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Earth Movement-Cubic Yards <br /> In Out Total <br /> Haul Route? ? Q Yes 0 No <br /> Explain haul route in detail: <br /> Fees to be Chargeci Amount Orono Inspections Required <br /> Permit Fee Amount ��� <br /> � Site <br /> Escrow Amount 0 Hardcover Removal <br /> � Footing <br /> Escrow Agreement received? � Poured Wall <br /> ��� As-Built Survey <br /> 0 Yes � No 0 Planting Plan <br /> � Wetland Buffer <br /> Escrow Money received? Final <br /> 0 Yes p No � Other(specify) <br /> Engineering review needed? <br /> Yes 0 I�o <br /> REMARKS (in-house): <br /> 5 <br /> �p�: <br /> x' <br /> Other Review: Reviewed by: Date Approved: <br /> EMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> �� Cjo�t.�d�fGror rp � '� OW,�!" �Lea � c. � ��P �"l.rot-� �G. <br /> �e�.�/ r�� ��iP a,�P�► afp�s �e�1- ��fr� �h��o�� �P n,rorP�/� 1��. <br /> � �(i Q� � �-. S Y�( (.t)i� l <br /> �t�t r c�((t�1��tr� r�t,csu�- �c u,�mi I-k� �—�d� - <br /> � C�n�#- M.(,w� � ��. �u�- �� r��.ed �raµ.� don'�- <br /> Update'd�aiRuary 2013 �� �� "'� `x- ���S ��c ���.�r��ll� • <br /> z:\forms\oId stufflplan review checklist for zoning permit applications 2013.docx � <br />