /> �eptic revfevv b�r: � ��` Datie Approvec�: <br /> Zoning revieNr by: Date Approvec8: <br /> Builcfic�g reviedv l��: Date Approved: � " ' ' '� <br /> Grading revl�w tsy: Date Approved:�-��' <br /> � �� <br /> Z�reir�g Distric�: � �� Zoning File#: � �3 Reso#: Reso Date: <br /> ZoRing: Lat l�re�: SF/AC 1�ic�th: Lot Coverage: SF �/o <br /> Survey Submitteci: es L7 No Date of Survey: �J-�-!�' Revised date(?)• �"�Jl �� <br /> Pro osed Setttacks: <br /> Fr�it(L�k�) I�ar(Street) � � � E w 1 ( P6 S E IAl 1 Other Buildin�s Wetland <br /> �` '� d � Side `� Side <br /> �,.. -, E ,��- . <br /> ,�' �� <br /> Defined Height:_,�` P�aic ki�ight:,�_ FFE: FF�cntinus�feet= (Existire�Contoui <br /> Pecimeter(linear�eet)= 50%_ #of�tories�Ok?�ES <br /> FOR A BUILDING WITH A BASEMENT OR CRAIl1lL SPAC�: <br /> The distanoe between the lowest FOR A BUii:DIN6 ON A SLAB FOUNDATION: <br /> `}.,� START WITH prcposed floor(of the basement or crawl <br /> ,i� space)and the highest peint of the roof. STARl'WITH T�distance between the Yop of slab antl <br /> if you ha�e a... the highest pant of the roof. <br /> GABLE OR HIPPED ROOF(no you Fiave a:.. <br /> a � • GABLE OR HIPPED RqOF no <br /> windows): Subtrect half the � <br /> �� distance beM�een the highest point ���)� Subhact haNthe dfstanc <br /> �" beriveen the fiighest point ofthe ro� <br /> t of the roof to fhe bw point of the <br /> SUBTRACTION corresponding gable or hipped roof W.the low pant of tfie cotresponclin <br /> i� SUBTRACTION gable or hipped roof <br /> � (BASED ON ROOF . GABLE OR HiPPED ROOF(with (BA$ED ON . GABLE OR HIPPED ROOF(with <br /> T�P�) windows): Subtract half the ROOF TYPE) windows): Subtrad halfthe distanc <br /> d�tance betwee�the top of tfie between�e toP of the.t�jphest <br /> highest wintlow and the highes# windcw and the highest poiht ef the <br /> point of the roof . r�{ <br /> F ALL OTHER ROOF TYPES(flat, � ALt OTHER ROOF TYPES(flak <br /> mansard�etc):Ne subtracdon. mansard et ;No subtradior�: <br /> AbDRION Atld the distance betwean the top of slab <br /> SubfractUie distance between the <br /> y;. SUBTRAC�ION f�S�D ON and the higheat existlng grade adjacent U <br /> � . ���eee basemenUcrawl space floor and the - EXIS'TING the foundatlon. <br /> ,� � (BASED ON DCISTING highest e�dsbng grade adjacent to the GRA ES � <br /> � � r> GRADES) foundation OR 10 feet(whichever is less). EQUALS. Defined lwiWing height <br /> '' � EQUALS Defined buflding height <br /> �� � <br /> Sf�crei��d District Wli �41�Pertnit Received Avera e Lakeshore Setba�k Met? Bic�fF <br /> Yes � No � N/A � Yes o <br /> �'Yes O No � es � No 0 N/A <br /> Permit Number: � - Setback: <br /> Stiorm�va$er C��alit�s F�ci�tan� Propo��d yariance Rec�uireci CI�P�equired <br /> C�verla t3istrict�'ier f��rdco�eer F@�rdca�v�c <br /> �%��> :. ' ,� '.�`_ ° �i es � No � Yes � No <br /> � - TYPe(S)� T e s <br /> , YPO� <br /> Updated: January 2013 <br /> v:\formslplan review chedclist 2013.doac <br />