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REMARKS (in-house): <br /> Fees to be Charged YES NO <br /> Permit Dc <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: $ , ‘3-2.-6, ' ✓Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ ite CI Plumbing 0 Grading/ Filling 0 Well <br /> Silt Fence/ Erosion Control 0 Mechanical 0 Fire 0 Electrical <br /> ardcover Removal 0 Septic 0 Water Connection <br /> 1XFooting 0 Fireplace 0 Sewer Connection <br /> ❑ Poured Wall 0 Masonry 0 Lawn Irrigation <br /> ❑ Foundation Survey 0 Mfg. 0 Landscaping <br /> ❑ Foundation Waterproofing 0 Other(specify) <br /> ❑ Radon Rock Bed <br /> ❑ Framing <br /> ❑ Insulation <br /> -Built Survey <br /> incl <br /> ❑ Other(specify) <br /> REMARKS (in-house): 54e Ge/61) 19(4 nita‘. "4 U 13 10 <br /> Other Review: Reviewed by: Date Approved: <br /> Access: Existing: 0 YES 0 NO New: 0 YES 0 NO <br /> OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED <br /> '01)141a1W aO Dv 144 2191q- 01310 <br /> letzdatAt td- 61/1/0f,0 (se,tt Gtti�,! l✓uv fa GrO".1 t'91 V -C <br /> Updated: January 2015 <br /> z:\forms\plan review checklist 2015.docx <br />