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�►veraga Lakeshore Setb�ck <br /> �hoceland��strict fi��C�� Permif liAeYt B{eaffi � <br /> �Yes � No Permit Number: � � . B Yes � No N/A � Ye No <br /> C] fV/A—see attached Setback: <br /> Storm�ater t,�uai'� Existing Propos�c� <br /> Overls�Dis#rict TEe� Harcicover Hardcov�r yariance Required CUP Reguir�d <br /> circie one %and s %and s <br /> ��•g�0�{3 Yes No G Yes No ' <br /> 1 � 3 4 � {.4U��.�'� T pe�s . TYP�t�)� <br /> �� � <br /> E�es to be Ch� ed YE8 i�0. <br /> P�ni� : , . . , ; <br /> Plan Review _;/' : <br /> St�s-S�rche�r�s _ �-�- , _ <br /> Inv�tigation�ee V" <br /> _ S1KC-�k�ttber�f SA�G l�#�s <br /> _ Other(specify)' <br /> S uare Foota e � er S uare Foota e <br /> Basement X _ . � <br /> :1�f loor X . ' � $ ; <br /> 2nd��OOf X ` $ <br /> Garage X = : $ <br /> Esttmated Cohstruction Value: _,li{'/T,0�� � <br /> Orono lnspectfons Required Vllork Requirtog S�parate Permits , <br /> f'ooting �3 Site G�Plumbing t�u�rading l�iNin� ,,� <br /> fl 'Poured:Wall � SiitFenc�lErosion Control C� Mechanical - l� ;�i�e <br /> Cl �pundation�urvey G Hard�:over:RBmoVai :O S�ptiC �J:y!llater.Coi�ri�itto�i <br /> t3;Foi�ridation Waterproofing � Other(specify) �7 F�eplace i3 �ewe,r"C��ih'e,ctibn <br /> `Fraining t3 Masonry t3 Lawra 1r�g�tioi� <br /> G fisulation G Mfg. ' !3 LandScapir�g�` <br /> G As-But�t Survey '17 Other(s1��Y) . ' : <br /> �ina1 <br /> � Lathe Required StatePermits ' <br /> !1 O#her(specify) <br /> � iAfeli ,,. ElechiCal <br /> RENiARKS;(in-house): <br /> OFFICU4L RERflARKS-TO BE R�QTED QK PERPiAi'C QND 3N6Ti�LLED: <br /> � See Bu[Icle �,cketowEedgement Forrre <br /> eleas of e as-built su rdcov e subm" <br /> Upcfated: October 2U15 <br /> '•lfnrmc\nlan rnvipw rharklict 1(L9R1F rinrv <br />