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1 <br /> Fees to be Charged YES NO <br /> Permif . <br /> Plan Review <br /> .`State`Surcharge. � ,/ <br /> Investigation Fee <br /> QAC'C44Nu of'SAC+Units <br /> Sewer Connection <br /> ater-I vection <br /> Park Fee <br /> :`S�te'�nspection:, <br /> Other(specify) <br /> 'Miscellaneous:Fees <br /> Calculated By: <br /> Square Footage $ per Square Footagi <br /> Basement X = $ <br /> 1st Floor X = $ <br /> 2nd Floor X = $ <br /> Garage X = $ <br /> Estimated Construction Value: $ 0 d 0 <br /> Orono Inspections Required Work Requiring Separat Permits Required State Permits <br /> • Site Plumbing 0 Grading/ Filling 0 Well <br /> O Hardcover Removal ,Mechanical 0 Fire 00p, <br /> Electrical <br /> 0 Footing 0 Septic 0 Water Connection <br /> 0 Poured Wall 0 Fireplace 0 Sewer Connection <br /> 0 Foundation Survey 0 Masonry 0 Lawh Irrigation <br /> 0 Radon Rock Bed 0 Mfg. <br /> Framing 0 Other(specify) <br /> Insulation <br /> 0 s-Built Survey <br /> Final <br /> 0 Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date �pproved: <br /> Access:Existing: 0 YES 0 NO New: 0 YES 0 NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated: 09/11/2009 <br /> zAforms\plan review checklist.docx <br />