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Earth Movement- Cubic Yards " <br /> In Out Total <br /> Haul Route? ? 0 Yes � No <br /> Explain haul route in detail: <br /> Fees to be Charged Amount Orono Inspections Required <br /> Permit Fee Amount <br /> � Site <br /> Escrow Amount � Hardcover Removal <br /> � � Footing <br /> Escrow Agreement received? � Poured Wall <br /> .� �� As-Built Survey <br /> 0 Yes No � ,_ „_��) � Planting Plan <br /> ������'� � Wetland Buffer <br /> Escrow Money received? m(� � Fina l <br /> �� � Other(specify) <br /> 0 Yes No <br /> Engineering review needed <br /> Yes 0 No <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> �I � � CJ'�nl I'l� S � l�l � <br /> �S � ►nd. <br />� � r � a � �� <br /> V�� MN T,�oT 3CP -z( 6 r rn.�v,noT � �1C�I� <br /> Updated:January 2013 <br /> z:\forms\old stufflplan review checklist for zoning permit applications 2013.docx <br />