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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �J lV t' C y Gil`�t Jia Permit No.:_`Z�/7 <br /> Description of work: Date Rec'd: 6/ 7Z1,6 <br /> Septic review by: Date Approved: <br /> Zoning review b Date Approved: / <br /> Building review by: Date Approved: <br /> Grading review by: Date Approved: w 12L <br /> Zoning District: Zoning File M <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution/ NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: 0 Yes 0 No Date of Survey: Revised dateM: <br /> Landscape plan submitted? 0 Yes Landscaper: 0 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 /> Building Height Analysis: <br /> Distance Between First Floor and defined Top of (a) <br /> Roof* See "building height" definition): <br /> First Floor Elevation from building plans): (b) <br /> Highest Existing ground level (per survey) or 10' (c) <br /> above lowest ground level, whichever is lower: <br /> Difference between b and (c): (d) <br /> DEFINED HEIGHT If highest existing grade is: (e) <br /> above FFE-Height is(a)-(d) <br /> below FFE-Height is(a)+(d) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> D Yes D No Permit Number: 17 Yes 0 No XNIA E3 Ye No <br /> M N/A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % ands %and s <br /> 0 Yes No 0 Yes No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />