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Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Yes No Permit Number: D Yes D No D N/A D Yes <br /> No <br /> D 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 /> Yes D No D Yes D No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Fees to be Charged YES NO <br /> Permit <br /> Plan Review <br /> State Surcharge (�- <br /> Investigation Fee ✓ <br /> SAC—Number of SAC Units /7 e bie <br /> Other(specify) (✓ <br /> Square Footage $ per Square Footage <br /> Basement X = $ <br /> 1 Sf Floor X = $ <br /> 2nd Floor X = $ <br /> Garage X = $ <br /> 647 <br /> Estimated Construction Value: $ / (J O01 000 <br /> Orono Inspections Required Work Requiring Separate Permits <br /> Footing 0 Site ,A Plumbing 0 Grading/Filling <br /> D Poured Wall 0 Silt Fence/Erosion Control *Mechanical 0 Fire <br /> D Foundation Survey 0 Hardcover Removal 0 Septic Water Connection <br /> D Foundation Waterproofing Other(specify) 0 Fireplace Sewer Connection <br /> A Framing 0 Masonry D Lawn Irrigation <br /> A Insulation 0 Mfg. 0 Landscaping <br /> D As-Built Survey D Other(specify) <br /> Final <br /> /D Lathe Required State Permits <br /> D Other(specify) <br /> 0 Well ffc Electrical <br /> REMARKS (in-house): <br /> OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: <br /> D See Builder Acknowledgement Form <br /> D Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2015 <br /> 7\fnrmc\nlan naviow rharklict 1f 9f11rinry <br />