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Fees to be Charged YES NO � �.
<br /> -Per.mit � '�;�*", ,,��� � ,�;_ �;
<br /> Plan Review
<br /> °'State�Surcharge r `„�,. -
<br /> Investigation Fee
<br /> -mSAC ��f��mber,of=SAC�U;�iits t °i , � �
<br /> , �:• � �,� ,,;< -
<br /> �. _,�. ...a : � .�_�� � -�-_,, � __
<br /> �. „•, ;
<br /> Sewer Connection
<br /> 4�1�fa�er�!C�o ' , - _.. .
<br /> �a����imx��� r. � , . . ,.
<br /> � � . . .: � ��
<br /> ..., �.�.,�,c_,�,�,� Y.� ��������. ���,,�� �*� .� � _�����^'_."=��
<br /> Park Fee
<br /> �i�e �"s�ec , .. . �.
<br /> ,�"�r �, "��on �
<br /> ��
<br /> :,m ,,..�,�� ,...� � , ,� ,
<br /> `
<br /> ,., r,
<br /> .. . . . . . �,,., � .
<br /> ,.;:�.r , � �
<br /> ,. ...,_.. .,�,.. , ....,, :..� _.. ..�.�� . r. �
<br /> Other(specify)
<br /> �i,,���SC��I'�iUIIEAI"lS��1eSq'�fti�����;� x � a�x e TM�,+� „ r � �
<br /> ,.—m-.wr-,...� .:,.:_ ,_.�.�_ -m-^� "�m.-'4��. �.. 3 fi ����`-�e: "�."i�'� t�'P�� �'.�-�r..�.`�sxs�A ��'taf��
<br /> �.-�,. r4..-�..�_ _ .., .. .�.,.,7v.a .,,.4;.�i.r ,aaAhh.:,:' ..a...l.;�.�,,.s
<br /> Calculated By:
<br /> Square Foota e $ per Square Foota e
<br /> Basement X = �
<br /> 15' Floor X = $
<br /> 2"d FfOOr X = $
<br /> Garage X = �
<br /> Estimated Construction Value: $ z`�, �z�-% y�`
<br /> Orono fnspections Required Work Requiring Separate Permits Required State Permits
<br /> 0 Site �'Plumbing � Grading / Filling 0 Well
<br /> � Hardcover Removal � Mechanical ❑ Fire ,d�Efectrical
<br /> ❑ Footing � Septic ❑ Water Connection
<br /> 0 Poured Wall ❑ Fireplace 0 Sewer Connection
<br /> � Foundation Survey ❑ Masonry ❑ Lawn Irrigation
<br /> � Radon Rock Bed ❑ Mfg.
<br /> .�" ❑ Other(specify)
<br /> 0 Insulation
<br /> � As-Built Survey
<br /> ,0'Final
<br /> � Other(specify)
<br /> REMARKS (in-house):
<br /> Other Review: Reviewed by: Date Approved:
<br /> Access:Existing: � YES 0 NO New: ❑ YES ❑ NO
<br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
<br /> Updated: 09/11/2009
<br /> z:\forms�plan review checklist.docx
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