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. . <br /> Fees to be Charged YES NO <br /> �?�rta1�t y ,` ` ,� , s. A`��� , n„f , °.1:,'r <br /> "a�y `"' 1.. . x, � ' �"'�-. .�,�`•t'�' �c}; <br /> �. . ... � H. , .,.. .. .. - F <br /> Plan Review - - <br /> �State��a�rclaar�ge_ �;;� ���.�; �.� � ;�„�,,��,,, y y�� ��, � �,.:� �,.,�: �. �r <br /> a.. �',����•;s.�t�K�Fa��r�'� �;- ^��.�_ .,�,�,� <br /> Investigation Fee <br /> M1`J�`LI��1 ' �c __, <br /> r <br /> , , �.Number�ofa�A`C°��!nits kl,`.��'.,'��;����°��'���` �;,-������;: �� '.� <br /> 5�. 4 J _ .�e <br /> Sewer Connection <br /> �'zWater�C�nnec`t�on `;`�',_ '�' �-,F���.'s�d�d�;„��.��'w,�`����`��,��.°" -.�,-._ <br /> - ,�. <br /> Park Fee <br /> 'Site lns;pecfiion - - � �� �������s ����� >u�, <br /> _ �:,; +, �fi, <br /> Other (specify) <br /> �Misce�l.laneous Fees;;�<' rr:; � '� �` 1� <br /> t � <br /> .�.'rL�7r,,5`€�:,+�`&�v..�.."; . r7.,.,..-; <br /> Calcu{ated By: <br /> Square Foota e $ per S uare Foota e <br /> Basement X = � <br /> 1S' Floor X = � <br /> 2"d FfOOr X = � <br /> Garage X = � <br /> Estimated Construction Value: � S�S� O(aD �" <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> 0 Site P umbing ❑ Grading / Filling ❑ Well <br /> ❑ Hardcover Removal Mechanical ❑ Fire �'Electrical <br /> ❑ Footing ❑ Septic ❑ Water Connection <br /> 0 Poured Wall ,�Fireplace ❑ Sewer Connection <br /> ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigafion <br /> � Radon Rock Bed ,@�Mfg. <br /> ❑ Framing ❑ Other(specify) <br /> �iatten <br /> � As-Built Survey <br /> Final <br /> D Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: � YES 0 NO New: ❑ YES ❑ NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Updated: 09/11/2009 <br /> z:l�orms�plan review checklist.docx <br />