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. , <br /> Fees to be Charged YES NO <br /> Permit <br /> Plan Review <br /> State Surchar e <br /> Investi ation Fee <br /> SAC— Number of SAC Units <br /> Sewer Connection <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other(specify) <br /> Miscellaneous Fees <br /> Calculated By: <br /> UBC: Construction Type: <br /> S uare Foota e $ per S uare Foota e <br /> Basement X = $ <br /> 1 S Floor X = $ <br /> 2" FIOor X = $ <br /> Gara e X = $ <br /> Estimated Construction Value: $ o?��DD °a /�6,t�LL� <br /> Orono Inspections Required Work Requirinq Separate Permits Required State Permits <br /> � Site 0 Plumbing ❑ Grading / Filling ❑ Well <br /> 0 Hardcover Removal � Mechanical ❑ Fire ❑ Electrical <br /> 0 Footing ❑ Septic ❑ Water Connection <br /> 0 Foundation Survey � Fireplace 0 Sewer Connection <br /> � Framing � Masonry � Lawn Irrigation <br /> � Insulation 0 Mfg. <br /> � Wall Board ❑ Other (specify) <br /> As-Built Survey <br /> 0 'nal <br /> 0 Other (s ecif ) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: 0 YES ❑ NO New: ❑ YES ❑ NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> ��r �lit A��f �r� �-<< S. .1-� Tc �'c?�Cc�� c:��� �('�v(� fio D �S� ^,S <br /> i�Cz�� � <br /> Updated: 07/01/2009 <br /> z:\forms\plan review checklist.docx <br />