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Fees to be Charged YES NO
<br /> :-Permif ,,,:,. � .���+ _ ��:�
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<br /> Plan Review �'
<br /> `State`Surcharge ,�= , { -,��.� ,���,�,�� J
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<br /> investigation Fee
<br /> :sS�,9,C-;Nli mber:of�SAC.0 n its :,;��_�,
<br /> Sewer Connection P
<br /> ��i'P.'��`�i���.Ci���'�„���'�ti'`��m��.^+`���i '��" _ � 5
<br /> E'` ry�+"�� r�a 7� t ,:'��
<br /> ,�. r � ��.A .. _.7 0 � :. ,� .., � ..r , xE�
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<br /> Park Fee
<br /> ";,xS7te�ln e��ion �� �` _ ,�n..� Y� ���;,� ,� +,�a� ���
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<br /> Other(specify)
<br /> �AYlasce�1anEo.us�F��es�,��;��,:�+r�F ;�� -�..,������� �r �� ,,,�� � � � �s,
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<br /> Calculated By:
<br /> Square Foota e $ per Square Foota e
<br /> Basement X _ �
<br /> 1St Floor X = �
<br /> 2nd Floo� X = �
<br /> Garage X _ $
<br /> Estimated Construction Value: � �ZS; L� �''=
<br /> Orono inspections Required Work Requiring Separate Permits Required State Permits
<br /> � Site � Plumbing 0 Grading / Filling ❑ Well
<br /> � Hardcover Removal ❑ Mechanical � Fire �' Electrical
<br /> ❑ Footing ❑ Septic 0 Water Connection
<br /> 0 Poured Wall ❑ Fireplace ❑ Sewer Connection
<br /> � Foundation Survey ❑ Masonry � Lawn Irrigation
<br /> ❑ Radon Rock Bed ❑ Mfg.
<br /> :C'�Framing ❑ Other(specify)
<br /> � Insulation
<br /> � As-Built Survey
<br /> ,�Final
<br /> � Other(specify)
<br /> REMARKS (in-house):
<br /> Other Review: Reviewed by: Date Approved:
<br /> Access:Exisfing: � YES 0 NO New: ❑ YES � NO
<br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERM(T)
<br /> Updated: Q9/11/2009
<br /> z:\forms\plan review checklist.docx
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