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Average La�ceshore Se#bac�c g#uff <br /> St�oreland District MCWD Perm�t Mef� <br /> Permit Number. CI Yes 0 No '� NIA O Yes '� <br /> � Yes 0 No No <br /> �; N/A-see attached Setback: <br /> Storn�►vvater Quaiity Existing Propose�i <br /> Overlay Dis#rict Ti$r Hardcover Hardcover Variance Required CUP Required <br /> ci�cle ane °Jo and s °k and s � <br /> 2� �aG�,� � Yes L•'� No C] Yes No <br /> � 2 3 4 5 ,,,.�,�� � ���, Type{s): � �YPg(S)� <br /> A <br /> + <br /> a�,/ <br /> Fees to be Char ed YES NO <br /> Permit <br /> Ptan Review <br /> St�te Surcharge <br /> investigation Fee <br /> SAC-Number of SAC Unifs <br /> Other(specify} <br /> S uare Foata e S S uare Foota e <br /> Basement X - $ <br /> k� 1�Fioor X = $ <br /> 2�' Floor � _ $ <br /> � Garage X - � <br /> Estimated Construction Value: <br /> �� r <br /> Orono Inspections Required Work Requirin�Separate Permits <br /> ''' � Plumbin � Gradin /Fillin <br /> Footing � Site 9 9 9 <br /> ff � Poured Watl L] Silt FencelErosion Controi Mechanicai � Fire <br /> ' ❑ Foundation Survey ❑ Hardcover Removal 0 Septic 0 Wat�r Connection <br /> ❑ Foundation Waterproofing 0 Other(specify) � Fireplace � Sewer Connection <br /> "' � �raming ❑ Masonry � Lawn Irrigation <br /> � Insulation ❑ Mfg; 0 Landscapir� <br /> s:' 1� As-Buitt Survey � Other(specify) <br /> Finat <br /> ❑ Lathe Required State Permits <br /> ❑ Other(specify) <br /> ❑ Wel] Eiectrical <br /> f 2�. 1.2' �W J Z ' ' <br /> REMARKS (in-house): ' <br /> � /�A � '�Y1�1,(�'�" �1�1 Z.�'�1�� ��'U�'�Y - -- <br /> OFFiC1AL REMARKS-TO BE NOTED ON PERMlT AND 1NITIALLED: <br /> �; <br /> g gr ent form <br /> �Prior tfl re{ease of escrow money an as-buift survey and hardcover calculations must be submfited and approved. <br /> f, <br /> Updated: October 2095 <br /> i' ���fnrmclnlan roviaw rhmrklict 1(L7f11.ri�nrv ... <br />