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� Fees to be Char ed YES NO <br /> ' Permit � <br /> Plan Review �' <br /> State Surcharge r/ <br /> Investigation Fee //-; � _ <br /> SAC-NumberofSACUnits Q � �13�y b.�b, ;�� "� <br /> � -"/tf5_" <br /> Sewer Connection <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other(specify) <br /> Misceilaneous Fees <br /> Calculated By: <br /> Square Foota e $ per S uare Foota e <br /> Basement X = � <br /> 15t Floor X = $ <br /> 2"d FIOOf X = $ <br /> Garage X = $ <br /> Estimated Construction Value: $ 523,c�cX� `�'�'" <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> ❑ Site �Plumbing � Grading / Filling ❑ Well <br /> � Hardcover Removal ,�Mechanical � Fire ,� Electrical <br /> Footing ❑ Septic � Water Connection <br /> ,�P ured Wall Fireplace ,�'Sewer Connection <br /> oundation Survey 0 Masonry �7'Lawn Irrigation <br /> Radon Rock Bed �Mfg. <br /> ,O�Framing ❑ Other(specify) <br /> lation <br /> s-Built Survey <br /> Final <br /> 0 Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: 0 YES 0 NO New: 0 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 checklist.docx <br />