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<br /> Fees to be Charged YES NO
<br /> �Perrn��t�` ,������-���;,��3,�- ,� �� ,�,��, �.., , 5 � a �, � �-; �� ��
<br /> �aa�'.-',` '�.�.y.@t q 1's:ts�, Yi, �`' 3w�h��nr..��� xf.'Af F ,� �F' a �=A
<br /> '�4`f .5'i+r"'M1.
<br /> Plan Review
<br /> -0S�a'xe�x�sc%�arr��ge��`��;��, � `�� �,� ' �`,�,�' � n a x, ,.. �
<br /> , � .;: , ,,
<br /> > ,.x�.., . ,�.. ,w, . ,-�"�__r .�.��� .����-� a .�� � �F �_�.��,s� , .
<br /> Investigation Fee
<br /> °SAC �N�:umber--�of��AC�"U,natst` `�-�,,,�� �'�+�����;���
<br /> >
<br /> _ � �,.�_:.�. � .�.g�;i� m, �. . .....Y,. - ��,:
<br /> Sewer Connecfion
<br /> Wate.r°Connection �'s�� _ ,�_<���.'��� ��������t��,��� �� . ����
<br /> Park Fee
<br /> wS�a:te�lns�p�ec�ian * ''�-�, , ��-`�„x'��_�, I �;
<br /> = ������'�F�' wc..v y .Y� s,+'t�.
<br />.
<br /> Other(specify)
<br /> �IlPlusce"E�a�rae,�.�s�F�ei��.�� `''�"�:',�'��s�r���`� w '�.R.} �� � ��� ��. ��.� ,e,�
<br /> ��.�-:.4.;.,.. n��r. ��� �3W, �.i�. R� -.rx.. „x ' :w=s.:ti�1, ,n ;.���-E'�`+.' �i. Yx:s
<br /> Calculated By:
<br /> Square Foota e $ per Square Foota e
<br /> Basement X = �
<br /> 15t Floor X = $
<br /> 2nd Floo� X = �
<br /> Garage X = �
<br /> Estimated Construction Value: $ �-{��, 0�O °�
<br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits
<br /> ❑ Site 0 Plumbing � Grading/Filling � Well
<br /> � Hardcover Removal � Mechanical � Fire Electrical
<br /> Footing ❑ Septic � Water Connection
<br /> ❑ Poured Wall 0 Fireplace 0 Sewer Connection
<br /> ❑ Foundation Survey ❑ Masonry � Lawn Irrigation
<br /> ❑ Radon Rock Bed ❑ Mfg.
<br /> �Framing ❑ Other(specify)
<br /> ❑ Insulation
<br /> Built Survey
<br /> : 'f�inal
<br /> ❑ Other(specify)
<br /> REMARKS (in-house):
<br /> Other Review: Reviewed by: Date Approved:
<br /> Access:Existing: � YES ❑ NO New: 0 YES � NO
<br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
<br /> ����,,.s'✓'�eJ�✓V�V� ���,+. ,���'J�✓t� Q•'?��i
<br /> S,s
<br /> Updated: Q9/11/2009
<br /> z:\formslptan review checklist.docx
<br />
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