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pLAw REVEW CHECKUSI FOR rTRUCTUE E S I ADDMONS <br /> Address: 5 � <br /> � r01_4.(: L._ Permit No.: /Mt 2.017 Ob <br /> Description of work: Vrk,U,:f---.... Date Rec'd: '7.1747 <br /> Septic review by: —kIW / -- VV c,U .mob <br /> Date Approved: <br /> Zoning review by: ( . '! Date Approved: l'240./7 <br /> Building review by: g"- A-t -,eDate Approved: Vz5-7/7 <br /> Grading review by: NA Date Approved: <br /> Zoning District: Ig,-16 Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF i <br /> Set &ubm tted: es 0 No Date of Survey: Revised date(?): <br /> Landscape plan submitted? D Yes Landscaper: N i 0 No/None proposed <br /> Proposed Setbacks: <br /> Front(L Rear(9firA ( 0 S E W ) ( N S0' E W ) Other Buildings Wetland <br /> Sideide <br /> 1 Of c �' -; • <br /> Building Height Analysis: <br /> Distance Between First Floor and defined Top of (a) <br /> Roof's (See"building height" definition): F-1;43 ° <br /> First Floor Elevation (from buildin• : -ns): (b) <br /> Highest Existing ground Iev per survey) or 10' <br /> above lowest ground I- - - , whichever is lower: '�) <br /> Difference betw-- (b) and (c): (d) <br /> DEFINED H HT If highest existing grade is: (e) <br /> above F -Height is(a)-(d) [7:2 <br /> belo FE-Height is(a)+(d) <br /> Shoreland District fiCylrD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Yes 0 No Permit Number: ,tet 0 Yes Q No /q 0 Yes <br /> No <br /> 0 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 /> 1 2C) 4 5 14.1001-1' 5070 0 Yes /�No 0 Yes <br /> /G No <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />