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. ci��Y oF o�or�o � : <br /> , <br /> � I3UILDING PERMIT APPLICATION <br /> EUILDI[JG PI:RMIT APPLICATIOP REQUSRF:N£�7T& ,, � _ <br /> �- i <br /> Requiremente to bo hnnded in with Duilding Permit Application: Con3tzuction Plans nhould include: I <br /> 1. Building Permit Application - to be filled out i aigned. <br /> 2. Energy Calculatione - filled out. 1. Pirst floor plan. <br /> 2. Footin and foundation lan. � <br /> 3. Purnieh Septic Report i Deciqn. 9 p <br /> a. Purniah a Certiflcate of Survey, includinq hardcovez 3. Elevationa (of all sides), <br /> calculationa and grading and drainaga plans aa requized. �. wall sections 6 croas sections. <br /> 5. Fuznish 2 sets of Construction Plena: 5. Details - Btaire �nd any special connections. <br /> o) 1 set foz City to keep on file - <br /> b) 1 eet for builder to use on eite <br /> _ TB$ ABOVS IEJFOF2MATIOP7 MUST SB SII�NYTTLrD BESORH PLAN RSf/IEW I3 DOY7S <br /> Work Seyond or without a required inspection will be subject to a penaltyi <br /> ZONING DISTRICT SITE ADDRESS 1 7�� +�hnral i nP l�ri va Wa�» h4T� <br /> � � � � r rc�tr3r- <br /> �` PROPERTY IDENTIFICAT60N NO.(PtD) �_� <-�"� � �� - ;� 3 ` L �I - L C%�'� <br /> FIRE DEPARTAAENT / / LOT BLOCK SUBDIVISION <br /> [.� , G+ r <br /> POST OFFICE ��� . OWNER (Name) (Address) (Phone) <br /> MR. & Mrs. Irwin Jacobs 1700 Shoreline Dr. 337-1800 <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial 8 Industrial Construction Plans <br /> — (Firm) (Address) (Phone) <br /> COND.USE DATE _ Cradit & Associates 9th & Miss. River 379-4947 <br /> BUILDER (Firm) (Address) (Phone) <br /> LOT AREA ,� <br /> ,�.� .4 c -�- <br /> Jensen Homes Inc. 900 E. Wa zata B v 4 <br /> W10TQQ, DEPTH QO r TYPE OF WORK hlew Addition Remodel Renovate . <br /> C 8 <br /> PROPOSED SETBACKS: AddltiOri ' <br /> FRONT i R.SIDE <br /> Op ti � /ST!!U(� CONST.TYPE BUILDING SlZE Estirnated Construction Valuation <br /> REAR � L.SIDE <br /> � y3� � L 42 W 42 Ht• 1 75 000 . 00 <br /> LAKE WETLANDS <br /> I t � STORIES B '� 2 3 PERMIT FEES <br /> ��� �� BLDG.PERMlT �fsO •SO <br /> ACCESS New xisting DWELL. SQ. FT. 1 7 6 4 <br /> UNfTS STATE FEE �• Sd <br /> AGENCY: City Cty StatQ I GAR.STALIS NUMBER OF BEDROOMS <br /> qT7, PLAN REVIEW � �� ` ��-- <br /> DET. SEPTIC SAC CHARGE <br /> APPROVAL DATE(S) : APP. DATE <br /> HARDCOVER PROPOSED USE OCCUPANCY SEWER UNIT <br /> Exieting 8: �o/ � , CLASSIFICATION <br /> Psoposed �: C l�' i PARK FEE <br /> PENALTI' <br /> GRADING COutvC�� <br /> �Staff App. Dat /N �2 OTNER <br /> ��CUP Apn. Date APP. DATE <br /> TOTALDUE � Q/���s <br /> REMARKS: <br /> INSPECTION REOU�RED �'1�ORK REOUIRiNG <br /> S[PARATE PERMITS <br /> O......FOOTIN6 Oe1or�Dour <br /> ❑......fRAMING roupRl� PlUM61N0.........................❑ <br /> ❑......INSUTATION MECHANICA�...................... ❑ Tho undersigned hereby mAkea Application for a building <br /> 0......wauoo�aoe.��..�oo��o . ezmit for thQ work deacribed, a <br /> 0......r�ron�aro�.oc��c.�r� ���'�'� '�'���"��"'�'���� � � p grees to do all work in stric <br /> accordnnce with the ordinances of the City of Orono and rulir <br /> ❑......bITEINSCECTION EEPTic..............................� of the State IIuilding Code Division, nnd declares that ull <br /> WOHK DEVONO OR WITNOUT A RE• �+EWE��•••�••••••�•�••••••••••••••••� facts and repzesentatio statedi�n�e true and correct. <br /> OUIREp INSPECTION WILL BE SUO� yyqTER..............................❑ �j <br /> JECT TO PENALTY. � <br /> OR�1D�N0�FIllINO...............❑ <br /> ?4 N UR$NgAOVANGE. CALLED-IN i1RE.................................❑ 9-8-8 6 . <br /> Date gnature <br />