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Fees to be Charged YES NO <br /> Permit _ <br /> Plan Review <br /> State"Surchar,ge , ,: • <br /> Investigation Fee � <br /> SAC-"Number of'SAC`Units �}�a�� � �, p.2 � ,; <br /> Sewer Connection <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other (specify) <br /> :Miscellaneous Fees „-_ ' , , � <br /> Calculated By: <br /> Square Foota e $ per S uare Foota e <br /> Basement X I = $ <br /> 15' Floor � X = � <br /> 2"d FIOOr I X = � $ <br /> Garage X = $ <br /> � a <br /> Estimated Construction Value: $ "155,UU� � <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ Site ,�Plumbing ❑ Grading / Filling ❑ ell <br /> ❑ Hardcover Removal ,�Mechanical ❑ Fire Electrical <br /> �Footing ❑ Septic �Water Connection ; <br /> �' Poured Wall �Fireplace �Sewer Connection � <br /> �Foundation Survey ❑ Masonry ❑ Lawn Irrigation <br /> �Radon Rock Bed �'Mfg. <br /> �,I� raming CYOther(specify) N�n�F,m Co, Dr�w�� <br /> nsulation ��,�.��� <br /> fd� s-Built Survey <br /> �inal <br /> ❑ Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> mO �� (( w� �I � d�s � �g� ll h� <br /> c a- ` <br /> o l� �c,r �.. I�k�s hc�., �jJ�� v s�- b�. v w�� �ec1 <br /> {'j �. 2�u.j C� c s r s s��G �, (' <br /> Updated: 09/11/2009 s�pr�v�,c�,,a.�,j po.�rw��� (reQC�1Y�� '�YCX\ �'�Q,ylVtl.{�InC.G• (Ya4�S• ��. <br /> z:\forms\plan review checklist.docx � �.�y p�m��, Y�QuI rF� '�tt�►� w�'K I Yl 'f'�G1�'1�- O�W� � <br />