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PLAN REVIEW CHECK ST FOR NEW STRUCTURES / ADDITIONS <br /> Address: 0 I' OC)2� flc(/�a Permit No.: 240/7` / Jqe <br /> Description of work: (/I MiceC,e 1/ eC%af7) Gic6 / Date Rec'd: OAT <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: /L q �/ <br /> Building review by: ���� Date Approved: /67/21 <br /> 4l l <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution / NA <br /> Zoning: Lot Area: SFA• Width: Structural •verage: SF <br /> Survey Submitted: D Yes • No Date of Survey: Revised date(?): <br /> Landscape plan submitted? D Yes La dscaper: D No/ None proposed <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) ( N E W ) ( N S W ) Other Buildings Wetland <br /> ide S'.e <br /> Building Height Analysis: <br /> Distance Between First Floor and defined Top o Roof* (Se- "building height" (a) <br /> definition): <br /> First Floor Elevation (from building plans): (b) <br /> Highest Existing ground level (per survey) or 10' abo - lowest ground level, (c) <br /> whichever is lower: <br /> Difference between (b) and (c)*: (d) <br /> DEFINED HEIGHT <br /> *If highest existing adjacent grade is above FFE- eight is(a)- .): (e) <br /> *If highest existing adjacent grade is below FFE-Height is(a) + <br /> Shoreland District MCWD •ermit verage Lakeshore Setback Bluff <br /> Met? <br /> D Yes D No Permit Number: D es D No D N/A D Yes D No <br /> D N/A—see . ached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUR Required <br /> (circle one) (% and sf) (% and sf) <br /> Yes D No D Yes D No <br /> 1 2 3 4 5 Ty (s): Type(s): <br /> Updated: June 2017 <br /> z:\forms\plan review checklist 06-2017.docx <br />