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, . � <br /> Fees to be Char ed �fS :�Ip <br /> __ ..� . <br /> ___ ,_. ,� -- <br /> . . _ _.....� . _ .��. ,_ ... • .. <.... ... _ ._ ,.. <br /> Plan Review <br /> � . . � .: <br /> � ,,: . <br /> Investigation Fee <br /> , <br /> , . �..._.�._;.. .: x.. . <br /> . . ... . . . <br /> Sewer iConnection <br /> .._ _. _ . _._t.. _ _ <br /> �ark fee <br /> otner(specify) . <br /> Caic�late�l By: <br /> S uare�oota e $ er uarE Foota e <br /> Basement X = � <br /> �1�Fbor � ; _ � <br /> 2"d Floor - � _ _ � <br /> Garage X � <br /> Estimatetl �onstr�c#ion Ualue: � (��a�9p `� <br /> Urono#nspectaons R�Auired �Alork�2eqwiring Separa#e Permits Requiretl 5tate`Perrni#s <br /> � Site _ F?lumbing � Grading /Filling ' � UUell <br /> � Hardcaver Remoyai Mechar�ical � Fire Efec#ricat <br /> � footing ` � Septic: C UVater Connection <br /> 0 Poured UVall �Fireplace 0 Sewer Connection <br /> '� Foundation Survey � Masnnry � Lawn irrigatian <br /> 'D Rad�n Roak Bed �/j�f9, <br /> 0 Framin9 O 'Other�specify) <br /> � Msulafiion <br /> � �s-Built Sunrey _ <br /> �'d�inal <br /> � Other(specify) <br /> ftEMARKS�in-house); <br /> 'Other Rewiew: Reviewed:bY�, Date Ap�ro�etl: <br /> Access:Existing: � YES � NO N�w: �� YES � NtJ <br /> REMAI�KS(TD BE N�T£D ON PERMIT AIaID 1N1TI�LLED BY PERSDN PULLING PERMIT) <br /> Updated: 09/11/20D9 <br /> r.lforms4plan review check(ist.doac <br />