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PLAN REVIEW <br /> //CHEC //IKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �0 �Co �/'V ,A y zeoe Permit No.: <br /> Description of work: Date Rec'd: <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: <br /> Building review by: Date Approved: Z- <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File M <br /> Resolution? Yes Reso#: Reso Date: Signed: es No Resolution/NA <br /> Zoning: Lot Area: S /AC Width: Struct al Coverage: SF % <br /> Survey Submitted: 0 Yes 0 No Date of Survey: Revised dateM: <br /> : <br /> Landscape plan submitted? 0 Y s Landscaper: 0 No/ None proposed <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) \( N S E W ) ( S E W ) Other Buildings Wetland <br /> Side Side <br /> Buildina Hei ht Analysis: <br /> Distance Between First Floor and defined Top fR f* (See "building height" (a) <br /> definition <br /> First Floor Elevation from building plans): A (b) <br /> Highest Existing ground level (per survey) or 0' ab ve 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 ab ve FFE-Height is(a)- d): (e) <br /> *If highest existingadjacent rade is b low FFE-Height is a + <br /> Shoreland District CWD Permit verage Lakeshore Setback Bluff <br /> Met? <br /> 0 Yes 0 No Permit N tuber: Yes 0 No 0 N/A 0 Yes 0 No <br /> 17 N/y—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and sf (% an sf) \ <br /> 0 Yes 0 No 0 Yes 0 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 />