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A��rag�Gakeshore Setback B6uff <br /> Shoreland �3is�rict [�!liCt�tD Permit ��? <br /> L� Yes Q No � N/A � Yes C! <br /> Permit Number: No <br /> � Yes C7 �Eo Setback: <br /> CS N/A-see attached <br /> Stormwater Quafity Exi�tin9 Proposed <br /> Overlay District Tier Hardcover Hardcover Varfance Required CUP Required <br /> circle one %and sf %and s <br /> O Yes � No O Yes � No <br /> 1 2 3 4 5 TYPe(s): tYPe(S)� <br /> Fees to be Char ed Y£S NO <br /> Fem�i# _ <br /> Plan Revie�r <br /> State Sut+�t�arge ` <br /> investigation Fee <br /> SAG-Number of�A+C Uni�s <br /> Other(specffy) <br /> S uace Foota e $ er S aare Foota e <br /> Basement X = $ ' <br /> 9�Floor X - $ <br /> 2^�Floor X _ $ <br /> Garage X = $ <br /> Estimated Constructian Valuec W �;..��� <br /> Orono Inspections Required Wark Requiring Separate, ermits , <br /> C] Footing � Site �C Plumbing � � �r�ding/Filling <br /> � P o u r�d W a A Q S i l t F e n c e l�rosion Controi �Mechanical � fire <br /> CI Foundation Surv�y � Martic4ver Rernoval Septic 13 l�Uater Cor�n��tion <br /> � `Four�dat�on`Waterproofiiig fl Other(specify} C7'�FirEplace fl Sew�t.Gonn�ctifin <br /> �'Framing _ � iNasor�ry fl Lawn Itri�atian <br /> dnsul�tion � Mfg. � La�dscaping <br /> � As-8uilt Survey . i] OthBr:(spe�ify) <br /> Final <br /> Required.�tate Pai'imi#s <br /> � Lath� <br /> :t] Other(specify) <br /> . O Well _ Elec�rieal <br /> REMARKS(in-housej: <br /> OFF1CiAL REMARKS-TO BE NOT�D OI� RERMlT AND tNiTiALL�D: <br /> � See Bu�t�er Acknowledgement Form <br /> a Prior to release of escrow money an as-built survey and hardcover cakulations must be submitk�d and approved. <br /> Updated:"October 2015 <br /> �•\fnrmcl�lan raviaw chonklicf 1f1.9f11S rFnrv <br />