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Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> es 0 No Permit Number: 0 Yes 0 No �A 0 Ye No <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 % and sf % and sf <br /> J� 0 Yes o 0 Yes No <br /> Type(s): Type(s): <br /> Fees to be Charged YES NO <br /> Permit <br /> Plan Review (/ <br /> State Surcharge <br /> Investigation Fee <br /> SAC—Number of SAC Units (/t <br /> Other(specify) <br /> Square Footage $ per Square Footage <br /> Basement X = $ <br /> X = $ <br /> 2nd Floor X = $ <br /> Garage X = Is <br /> Estimated Construction Value: $ <br /> Orono Inspections Required Work Requiring Separate Permits <br /> noting 0 Site 0 Plumbing 0 Grading/Filling <br /> 0 Poured Wall 0 Silt Fence/Erosion Control 0 Mechanical 0 Fire <br /> 0 Foundation Survey 17 Hardcover Removal 0 Septic O Water Connection <br /> 0 Foundation Waterproofing 17 Other(specify) 0 Fireplace 0 Sewer Connection <br /> raming 0 Masonry 0 Lawn Irrigation <br /> 0 Insulation 0 Mfg. 0 Landscaping <br /> 0 As-Built Surve 0 Other(specify) <br /> Final <br /> 0 Lathe Required State Permits <br /> Other(specify)rit !< �.�ro /—rv1Ct <br /> 0 Well 0 Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> er Ack emen Q � MAk& <br /> /;L <br /> rior to release of escrow money <br /> .��e kd <br /> Updated: October 2015 <br /> 74nr clnlnn raviaw chanklict 9(-9(115 riner <br />