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Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> 0 Yes fi'No Permit Number: 0 Yes 0 No " /A 0 Ye No <br /> N/A-see attached Setback: <br /> l� - <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> (circle one) (% and sf) (% and sf) <br /> ❑ Yes No 0 Yes Flo <br /> 1 2 3 4 50 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 <br /> Other(specify) <br /> Square Footage $ per Square Footage <br /> Basement X = $ <br /> 1St Floor X = $ <br /> 2nd Floor X = $ <br /> Garage X = $ <br /> Estimated Construction Value: $ <br /> Orono Inspections Required Work Requiring Separate Permits <br /> 0 Site 0 Plumbing 0 Grading/Filling <br /> ?<Footing <br /> Poured Wall 0 Silt Fence/Erosion Control 0 Mechanical 0 Fire <br /> ❑ Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection <br /> ❑ Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection <br /> *Framing 0 Masonry 0 Lawn Irrigation <br /> ❑ InA-Asulation 0 Mfg. 0 Landscaping <br /> s Built Survey ❑ Other(specify) <br /> Final <br /> ❑ Lathe Required State Permits <br /> ❑ Other(specify) <br /> 0 Well 0 Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> Se uilder gemen <br /> Prior to release of escrow money an as-built survey must be submitted and approved. <br /> Updated: October 2015 <br /> 7•\fnrmc\nlan rauiava rharklict 1(1Af11F dr-Iry <br />