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Earth Movement - Cubic Yards <br /> In Out Total <br /> Haul Route? ? 0 Yes ❑ No <br /> Explain haul route in detail: <br /> Fees to be Charged Amount Orono Inspections Required <br /> Permit Fee Amount <br /> ❑ Site <br /> Escrow Amount 0 Hardcover Removal <br /> ❑ Footing <br /> Escrow Agreement received? ❑ Poured Wall <br /> ❑ As-Built Survey <br /> ❑ Yes 0 No 0 Planting Plan <br /> ❑ Wetland Buffer <br /> Escrow Money received? 0 Final <br /> ❑ Yes 0 No 0 Other (specify) <br /> Engineering review needed? <br /> ❑ Yes D No <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated:January 2013 <br /> z:\forms\plan review checklist for zoning permit applications 2013.docx <br />