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�. <br /> Fees to be Char ed YES NO <br /> Permit (/' <br /> Plan Review j� <br /> State 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� Floor X = $ <br /> 2nd FI0o1' X = $ <br /> Garage X = $ <br /> Q //� m� <br /> Estimated Construction Value: $ d�, �� v <br /> —T <br /> Orono Inspections Required Work Requiring Separate Permits <br /> � Footing � Site �Plumbing � Grading/Filling <br /> � Poured Wall 0 Silt Fence/Erosion Control �Mechanical 0 Fire <br /> � Foundation Survey � Hardcover Removal � Fireplace � Water Connection <br /> � Framing 0 Other(specify) 0 Masonry � Sewer Connection <br /> 0 Waterproofing/Drain tile 0 Mfg. O Lawn Irrigation <br /> 0 Foundation Waterproofing � Other(specify) � Landscaping <br /> �Framing 0 Septic <br /> 0 Insulation <br /> 0 As-Built Survey <br /> Final <br /> � Lathe Required State Permits <br /> � Other(specify) <br /> 0 Well lectrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> 0 See Builder Acknowledgement Form <br /> � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> � <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />