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Fees to be Char ed YES NO R <br /> Permit <br /> Plan Review <br /> State Surcharge <br /> Investigation Fee <br /> SAC—Number of SAC Units <br /> Sewer Connection <br /> Water Connection <br /> Park Fee <br /> Site Inspection <br /> Other(specify) <br /> Miscellaneous Fees <br /> Calculated By: <br /> Square Foota e $ per S uare Foota e <br /> Basement X = $ <br /> 1 St Floor X = $ <br /> 2nd FIOo� X = $ <br /> Garage X = $ <br /> � �r�,,� O� <br /> Estimated Construction Value: $ ��i W 0 <br /> Orono Inspections Required Work Requiring Separate Permits Required State Permits <br /> � 6ite ❑ Plumbing 0 Grading / Filling �ell <br /> 0 Hardcover Removal � Mechanical ❑ Fire Electrical <br /> ,,13' Footing � Septic 0 Water Connection <br /> � Poured Wall 0 Fireplace ❑ Sewer Connection <br /> 0 Foundation Survey 0 Masonry ❑ Lawn Irrigation <br /> � Radon Rock Bed 0 Mfg. <br /> �Framing � Other(specify) <br /> �nsulation <br /> ❑ As-Built Survey <br /> ,�Final <br /> 0 Other(specify) <br /> REMARKS (in-house): <br /> Other Review: Reviewed by: Date Approved: <br /> Access:Existing: 0 YES � NO New: 0 YES 0 NO <br /> REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) <br /> Th�s ��,m��C ►s c� -1-h� g�,r�,r h �CU . ��r��� -� <br /> d e� s be ss �� � <br /> rov�e d� • c� crt��- x �s� <br /> 5 z-me.. scu � �x�shhe.� s�s . , � <br /> Updated: 09/11/2009 <br /> z:\forms\plan review checklist.docx <br />