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Fees to be Charged YES NO
<br /> �Penm�i����n, ��(�,�� �����, v i���.� a�� ti 4� __ � ��� ��3�r �� � <
<br /> a�7°Yx�'L�i�1'3 r I k '�v'� .���.'vl ;�n*�r.M,...4y.ax ':b�,h���{*d.� i� �� .sS'�-t�1�,r -^�u`''•,;�
<br /> ,_.,h. -`�:
<br /> Plan Review �
<br /> �,,State'�+J����'i�[��� E'9 ���i,�",,,�as'��,, y, � ,._� �_ . � i �:�.�. �.. # f..� S� r°�, :,
<br /> � � � � ., ��� ,_�����,.� °,
<br /> .,., ,3 . �s=a. �a. ? s����,�'�,� �� � �. ��'�.
<br /> -_, -.._,:��'.._ .P.�.ib38 +'4�.e .. . .
<br /> Investigation Fee
<br /> '`SAC--',Number=of"SAC"U:nif`s - ����'���:n���',��`'����i_ �, . , ��
<br /> � �:�_�
<br /> Sewer Connection
<br /> .Wate.r;�Conne.ction,- _ ,��;�4z����,�t� , A' ��,�����
<br /> Park Fee
<br /> ,�sS�ate�lnsp,ection ������� ��.,�r�k� r� ;�� �� �� .�,.
<br /> ' _ ��Yli'.!�"uS+".� M��1,+�'�P7]'F ���.1.4 �'.6�vs'aK.'x-h�e���
<br /> _. x.�.�.... .. .�._ . ... „. :
<br /> Other(specify)
<br /> �IYlas�ella�ne.ous�F�e�s �`���"'���.. `"�r}� �'"�,"�`���"���.� � � '� , ����,��'
<br /> .�.�3.��,.���..,�. �p. �}
<br /> :�N>�2d vkW�rt3, �,yri i '�9iAh�t+.. .''�'�a.-.;i�4.
<br /> Calculated By:
<br /> Square Foota e $ per S uare Foota e
<br /> Basement X = $
<br /> 1s1 Floor X = �
<br /> 2na Floo� X = $
<br /> Garage X = $
<br /> Estimated Construction Value: � L(a�� fl Q� o,
<br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits
<br /> 0 Site �lumbing � Grading/Filling ❑ Well
<br /> ❑ Hardcover Removal echanical � Fire Electrical
<br /> ❑ Footing � Septic 0 Water Connection
<br /> ❑ Poured Wall �Fireplace 0 Sewer Connection
<br /> � Foundation Survey � Masonry ❑ Lawn Irrigation
<br /> ❑ Radon Rock Bed �fg.
<br /> ,�Framing 0 Other(specify)
<br /> Insulation
<br /> 0 As-Built Survey
<br /> �Final
<br /> ❑ Other(specify)
<br /> REMARKS (in-house):
<br /> Other Review: Reviewed by: Date Approved:
<br /> Access:Exist;ng: ❑ YES � NO New: 0 YES ❑ NO
<br /> REMARKS (TO BE NOTED ON PERMIT AND INiTIALLED BY PERSON PULLING PERMIT)
<br /> U pdated: 09l11/2009
<br /> z:lformslplan review checklist.docx
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