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Jan-31-2��Z 1�:QZam From-CITY OF ORONO +9521494616 I-587 P.006/DO7 F-098 <br /> C� r � <br /> Total Fe�: ` <br /> � ,' '� `�)� �,, �) �' Date Re�eived: c� -/E'' -C1� <br /> Entered By: �i_ ,�`� � Pemut�: ��� �/ <br /> 1"° <br /> crrY o� o�o�o � BUII,1)IrtG PERM�T APPLIeAT'�DiV <br /> A�1 information must be submitted �n full befare plan review�vill be started, <br /> (please p�nt all informcz�on) • <br /> THE APPL�CANT IS:---- (circle on�) UWI�tER p ON7'R.ACTOR ` <br /> JOB Si'I'E A.DDRESS: ` - c N�}Q �,Ja`�p � fl �P: ._��-�-'� <br /> NAME QF aWNER: � i�-� �,.,t'�C'Tl.� PHOI�E: {home} `� -�rz �?f G'�� <br /> �� (work) � <br /> tr , � MAI,LL,J�TG ADD�SS; �,�77$��� � `�,�cc�� CI'�X: cf'J R�n;� ZIP: :553� <br /> , 4 <br /> �J ` �`� , <br /> , �� <br /> ` <br /> �'; �,, CONTR.ACTO�t:� :>7'��1�3� �5�'>�-`+ c , PHUNE: `�-y�1�?—`�''�� <br /> � CON'.�'ACT PERS4N: �, F �� MOBYLE/PA.�� �1Z.-L�<z�- _ �`�:S <br /> MAYC.ING ADDRESS; �f�'3 r Z 1Yl►�1��"c�? �� C�T'Y: (,�,fi-����� ZIY: - .3g'% <br /> STATE Y.YCENSE: # ► �� - <br /> a�tc��c��r��nv��:C��� ����;��., ��� rxorr.�: 7C�`�-�5�i•- 93�� <br /> �.nv��nb�ss: �9�.�..� �r�a�n;.,�; c��: ��.��.�,:TH z�: �����, <br /> NAME:_ R,EGISTI7ATION# <br /> TYPE Ok' �ORK: New Addition Accessory Structare <br /> 11�ave Remodel/Aatera 'on Land Alteratiort <br /> PRO�'OSED WQRK (describe in detai�;�y}�-��f �.[��i c�,��`�����ry�--��A <br /> STORIES: SQ. FEET OF'�ACH�'�.QOR: <br /> N4. 4F$EpROOI�IS: GAR�iGE STAI,LS.: ATT. �. D�T. <br /> ESTIMATED CQNS�`RUCTI�N VALUA'�'.ION �excluding land}:� � �'���c� ""`- <br /> �hereby appIy for a building p�it and I acknawledge that the inforu�ation above is complece auci <br /> acCurate; that the work will be ix�Conformance with the ordutat�,ces and codes of the City a�,�d with <br /> the Stace Building Code; that I understa�tid thi�; is not a permii and work is not to stazi tivithout a <br /> permit; aud that the work wi�I be in accor it� rhe approved plan. <br /> AP�'Y.YCANr'S SIGNATURE: DATE: �> %7 c�3 <br /> NOTE� i <br /> ��j'.�3nmes evertts require separate perm�t approvnl by PoX�ce De�q�rtment uJtd <br /> City Cauncil b0 days prior ta the eve�t. Non permi#ted events wilt not he allowed. <br /> S <br />