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Fees to be Charged YES NO � <br /> P.ermit� - � � <br /> Plan Review � <br /> State:;Surcharge �,/ <br /> Investigation Fee � <br /> SAC—��Num'ber of'SAC:Units .�'�..�j��+,r�, ;_..�;:� <br /> Sewer Connection <br /> �Illa#er�:,C o n n e ct i o n <br /> _ ._ <br /> Park Fee <br /> �Srte�lnspection� , ,� ,• < � ,. <br /> :, . ,. <br /> , , '. - , , _: <br /> ' Other (specify) <br /> ,;Misce'Ilaneous F.ees ,._ _ ., < ,;; � :_ <br /> Calculated By: <br /> Square Footage $ per Square Foota e <br /> Basement X � _ $ <br /> 15t Floor j X �I = I $ <br /> 2nd Floo� X � _ � $ <br /> Garage X = � <br /> Estimated Construction Value: � 375.(�0 0 �'—° <br /> Orono Inspections Required � Work Requiring Separate Permits Required State Permits <br /> ❑ Site Plumbing ❑ Grading / Filfing ❑ Well <br /> ❑ Hardcover Removal �Mechanical ❑ Fire �Electrical � <br /> Footing ' ❑ Septic �0 Water Connection <br /> P ured Wall Fireplace ��ewer Connection <br /> Foundation Survey ❑ Masonry �Lawn Irrigation <br /> adon Rock Bed �Mfg. <br /> Framing ❑ Other (specify) <br /> �nsulafion <br /> s-Built Survey <br /> inal <br /> ❑ Other(specify) <br /> � <br /> t <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO <br /> REMARKS (TO BE NOTED ON PERM(T AND lNfTIALLED BY PERSON PULLING PERMIT) <br /> � i i ���f�'t,�✓ �d���?; ` ; , � , -f� �'�C��e �1�r�.i Q��I i�r-� '�'I ��� f I G �.��v� ���f3 — Tv � ,��. � <br /> � � :.:.� • s� ,�: <br /> �L r' <br /> Updated: 09/11/2009 <br /> z:\forms\plan review checklist.docx <br />