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� , _. <br /> Fees to be Char ed YES NO <br /> Permit <br /> Plan Review ;�' <br /> St�te Surcharge (/" <br /> Investigation Fee ,. <br /> SAC—Number of SAC Units <br /> Other(specify) <br /> S uare Foota e $ er S uare Foota e <br /> Basement X = $ <br /> 1 St Floor X = $ <br /> 2nd Floo� X = $ <br /> Garage X = $ <br /> i, <br /> Estimated Construction Value: $ �O, <br /> Orono Inspections Required Work Requiring Separate Permits <br /> 0 Footing � Site � Plumbing � Grading/Filling <br /> 0 Poured Wall � Silt Fence/Erosion Control Mechanical � Fire <br /> � Foundation Survey 0 Hardcover Removal � Fireplace � Water Connection <br /> � Framing 0 Other(specify) 0 Masonry 0 Sewer Connection <br /> 0 Waterproofing/Drain tile � Mfg. 0 Lawn Irrigation <br /> � Foundation Waterproofing 0 Other(specify) � Landscaping <br /> �Framing <br /> O Insulation <br /> 0 As-Built Survey <br /> Final <br /> � Lathe Required State Permits <br /> � Other(specify) <br /> 0 Well Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> 0 See Builder Acknowledgement Form <br /> 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />