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� r <br /> Fees to be Char ed YES NO <br /> Permit . <br /> Plan Review <br /> State Surcharge <br /> Investigation Fee <br /> SAC—Number of SAC Units <br /> Other(specify) <br /> S uare Foota e $ er S uare �oota e <br /> Basemet�� .y . y : X "_ $ <br /> 1� Floor X •_ $ <br /> 2nd FI00� X = $ <br /> Garage X = $ <br /> Estimated Construction Value: $ ,��i��l�"l�' � <br /> Orono Inspections Required Work Requiring Separate Permits <br /> Footing � Site � Plumbing � Grading/Filling <br /> � Poured Wall 0 Silt Fence/Erosion Control � Mechanica� 0 Fire <br /> 0 Foundation Survey � Hardcover Removal � Fireplace � Water Connection <br /> 0 Framing 0 Other(specify) 0 Masonry 0 Sewer Connection <br /> � Waterproofing/Drain tile 0 Mfg. � Lawn Irrigation <br /> � Foundation Waterproofing 0 Other(specify) � Landscaping <br /> Framing <br /> 0 Insulation <br /> s-Built Survey <br /> Final <br /> � Lathe Required State Permits <br /> � Other(specify) <br /> 0 Well Electrical <br /> REMARKS (in-house): � Ir �.(,�V I ' Z �'�7. <br /> OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: <br />�See Builder Acknowledgement Form <br /> 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />