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• <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Yes 0 No Permit Number: 0 Yes 0 No 0 N/A 0 Yes <br /> No Cl <br /> 0 N/A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> (circle one) (% and sf) (% and sf) <br /> D Yes 0 No D Yes 0 No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Fees to be Charged YES NO <br /> Permit <br /> Plan Review V' <br /> State Surcharge L/ <br /> Investigation Fee LA <br /> SAC—Number of SAC Units <br /> Other(specify) <br /> Square Footage $ per Square Footage <br /> Basement X = $ <br /> 1St Floor X = $ <br /> 2nd Floor X = $ <br /> Garage X = $ <br /> Estimated Construction Value: $ OQD <br /> Orono Inspections Required Work Requiring Separate Permits <br /> O Footing 0 Site Plumbing 0 Grading/Filling <br /> O Poured Wall 0 Silt Fence/Erosion Control l"Mechanical 0 Fire <br /> O Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection <br /> O Foundation Waterproofing D Other(specify) yZFFireplace 0 Sewer Connection <br /> Framing 0 Masonry 0 Lawn Irrigation <br /> InsulationMfg. D Landscaping <br /> O As-Built Survey Other(specify) <br /> Final <br /> O Lathe Required State Permits <br /> O Other(specify) <br /> 0 Well Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> 0 See Builder Acknowledgement Form <br /> 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2015 <br /> r\fnrmc\nlan rPVIPMI rhorklict 1(1-9(11F rinry <br />