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.s r <br /> " i CITY CF ORONO - BIIILDING PERM_IT APPLICATION <br /> Tota1 Fee: $ , �/� � C� Date Received: v ^ �� � �� <br /> Date Approved: <br /> Entered By:�,(',/v <br /> Permit�: �'�,:�7 <br /> AT•T• INFORMATION MIIST B$ SIIBMITTSD IN FIILL BLFORE PI,AN REVIEW WIIS� B$ STARTED <br /> (See Check-off List Enclosed) <br /> ------------------------------------�------------------------------------------- <br /> THE APPLICANT IS: (circle one) _OWNER%or CONTRACTOR <br /> � 1 <br /> / � � --� , <br /> JOB SITE ADDRSSS: � �`� � ZIP: ��5 ��C�' <br /> � <br /> �,� , �,� � �l ���� (work) ���� - 7l5� <br /> i � // <br /> NAM�? OF OWNER: ��l! ' `C�� • - � �i Iti L H �/� PHONE: (home) "�` 7�= �� �� <br /> MATLING ADDR.ESS: ° 5 �-(� ! CITY: ZIP: <br /> CONTR�CTOR: PH��' <br /> 2+►�ILING ADDRESS: CITY: ZIP: <br /> STATS LICENSE: � <br /> ARCHITECT/ENGINEER: PHONE: <br /> MATLING ADDRBSS: CITY: ZIP: <br /> gp,�,�g: RSGISTRATION tt <br /> TYPE OF WORR: New Addition Accessory Structure Move <br /> Demo Re.*nodel/Alteration� Renovate Land Alteration <br /> . <br /> �ROPOSED WORR (describe in detail) : � G�G � � L ' � �-� v <br /> � �/'�/ � <br /> r / <br /> -� �;�� �� �r � t� C��n�l� �r � � �- �1�1���� � <br /> �r���� Ct,e� h` �% C��`t���� <br /> STORISS: SQ. FEST OF EACH FLOOR: <br /> 3�70. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> o;Q�- ' <br /> ESTIMATED CONSTRIICTION VALIIATION (eacludi.ag Iand) : $�l� � ��� l��h����� <br /> I hereby apply for a building permit and I acknow that the information <br /> above is complete and accurate; that the wor}c will. be in conformance with the <br /> crdinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work wil 1 be in accordance w't �the approved plan. � <br /> APPLICANT'S SIGNATIIRE: DATE: �� <br /> � <br /> m <br /> � <br />