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� ti <br /> " Fees to be Char ed YES NO <br /> Permit �/' ,, <br /> Plan Review � <br /> State Surcharge j�.-� <br /> �� Investigation Fee <br /> SAC—Number of SAC Units (/'" <br /> Other(specify) y�^ <br /> S uare Foota e $ er S uare Foota e <br /> Basement X = $ <br /> 1 S' Floor X = $ <br /> 2nd FI00� X ° _ $ <br /> Garage X = $ <br /> Estimated Construction Value: $ �,(`/�4�_� � <br /> Orono Inspections Required Work Requiring Separate Permits <br /> Footing 0 Site Plumbing � Grading/Filling <br /> Poured Wall Silt Fence/Erosion Control Mechanical 0 Fire <br /> Foundation Survey 0 Hardcover Removal Fireplace 0 Water Connection <br /> 0 Framing 0 Othe�r(specify) , � Masonry � Sewer Connection <br /> �,Waterproofing/Drain tile �Mfg. � Lawn Irrigation <br /> � Foundation Waterproofing � Other(specify) � Landscaping <br /> Framing �Septic <br /> Insulation �� ' <br /> As-Built Survey <br /> Final <br /> Lathe Required State Permits <br /> � Other(specify) <br /> Well lectrical <br /> REMARKS (in-house): <br /> � <br /> ; <br /> OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: <br /> � See Buil�er Acknowledgement Form <br /> � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> �I� <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />