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Fees to be Char ed YES NO <br /> Permit <br /> Plan Review V' <br /> State Surcharge li-- <br /> Investigation Fee V� <br /> SAC—Number a#SAC Units J �n� <br /> Other(specify) <br /> S uare Foota e $ er S uare Foota e <br /> Basement p X � �,7 = $ � � . � <br /> 1St Floor �7(�J� X ���. Z = � 9 7 o g 3 <br /> 2nd Floo� , L, X �7�, � _ $ <br /> Garage X �, 7 � _ $ � Z_C� <br /> )'� Q� <br /> Estimated Construction Value: $ �`�',�'�, ,� �� '�� <br /> Orono Inspections Required Work Requiring Separate Permits <br /> Footing � Site � Plumbing � Grading/Filling <br /> Poured Wall Silt Fence/Erosion Control Mechanical 0 Fire <br /> Foundation Survey � Hardcover Removal Fireplace �L Water Connection <br /> 0 Framing � Other(specify) � Masonry. �Sewer Connection <br /> �Waterproofing/Drain tile �Mfg. 0 Lawn Irrigation <br /> � Foundation Waterproofing � Other(specify) � Landscaping <br /> � Framing <br /> Insulation <br /> As-Built Survey <br /> Final <br /> Lathe `! Required State Permits <br /> 0 Other(specify) <br /> 7 ,Z g, �� <br /> i 5 8� �� � Well Electrical <br /> REMARKS (in-house): ` ! � 7 - �;�-F�.,�; <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 submitfed and approved. <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />