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' . , .�a��4-T���.�.a s,+-��,.za;�a.�5c-;t+�as.:st�.,:��as,,.:rs��-�a-.,..aa�sv'.�atc:�a�:��s,�s�.r,. ra��t' _ , . , '+k�'�u� :.���'��'�R <br /> Fees to be Charged YES NO <br /> Permit <br /> Plan Review <br /> State Surchaege <br /> Investigation Fee <br /> SAC—Number of SAC linits � <br /> �� Sewer Connection � . ; <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other(specify) <br /> Miscellaneous Fees <br /> Calculated By: <br /> S uare Foota e $ er S uare Foota e <br /> Basement X = $ <br /> 15t Floor X = $ <br /> 2nd Floo� X = $ <br /> '' Garage X = � <br /> � Estimated Construction Value: $ Z`t 1. �33.`� z sc_Z: p rt'''+'G�-4 �✓� C-jd�l.C� <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> � Site � Plumbing ❑ Grading / Filling � Well <br /> � Hardcover Remova� 0' Mechanical 0 Fire �` Electrical <br /> ,0' Footing � Septic ,0`Water Connection <br /> ,0' Poured Wall ,0' Fireplace �0"Sewer Connection <br /> � Foundation Survey ❑ Masonry 8'Lawn Irrigation <br /> 8' Radon Rock Bed �'Mfg. <br /> �'Framing � Other(specify) <br /> 1a Insulation <br /> ,0'As-Built Survey <br /> �'"Final <br /> 0 Other(specify) <br /> REMARKS (in-house): <br /> ; <br /> < <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: 0 YES ❑ NO New: � YES ❑ NO <br /> F: <br /> REMARlCS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> � <br /> I U dated: 09/11l2009 <br /> P <br /> ' i z:\forms\plan review checklist.docx <br /> ���'�'v2.' �5+..� -�t "" '4 .�"'� '«w9c�,'�s 3F= g� +e -., a'..: r•,a�as:S . „ . .�. ... , `� .k ..: .. � �.P::�: <br /> � '%`e�;, a� .�r�,�•,�zr���*��,r�'.��..*.��°`��F.`�-'.�,..s���,^_'y_.a'�-nn:�..� t��, •. �`�9,,,.,�. ,.,�,,`�i ,..: . ._ �cb�, _:#������``�;'���"�^,.*.��,'�.,�+��-...��,�.a'�.."��": ,��..���� <br />