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Earth Movement-Cubic Yards <br /> In Out Total <br /> Haul Route? ? � Yes � No <br /> Explain haul route in detail: <br /> � <br /> Fees to be Char ed Amount Orono Inspections Required <br /> Permit Fee Amount <br /> ---�" � Site <br /> Escrow Amount � Hardcover Removal <br /> ��� � Footing <br /> Escrow Agreement received? 0 Poured Wall <br /> � As-Built Survey <br /> 0 Yes � No � Planting Plan <br /> 0 Wetland Buffer <br /> Escrow Money received? inal <br /> ❑ Yes � No 0 Other(specify) <br /> Engineering review needed? <br /> � Yes No <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: d( ��( <� <br /> RE ARKS (TO BE NOTED ON PER IT AND INITIALLED BY PERSON PULLING PERMIT) <br /> 6 <br /> �V�o r Y�L u.. S rh 'J `�.¢D� r <br /> �- <<� � A ► c� <br /> Updated:January 2013 <br /> z:\forms\plan review checklist for zoning permit applications 2013.docx <br />