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Earth Movement-Cubic Yards <br /> In Out Total <br /> Haul Route? ? 0 Yes 0 No <br /> Explain haul route in detail: <br /> Fees to be Charged Amount Orono Inspections Required <br /> Permit Fee Amount 150 <br /> O Site <br /> Escrow Amount 0 Hardcover Removal <br /> 0 Footing <br /> Escrow Agreement received? 0 Poured Wall <br /> 0 As-Built Survey <br /> O Yes /No 0 Planting Plan <br /> O Wetland Buffer <br /> Escrow Money received? Final <br /> O Yes No 0 O her(specify) <br /> Engineering review needed? <br /> O Yes to <br /> REMARKS (in-house): k 1 VCfl4Y ( (OV �.�•. Row-- Ay.= 141.5 P-3,tO(OZ.ti) v�40g:tl�o <br /> 4oUtIS Z3 �s2.3 1 r( g.4(f 3+rkLh mi coy <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 />