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Fees to be Charged YES 'NO <br /> Permi't ` ' <br /> .� � <br /> . . . _ ..,A .k,� <br /> .. ...,, .._; <br /> Plan Review �F - ` F <br /> ,State-�Surchar9�e ,I ,-�.'._.;, � :� <br /> {..�- <br /> investigation Fee <br /> ;�SAC :���N,��ber:of-`SAC:U�aits � „, <br /> . ., , , . . , _ .... : <br /> . , <br /> Sewer Connection i <br /> �C�l����u��r.Ci���,n��'�a. �ir�-��'�'`�"��'���5������ . ���=:" .�?.�,��•."�d.���� ::�xx�q.r�,,4��,i�. <br /> Park Fee <br /> ,., ,��,.� - . ,., . <br /> �.��'�I�s,�ec�fron����, , <br /> �, <br /> -� � , _,,. � <br /> . . .�..,r .. ..._, r.)4�: ' ' . :i� <br /> ... 4.I'� ' ''�' •, 9 <br /> n ..�.... . ...�, . . .r-,- ,...�_ -�, . t i....._ ,, <br /> Other(specify) <br /> �h9f�sr�'�a��m.�s�F�es �}.��"��'���� q . ������ " �* <br /> .A..S �%7a. Y�. „Fq�. .��}y 4yc�� ���:{rkY.. � <br /> ...�. W+*.P .�✓^!.. n._ ..�...�V , h. ve <br /> Calculated By: <br /> Square Foota e $ per Square Foota e <br /> Basement X = $ <br /> 15' Floor X = � <br /> 2nd Floo� X = � <br /> Garage X = � <br /> Estimated Construction Value: $ ��'C?:C��C' `�� <br /> ---z <br /> Orono inspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ Site �P umbing � Grading / Filling ❑ Well <br /> � Hardcover Removal echanical 0 Fire �Electrical <br /> D Footing ❑ Septic 0 Water Connection <br /> � Poured Wall ❑ Fireplace � Sewer Connection <br /> ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation <br /> ❑ Radon Rock Bed ❑ Mfg. <br /> ¢�Framing ❑ Other(specify) <br /> ��Insulation <br /> � As-Built Survey <br /> �Final <br /> D Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: 0 YES ❑ NO New: ❑ YES ❑ 1V0 <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated: 09/11/2009 <br /> z:\forms�plan review checklist.doc� <br />