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Earth Movement-Cubic Yards <br /> In Out Total <br /> Haul Route? ? � Yes � No <br /> Explain haul route in detail: <br /> Fees to be Charged Amount Orono Inspections Required <br /> Permit Fee Amount ���� <br /> 0 Site <br /> Escrow Amount 0 Hardcover Removal <br /> � <br /> Escrow Agreement received? 0 Poured Wall <br /> As-Built Survey <br /> ` �� 0 Yes � No --- �-�"�an <br /> �'" " ' � Wetland Buffer <br /> Escrow Money received? � Final <br /> �� (� � Yes � No � Other(specify) <br /> r Wr � <br /> Engineering review needed? <br /> 0 Yes � No <br /> REMARKS (in-house): -�i � � I � � l�` l f � �� <br /> �l�'�'► � ,� � � S�-��( a�� <br /> Other Review: Reviewed by: Date Approved: <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIA LED BY PERSON PULLING PERMIT) <br /> -- �-vU�Ov�/ wy'1 v ; �,ot �— � -�iv �v cJ <br /> � � <br /> x <br /> Updated:January 2013 <br /> z:\forms\old stufflplan review checklist for zoning permit applications 2013.docx <br />