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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 Char ed Amount Orono Inspections Required <br /> Permit Fee Amount �� <br /> � Site <br /> Escrow Amount � Hardcover Removal <br /> ��� 0 Footing <br /> Escrow Agreement received? 0 Poured Wall <br /> � As-Built Survey <br /> �es 0 No 0 Planting Plan <br /> � Wetland Buffer <br /> Escrow Money received? Final <br /> �" Yes � No 0 Other(specify) <br /> / <br /> Engineering review needed? <br /> � Yes �o <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated:January 2013 <br /> z:\forms\plan review checklist for zoning permit applications 2013.docx <br />