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�T;.- .,>�-�-"a-._r-•aa,. �„�rrz_. . .�-'•'-�.....-,..p_,. _:-,..- T--, r-_=.-... � .<.,-> ..:,.v; -_'^ . '�-�ra. - �c� -^�'^:7,._��'�r-^"�r«`,��-s,:•.-z. <br /> Fees to be Gharged YES NO <br /> Perrnit <br /> Plan Review <br /> State Surcharge <br /> Investigation Fee <br /> Si4C-Nurnber of SAC Units -Z-,�e�,�,5r'-�- � a�- <br /> Sewer Connect►on <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other(speEify) <br /> Nliscellaneous Fees <br /> Calc�lated By: <br /> Square Foota e $ per Square Foota e <br /> Basement X - � <br /> 1 S` Floor X ( � <br /> 2"d Floo� X - � <br /> Garage X - � <br /> Estimated Construction Value: $ ���.�pv �� <br /> Orono Inspections Required Work Requiring Separate Permits Ftequired State Permits <br /> 0 Site ,O�Plumbing � Grading/ Filling � Well <br /> 0 Hardcover Removal / Mechanical � Fire � Electrical <br /> Footing ❑ Septic � Water Connection <br /> oured Wall �ireplace ,�Sewer Connection <br /> oundation Survey a Masonry �awn Irrigation <br /> ,� Radon Rock Bed �Mfg. <br /> Framing ❑ Other(specify) <br /> �lnsulation <br /> J3'As-�uilt Survey <br /> �Final <br /> � Other(specifyj <br /> REMARKS (in-house): <br /> � <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: Q YES ❑ NO New: � YES ❑ NO <br /> REM�►RKS (TO BE NO�TED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated: 09/11/2009 <br /> z:\forms�plan review checklist.docx <br />