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Fees to be Charged YES NO <br /> . , .. : ; . z�, .,. <br /> , Permit"; . , :, , = :, <br /> Pian Review � <br /> State:;Surchar,ge . �,.�� <br /> Investigation Fee <br /> SAC-�N�rriber-:o`f SAC'-Uni#s ,,�d 'µ�/'S '' U, <br /> Sewer Connection <br /> 1N�ater-;,Connection `` <br /> _ . <br /> , . ,: � . <br /> Park Fee <br /> `':5ite�lns�pection� �� � <br /> _ _ <br /> Other (specify) <br /> `;Misce9laneous Fees ��.< <, <br /> Calculated By: �- <br /> Square Footage I $ per S uare Footage <br /> Basement X = $ <br /> 1 S' Floor � X = $ <br /> 2nd Floo� X = � � <br /> Garage X � _ $ <br /> Estimated Construction Value: $ ?b 5 � 3b�j <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ Site �Plumbing ❑ Grading / Filfing Well <br /> ❑ Hardcover Removal �' Mechanica� ❑ Fire Electrical <br /> Footing ❑ Septic ❑ Water Connection <br /> �' ured Wall ,�Fireplace ,�' Se�Ner Connection <br /> Four,dation Survey ❑ Masonry �L� <br /> ,I� Radon Rock Bed �' Mfg. <br /> Framing ❑ Other(specify) �( �"ey���/1,K� <br /> ulation //V'VLId''f_ � (Jj'( �l"'�� <br /> s-Built Survey rLZ����,yvvt,( ' �'(l�/� ' <br /> ,p.�Final � L ' <br /> ❑ Other(specify) « f� r'�'�� � f <br /> '�-�„ �� ,�,� ta <br /> REMARKS (in-house): �� w ur'd • . . <br /> �� <br /> ` <br /> Other Review: Revieweci by: <br /> Access:Existing: ❑ YES ❑ NO New: � . <br /> REMARKS (TO BE NOTED ON PERMfT AND INITIALLED BY PERSON PULLING PERMi�� <br /> � �la��s fov t ��e -�cx�F.�� ��l��. r��u�rc�l loz�v� is�va��-e- �f �-+'������'av G�r ��1�<� <br /> � I Ne�1 dh�!�i,�f fe� � C!��>;c wa=f-z.m�-. e��s,-u1,-,�.�� ���,--cd t-a br �c�c-�c +-���1 ,�,,, i F,,+� i��t� <br /> af c,o. q ��a�,�° es�,�„�, �Q�r�`�+ �s c� ���a �Q�� ��-�f <br /> *I.a.��ca� �(a,� v-P� ,rP d ( S e2 ���fi r�-u �g 7� <br /> Updated: 09/11/2009 <br /> z:\formslplan review checklist.docx <br />