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« �" CITY OF ORONO - BQIZDING PERtLIT APPLIC�TION <br /> /_�j �� . Dat� Fteceived: _ <br /> Total Fee: S V� `C - <br /> Date A�proved: � <br /> Entered Bv: Permit�: � - _-_- .- <br /> gt77,I, BEFORE PI,AN REVIEW WILL BB S�`�T� <br /> �L IgppgMATION MIIST BS SII�I`'SI�D � List Enclosed) <br /> (ge� Check-aff ------------------------- <br /> ������ ��������a-s�w+ie����������������� <br /> T� APPLICAt1 ` <br /> T IS: (circle one) ��`R`I�or CONT.�ACTOR <br /> p,s�o S� w �d , ZIP: ..S-S�� � <br /> JOB SITE A�DRSSS: Z . (work) <br /> ' _ PHONE: (home) `l� �1-d4 Z__� <br /> �rle � r1 <br /> NAME OF OWNF:R: \ ZIP: SS�`t � <br /> OS'io S��, oO��� CI?'Y: �/�O r,..c� <br /> 1�tATI,ING ADDRESS: Z ` <br /> PHONE: <br /> CONTR�C'S�R= ZIP: <br /> CITY: <br /> MAZT SIIG ADDRESS: <br /> STATE LICENSE: � <br /> PHONE= <br /> ARCHITECT/ENGINEF.R: ZIP: <br /> CITY: <br /> MATI�ING ADDRESS: <br /> REGISTF�TION a <br /> N�: <br /> Move � <br /> New Additian _ Accessory Structure _ — <br /> TYPE OF WORR: Renovate�C Land Alteration <br /> D�o gemodel/Alteration <br /> _ ` �` <br /> ' y� r � <br /> PROPOSED WORR (describe ia detail) = <br /> STORIES s �/ S4• �T aF F.�+CS FLOOR s <br /> G�iR.AGg gTAT•T•S: ATT. DET. _ <br /> NO. OF BIDR�OMS: 3 °"-� <br /> g,�TT1�tATED CDNSTRIICTZON VALIIATSON (eaclndin�J <br /> i�a� : s �� .-�dU <br /> ermit and I ackaowledge that the information <br /> I hereby apply for a buil.dinq pthat the work will be in conformance w h thi <br /> lete and accurate; and with the State Buil.dinq Cade; <br /> above is cemp without a pe��-t' and <br /> ordinances and codes of e�itzand work is not to start <br /> understand this is not a p <br /> that the work will be i accordance wi the p oved pla.a. _ . . <br /> ` � . � ��+ <br /> DATE: <br /> APPI.ICANT'S SIGN�TURE= � , <br />