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Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Cl Yes 0 No Permit Number: 0 Yes 0 No 0 N/A 0 Yes <br /> e No 0 <br /> 0 N/A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % ands %and s <br /> 0 Yes 0 No 0 Yes 0 No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Fees to be Char ed __,_YESON-WON <br /> s ,rK <br /> L . <br /> Plan Review L2 <br /> Investigation Fee <br /> 'k` f 4 <br /> ac.+ R o'0, �5 f#itS+w,sy � <br /> Other(specify) <br /> Square Footage $ per Square Footage <br /> Basement X. _ $ <br /> 18t Floor X = $ <br /> 2nd Floor X = $ <br /> Garage X = $ <br /> ,�1 ma <br /> Estimated Construction Value: $ Z�, (000 <br /> Orono Inspections Required Work Requiring Separate Permits <br /> 0 Footing 0 Site Plumbing 0 Grading/Filling <br /> 0 Poured Wall 0 Silt Fence/Erosion Control Mechanical 0 Fire <br /> 0 Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection <br /> 0 Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection <br /> Framing 0 Masonry 0 Lawn Irrigation <br /> Insulation 0 Mfg. 0 Landscaping <br /> As-Built Survey 0 Other(specify) <br /> Final <br /> 0 Lathe Required State Permits <br /> 0 Other(specify) <br /> 0 Well Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> 0 See Builder Acknowledgement Form <br /> 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2015 <br /> -.SIC- %-­­­...- .,..I �- <br />