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JUN-20-2002 16:34 FROM:ST CROIX VALLEY CONT 95z4704413 T0:+9522494616 P.002�003 <br /> Jun-«�-20�2'-01:26pm Frum-tITY OF ORONO +p6Z24B4616 T-406 P.002/003 F-461 <br /> - <br /> ���1I�'�/ Tota! Fee: $� r D.�,�� _ Date Receivcd: <br /> � Efliared By: � Pennit#: <br /> V <br /> CITY OF O ONO - BUII1D11�G PERNIIT APPLYCATION <br /> �J <br /> Ali information must be�u.bmitted in iull before plan revfew will be started. <br /> (please print all infornwtioR) <br /> ---�__—___---�_..�. . _....r_� �._......�__ <br /> THE A�'PLICANr �S: (e�rcle one) OWNEI.t O CONTRACTOR <br /> J08 S�.TE AbDRES5: . °2�J�'�' ��r�-� �/ti,e, �� • ZYp: .r.�3 q � <br /> � 9�fa -�1��= �8� <br /> NaME o� owxER: ���� M � ��-��2 rHox�: cnome) Gr z-�+7s—I���y <br /> (warl� <br /> MAIX.Y'NCY ADDRFS9: 02�r� Sl�.,o.�Q..�.�.�Q�,�, CTTY: [K TK,4 Se�c,N ZIJ�':,� �s'3� <br /> CONTRACTOR: �. �� riU�t-�c� �'�ct�,�1� �ON�: 9.l t- `F 70-�.,��f�3 <br /> C0�ITACTPERSON: 1,�-�, 3�02 MO�IY.E/PAGExt: `.ri �7�'-�'��4 <br /> MAILriv�ADDR�.SS: �.ri � }}r� 7 CI'I'Y: �xce�y�z. ZIP: ��"331 <br /> � <br /> STATE LICENSF: � C- Zc�3o�}7'f�i' <br /> ARCHI7'�CT/ENCYIlVEER: P130NE: <br /> M�Il�1G,�DIiESS: CI'Y"Y: ZIP:�_ �� <br /> N�: ItEGY.STRATION� <br /> TYp� OF WORK,: New_ Addition Acrxssory Sticucwre <br /> �V1ove RemodeUAlteration Land Alteration_____^, <br /> P`ROPOSE.D WORB(desc�ibe in detai�: �E�-v-F�i -� c/Q c�o� �Ce�•4� <br /> �-- <br /> STORY�'.S: ______ SQ.FEET OF FrACH FL04R <br /> � NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMA�D CONrSTRUCT1aN VALUATYON(eaccluding land): � �9, 3 �I C� - 4�" <br /> , <br /> I hereby apply for�buil.di�g pera�it a�,d Y BClaeowledge that the infotmation above is completo and <br /> �ecucace; lhat the Work will be in conf0�rm8i�ce with�tte ordinanCOS aBd codeS 0t the Ciry arid with <br /> tbe STate Building Code; that i understand tlais is not a permit amfl work is not to start withou� a <br /> permit; and that th� work will be in o�e with the approved plan. <br /> APPYiYCAN�'S SIGNA G'c�-.-- DATT: ` - Z.� - �— <br /> 1VOTE! Para�le_e, Homes eve�tts reqti�'e separ�te permit approval by Pokce Deputb»enr a�d � <br /> Cuy Counc�a 60�iys prior to the everu. Non-pernadtted eveRts will nvt be ullawed. <br />