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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 <br /> V I <br /> V 0 Site <br /> Escrow Amount 0 Hardcover Removal <br /> fzoo o 0 Footing <br /> Escrow Agreement received? 0 Poured Wall <br /> yAs-Built Survey <br /> /Yes 0 No 0 Planting Plan <br /> 0 Wetland Buffer <br /> Escrow Money received? 0 Final <br /> Yes 0 No 0 Other(specify) <br /> Engineering review needed? <br /> (es 0 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 /> Pt;o t 40 Y t LtgSc of CSc lrow Mar an as-bui if S U,v� nuul- <br /> bx Su m(Ike ark O frOYt01 . <br /> Updated:January 2013 <br /> z:\forms\plan review checklist for zoning permit applications 2013.docx <br />