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Nov-19-01 05 :44P P.O1 <br /> no�• ia-T0o1 10:30am From-CITY OF OROMO +g521494616 T-206 P.002/003 F-065 <br /> � ,7 � <br /> � � Total Pee: $ � � Date Rcceived: 1-��� ���-�y�� <br /> � Entered By: Tz r� Perwic#: , � —,14 �� i <br /> • L 4 �'��� , � ' ,j�l�- �.. � <br /> CITY OF ORONO - BU]LDING PERMYT APPI,.ICA'Y'ION <br /> . All ipformation must be subtuitted in �u]I before plan review w�] be started. <br /> � (please print a!I infornearion) <br /> T�iE APPLICANT YS: (circle o OWN -OR CONT'RACTOR � � � <br /> �._ _ _ __ ___ <br /> JOB SITE A.DDRE.SS: �SS'SC� p S`r�,f'�. I�;,.,� �CJ��, ZYI': S �� '� <br /> NAME OF OWI�IER: ��� ������ PHO1V�: (hOme) `S,�' 3�'C>- /�� <br /> (work) S�- "�f - �/� <br /> �sa.u.nvG a�D�tESS:�� S� S���G� ��CrrY: �,J�1 z�:��I <br /> corrrRacToR: Pgor�= <br /> CpNTACT P�RSON: �M4BILE/Y'AGER: <br /> MAILIlVG ADDRESS: CTT'Y: Z1P: <br /> STATE LYCEN'SE: # <br /> ARCHITECT/�1GINEER: PSONE: . <br /> MAIY.ING ADDYtESS: �______CI'r"Y: ZIP: <br /> NAME; REGISTRATTON� � <br /> TYpE O�'WORK: Nea► Addition Accessory Suucture <br /> Move Remodel/Al�eration� Land Alceration <br /> PROPOSED WOItK(describe in derain: _,K o 1� <br /> STORYES: I SQ.FEET OF F;ACH FLOOR: �S� <br /> ' NO. OF BEDROOMS: GA1tAGE STALLS: A'T7.. DET. � <br /> ESTYMA.TED CONSTRUCTION VALUATION(exClUding Ian�: $ t <br /> I hereby apply for a building permit a.nd I acl�owledge cbar the inforniadon above is complete and <br /> accurate; that the work will be in conformance with the ordinances s of the Ciry and with <br /> the State Building Code; chac I und stand this is uoc a petmic and ork u noc to scarc without a <br /> permit; and thai the work will be ', accor ance wi � approvt plan. <br /> � ' . <br /> APPL�CANT'S SIGNATURE: �' DATE: � j �'I 9' �I _ <br /> NOTE! PaTade of o»�es eve � equ�re saparate permit app avol by Police Department and <br /> G�ly Counci160 days prior to the event. NoR permitted events wilI not be allowed. <br />