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CITY OF �ORONO - BUILDING PER�+tIT APPLICATION <br /> c� i � <br /> Total Fee: $ � J �� • Date Received: ��� � �� <br /> � Date Approved: <br /> i Entered .By: <br /> Permit#: � �D / � <br /> i <br /> AT,T• INFORMATION MOST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED <br /> ------------------------------------��---��-------------------------------------• <br /> THE APPLICANT IS: (circle on OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: � 1�i (� ��/'��y�U(��� T�--�/` ZIP: �� �3 � <br /> �-� (work) <br /> NAME OF OWNER: �C� � ��D C�}� PHONE: (home) ��� F� <br /> MAII,ING ADDRESS:�7�j� �/ ��f�y�0(Jl� ,�� CITY:���L.,S/�� ZIP: �5�� <br /> CONTRACTOR: / v Q���-� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> TYPE OF WORR: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration� Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : ''�`2'(p Ue �lD,��% l�i� ��i4 S?CR,i����'� , <br /> �/rr(Q C'�S� 2!�' 02 57%4�,es G� /l�� '7b �,e�T� � /�,8/Q- '_./��k'fF/x�2 d� <br /> C�?CAi E �o���v ^��L�i���'�'" � �f-�� �.� <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET. <br /> � <br /> ESTIMATED CONSTRUCTION VALIIATION (excluding land) : $ ��j�� �iC�da <br /> I hereby apply for a building permit and I acknowledge that the informatio <br /> above is complete and accurate; that the work will be in conformance with tr <br /> ordinances and codes of the City and with the State Building Code; that <br /> understand this is not a �ermit and work is not to start without a permit; an <br /> that the work will be in accordance with the approved plan. <br /> — ___ -s.- --- <br /> �, ___� .. ------�_�--�� <br /> APPI�ICANT'S SIGNATIIRF��'-- �----;-- �''� DATE: <br /> (Please fill out the reverse side of this form) <br />