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Fees to be Charged YES NO • <br /> 7P,p.��frnl����"'�p J�M�Kr...xFM1�SaT�T,' "s�`•"t a �i�� rI '*�w 's �_�9 � i�j��.�,m � u -� �;'f • <br /> �k�. � ,:a+a.��w�'G�s,�{��"j�"Y`r, . + : s.af .w,.s _ x •,f:t*� <br /> P{an Review <br /> S�ate��u�r � �, � ��� ��, ��p �N r �...a � ,t <br /> -0 , �� cha�r e��i���` ��'�� '� '' "" ���.�°�� <br /> ��.,s �, .i,'�1"`m'�..,�x` sY���S��t" ��+� ��, ?�� <br /> Investigation Fee <br /> �',��`� �,�Talu�raber.�v�f'�A��UU�a�#s�.�4��� ��`��"��. �;�iq� � �� <br /> Sewer Connection <br /> �1Naxe�r�Co.n�necfiion ��-`�� } �� � � = F <br /> � ��� � ��'' -���;� <br /> .. . . t.��.;_ „ .: <br /> Park Fee <br /> �S'ite lnspection = ��� ��'���y����� � �R���r�� ` <br /> - �,rt� <br /> Other (specify) <br /> � `iis�e�Jlan" <��_ �,� s,��� � � <br /> eou° <br /> s�F.�ee�� .�, <br /> �R. ,<<.,�.�������;:���4''�4���,s��:� <br /> � . �„ ,. ; ..E <br /> ,�-� ,,�. ,_ ._. ., : <br /> Calculated By: <br /> Square Foota e $ per Square Foota e <br /> Basement X = � <br /> 1 St Floor X = $ <br /> 2"d FlOor X = � <br /> Garage x = $ <br /> Estimated Construction Value: � ZS�,pdp `'a' <br /> � <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> � Site ,�Plumbing � Grading/ Filling ❑ Well <br /> ❑ Hardcover Removal Mechanical � Fire Electrical <br /> ❑ Footing 0 Septic � Water Connection <br /> � Poured Wall ❑ Fireplace ❑ Sewer Connection <br /> ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation <br /> ❑ Radon Rock Bed ❑ Mfg. <br /> Ja' Framing � Other(specify) <br /> ��nsulation <br /> `"Fd.,As-Built Survey <br /> ,0' Final <br /> ❑ Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: � YES ❑ NO New: ❑ YES 0 NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> �'�,��-u�°r,,�'* "'�- f'�r�,'� .�,.'�'.,�/2 �i°D��-C, C� d� <br /> Updated: Q9/11/2009 <br /> z:\formslptan review checklist.docx <br />