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Fees to be Charged YES NO <br /> Permit <br /> Plan Review <br /> State Surcharge <br /> Investigation Fee <br /> SAC—Number of SAC Units <br /> Other(specify) <br /> Square Footage $ per Square Footage <br /> Basement X = $ <br /> 1� X $ Z5 73 <br /> 2nd Floor X = $ <br /> Garage x _ $ <br /> Estimated Construction Value: $ Z <br /> Orono Inspections Required Work Requiring Separate Permits <br /> Footing ❑ Site ❑ Plumbing ❑ Grading/Filling <br /> ❑ Poured Wall ❑ Silt Fence/Erosion Control Mechanical ❑ Fire <br /> ❑ Foundation Survey ❑ Hardcover Removal ❑ Fireplace ❑ Water Connection <br /> ❑ Framing ❑ Other(specify) ❑ Masonry ❑ Sewer Connection <br /> ❑ Waterproofing/Drain tile ❑ Mfg. ❑ Lawn Irrigation <br /> ❑ Foundation Waterproofing ❑ Other(specify) ❑ Landscaping <br /> ❑ Framing <br /> ❑ Insulation <br /> ❑ As-Built Survey <br /> Final <br /> ❑ Lathe Required State Permits <br /> ❑ Other(specify) <br /> ❑ Well Electrical <br /> REMARKS (in-house): <br /> acm <br /> OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: <br /> 1 <br /> 112 <br /> 1ee Builder Acknowledgement Form <br /> [3 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />