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Average[.akeshore Settsack �'u� <br /> ShoreE�n�! �isfirEct �RC�'�"Q P'ee�nf� t�iet? <br /> Permit i�umber: Q Yes � No N/A � Yes <br /> �Yes t� No No <br /> N/A—see a#tached Setback: <br /> Stormwrater Qualit�/ Existing Fraposed <br /> Overlay�i�tr�ct Tier Hardcov�r Hacdcover Nariance Rec�uired CUP Required <br /> circle one %and s % and s <br /> 2�O ; ; ;, � Yes No G Yes No <br /> 1 2 �3 4 5 l ���'� •� .;-- TYPe(S)� TYPe(S)� <br /> � ��L... � �. ;:� � <br /> Fees to be Char ec1 YE3 NO <br /> P� <br /> Plan Review V' <br /> S�S Swci�ar�e' �/ <br /> Ir�vestigation Fee t/r <br /> �kC—N�sr t�BI�C�n�s �!' <br /> Other(specify) <br /> S uare Foota e $ er uare Foota e <br /> Basement X = � <br /> 1�fioor X ' $ <br /> 2nd��00� X — � <br /> Garage X = $ <br /> Estimated Construction Value: <br /> Orono Inapections Required Wotk Requiring Separate Permits <br /> Footing : � Site O Piumbing Q Grading/Filling <br /> � Roured Wa11 � Silt Fence/Erosion Control D Mechanical Q Fire <br /> C7. Foundation Survey L] Hardcover Removai � Septic C7 Water Coitnection <br /> ta Foundation Waterproofing [3 (�ther(specify) - � Fiteplace O Sewer Connection <br /> framing �` Masonry G Lawn lrrigation <br /> � lnsulation O Mfg. O Landscaping <br /> O As-Bu11t Survey � Other(sPecifY) <br /> inal <br /> G Lathe Requi�eti State PermitS <br /> G 'Other(specify) p Well C! Eiectrical <br /> REMARKS(in-house): <br /> OF�'1CIAL:REMARK3-TO BE NOTED OW PERAAlT AND iNITi/�LLED: , , , _ ,: ;;� <br /> � � � <br /> , . ; : ; : . . : <br /> , . , : , , . <br /> . ., <br /> S Buil n ent , .,,. ; . � � . . . .- � . � . <br /> , , � � . � . . , , ` . � . ;1,�. �,r. �'�" <br /> .x . -. �;., ' <br /> C� Prior to releas of escrow money an as-built survey e�� ha��coupr���r �� t� �riiust be su�mitted and approved. `,� ��,#.. <br /> updated: October 2015 <br /> �•lfnrmclnl�n rs+viAw rhorklict 1f�7A1F rtnrv <br />