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� ,. . , _.� , , .._ .._.. , ., . ..:. k .... . . . _ . .. _ - , <br /> f <br /> �. <br /> t, Fees to be Charged YES NO <br /> � Permit <br /> f Pfan Review <br /> � State Surcharge <br /> ` Investigation Fee <br /> � <br /> � SAC—Number of SAC Units � p, k,,� � � �''" <br /> z <br /> � Sewer Connection <br /> ' 1lVater Conn�ction <br /> �� Park Fee <br /> �' Site tnspection <br /> � Other(specify) <br /> � 11�isceElaneous Fees <br /> � <br /> � Caiculated By: <br /> ; <br /> � <br /> , <br /> �I; Square Foota e $ per S uare Foota e ( <br /> Basement X = $ <br /> � 1 St Floor X = $ <br /> ! <br /> �' 2nd Floo� X = $ <br /> � <br /> a Garage X = $ <br /> {' <br /> L <br /> }. <br /> �� <br /> � Estimated Construction Value: $ ��vA °�v <br /> � <br /> �t Orono inspections Required Work Requiring Separate Permits Required State Permits <br /> � <br /> � Site �Plumbing ❑ Grading / Filling � Well <br /> �:. � Hardcover Removal Mechanical 0 Fire � Electrical <br /> Footing � Septic ❑ Water Connection <br /> � ��ured Wall ,�Fireplace 0 Sewer Connection <br /> -=�undation Survey ❑ Masonry � Lawn Irrigation <br /> � 0 Radon Rock Bed ,�- Mfg. <br /> � ,�Framing ❑ Other(specify) <br /> � sulation <br /> � ' s-Built Survey <br /> � � Final <br /> �' � Other(specify) <br /> �; <br /> F <br /> � <br /> � REMARKS (in-house): <br /> �, <br /> � �� ��/�t,���, �� , �� E b �s�1'�'�� <br /> �' <br /> � <br /> �` Other Review: Reviewed by: �� � �/`' Date Approved: � `� � U � � <br /> �. <br /> � Access:Existing: 0 YES � NO New: ❑ YES 0 NO <br /> s ��"i�` i `e� . <br /> �" �`���--� J; �"���� <br /> p`'' REMARKS (TU BE NOTED ON PERMIT AND INITIALLED BY P�R3�N�UL�ING PERMIT) <br /> � � �t"i/�� Vt/�� w��r � ��` � ��� l���de� �1 f���� <br /> � � w� � -��v��-t-��n• <br /> ��.� ����v � ��-� ��o��� ��-i�� — �: ��� t��� <br /> � �, �� x� ��� ��� � �� �,� �� ��i � -� �-f��. <br /> Updated: 09/11/2009 <br /> z:\formslplan review checklist.docx <br /> � <br /> m. 7 .�h` ��"������` ��� � ��� �,..� '_ _�'��'��-` ,�.. . �".� ���# � � �;_'�� � <br /> �.`t�ti w�._.,�+i�zr �< ._�,o. . >��.�� _ . �_u �a , +� .�az�: �«� �� ��,m .�,�. � �' .s. ,� �'ci�` _ ._.,.> <br />