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. <br /> Fees to be Char ed YES NO <br /> Permit ✓' <br /> Plan Review [/` <br /> State Surcharge (/� <br /> Investigation Fee <br /> SAC—(dumber o#SAC Units � <br /> Other(specify) t� <br /> S uare Foota e $ er S uare Foota e <br /> Basement X = $ <br /> 1�' Floor X = $ <br /> 2nd FI00� �.j X � i J�' _ $ <br /> Garage X = $ <br /> Estimated Construction Value: $ �� 7 7� �J� <br /> Orono Inspections Required Work Requiring Separate Permits <br /> � Footing � Site � Plumbing � Grading/Filling <br /> 0 Poured Wall � Silt Fence/Erosion Controi Mechanicai � Fire <br /> 0 Foundation Survey � Hardcover Removal 0 Fireplace 0 Water Connection <br /> 0 Framing � Other(specify) � Masonry � Sewer Connection <br /> 0 Waterproofing/Drain tile � Mfg. � Lawn Irrigation <br /> 0 Foundation Waterproofing 0 Other(specify) � Landscaping <br /> �Framing � Septic <br /> � Insulation <br /> 0 As-Built Survey <br /> Final <br /> 0 Lathe Required State Permits <br /> � Other(specify) <br /> 0 Well Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: <br /> � See Builder Acknowledgement Form <br /> � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />