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Fees to be Charged YES NO �
<br /> :Per.mit
<br /> Plan Review „
<br /> �
<br /> ;�State��S�urc"har9� - �f� ��r .;f;� �
<br /> . . . . . , ._ _ . T,. , ^ : ,�
<br /> Investigation Fee
<br /> �S�AC ':��N,urraber of<SA'C�tJ�i�#s ��"�'{�� °�,' t� � ~��� �� �`�� ;�;�� ��:;
<br /> _ + a� �Sv��M ,.�F�w,k-? ���ar�,�.�.�y� ��'u.&�a�; �d ,�. t,. ,:�aw�;`
<br /> Sewer Connection
<br /> +�t C�,Y.'P.T' '.��u�ni�.Ci�'�a'V,■u� 2° � r,,..,r ✓f"'�.'lrl,;� C� 1h��`�f��.._ ..��,:�
<br /> _.�._ .�.�,-, _ �`.s�'J���i��'._..,c, ��%�.+�,.�.�*,'�.�J "+r�!.. i�
<br /> Park Fee
<br /> � � ,
<br /> ,
<br /> .°`�9��e�Ins�e�c�E�ion �, � , �. � . �����.
<br /> �...�.,� -�.. � �..- , � �.,,, E , �c �,.. �,� '- 1 '
<br /> ` ..— . .. . .. . _ .:.z��., ,.,. �. ., _ _...
<br /> Other(specify)
<br /> �Ylfasce'11ar�eous��ee�s r��+�„��x�';`"'y'�*� ;� '�,,'� � ' -g ��� �k�;� .��
<br /> ��..nx.��-a. .�.,�.-.�'�n .�4.;:�r.v�4��n+.'�.,';?. �'���'�A,�,�,�„i-�. '��s ,F �
<br /> Calculated By:
<br /> Square Foota e $ per Square Foota e
<br /> Basement X - $
<br /> 1 S' Ffoor X = $
<br /> 2nd Floot' X = $
<br /> Garage X = �
<br /> Estimated Construction Value: $ 23,u d �'�J
<br /> Orono fnspections Required Work Requiring Separate Permits Required State Permits
<br /> � Site Plumbing 0 Grading / Filling ❑ ell
<br /> ❑ Hardcover Removal ❑ Mechanical � Fire Electrical
<br /> 0 Footing ❑ Septic D Water Connection
<br /> ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection
<br /> ❑ Founciation Survey 0 Masonry ❑ Lawn Irrigation
<br /> � Radon Rock Bed ❑ Mfg.
<br /> �Framing � Other(specify)
<br /> 0 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 � NO New: ❑ YES ❑ NO
<br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
<br /> Updated: 09/11/2009
<br /> z:\forms\plan review check(ist.docx
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