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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � O e,,-n 74y e, Permit No.:Z©� Z— <br /> Description of work: e 2-12 O zi war Date Rec'd: <br /> Septic review by: Date Approved: <br /> Zoning review by. Date Approved: <br /> Building review by: Date Approved: xh <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File M <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution I NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: ❑ Yes ❑ No Date of Survey: Revised date(?): <br /> Landscape plan submitted? ❑ Yes Landscaper: ❑ No/ None proposed <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Buildina Hei ht Analysis: <br /> Distance Between First Floor and defined Top of Roof* (See"building height" (a) <br /> definition <br /> First Floor Elevation from building plans): (b) <br /> Highest Existing ground level (per survey) or 10' above 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-Height is(a) -(d): (e) <br /> 'If highest existing adjacent grade is below FFE-Height is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> ❑ Yes ❑ No Permit Number: ❑ Yes ❑ No ❑ N/A ❑ Yes ❑ 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 sf % and sf <br /> ❑ Yes ❑ No ❑ Yes ❑ No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Updated: June 2017 <br /> z:\forms\plan review checklist 06-2017.docx <br />