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Fees to be Charged YES NO <br /> <Perm��i�t� � � � ,,. �<;�f� <br /> �,'.�. <br /> Plan Review <br /> 1" • � <br /> State,Surcharge - � =:f' � �-a�;'i <br /> fnvestigation Fee • <br /> "SAC �:,�N�rt�tiex.-of=SAC�U,ra:its �;- <br /> _... , _._ _ _ ... _�,. . . , ..,. <br /> Sewer Connection <br /> ':�1Na��e���ru�n�:c�sio.n�����`�"�. ��, ����'��t��� �� t�.� ,�J ;� <br /> �.w <br /> Park Fee <br /> '�te�l�s;p,esc�'innq�'�y^' �`1- ,x��yy � ..e <br /> a�aas��..l r�'1�tV��'.`��.'1F�i�� � ) fit�'tFt��� ya� -�'a'vA� - �' h�,.�� �� <br /> Other(specify) <br /> ;�IYI�sc��la�e�.�'s�F�es Y �`�'�� �� ��� . � -��� ��� �. . <br /> „� �������� �� r{>�� � � � .;� <br /> _ �., - z, r: `�.�., �? '�:.,,.�-'t,�„[�t4,:�Fv r '�..�r- aa,�.-,`nt,.,n4+t•; �'k_,"-.��.': <br /> . ,-_,.. ..�... �.. ,.. _ . .: ,. ,� r . �r,.�; . .,.� <br /> Calculated By: <br /> Square Foota e $ per Square Foota e <br /> Basement X = � <br /> 15t Floor X = � <br /> 2nd FIOo� X = $ <br /> Garage X = � <br /> Estimated Construction Value: � I��,(;�C; y�` <br /> Orono fnspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ Site Plumbing � Grading / Filling � Well <br /> 0 Hardcover Removal � Mechanical � Fire Electrical <br /> � Footing � Septic ❑ Water Connection <br /> � Poured Wall 0 Firepiace D Sewer Connection <br /> ❑ Foundation Survey 0 Masonry 0 Lawn Irrigation <br /> � Radon Rock Bed ❑ Mfg. <br /> Framing � Other(specify) <br /> � Insulation <br /> � s-Built Survey <br /> Final <br /> 0 Other(specify) <br /> REMARKS (in-house); <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: � YES ❑ NO New: ❑ YES 0 NO <br /> REMARKS (TO BE NOTED ON PERMIT AND iNITIALLED BY PERSON PULLING PERMIT) <br /> Updated: 09/11/2009 <br /> z:\formslplan review checklist.docx <br />