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CITY OF ORONO - BIII"� PER�iZT A.PpZIC�TION <br /> � Date Received: <br /> Total. Fee: � - <br /> Date A��roved: � <br /> , � � � � <br /> Entered Bv: Per_nit� � � _ __ <br /> p�Z INpORriATION MIIST BS SIIBMITZ'ED IP7 F1TLI. BEFORE PLAN REVIEW WIIS� B$ S��T� <br /> (Se� Check-off List Encl.osed) __________ <br /> �� �,pL=�NT Ig: (circle one) Oj1NER or CONT_�ACTOR <br /> JOB S <br /> ITE ADDRSSS: I �! l l (/� / //�/ ��? "�v�� Z=P: <br /> (work) <br /> �ME OF OWNEft: �/��fU�/!/� //l /(/��%/ ���� _ PHONE: (horae) <br /> N <br /> CITY: ZIP: <br /> MATLING ADDRESS: � <br /> ���. PHo�: ����� — <br /> �I'�>, ,n �i1� _ <br /> CONTRACTOR: U ZIP: /�/.1/� <br /> MATLZNG �D�SS: �i y;l UL ���� _ ��: 6�-�l <br /> STATE I,ICENSE: T D�� / �/ , <br /> /� � PHONE= <br /> ARCHZTECT/ENGINEER: /V <br /> CSTY: ZIP: <br /> MATZING ADDRESS: <br /> REGISTRATION � <br /> NAME: <br /> Accessory Struct sre Move <br /> TYPE OF WORR: New Addition Land Alteration <br /> Demo <br /> R�*nodel/Alteration Renovate <br /> ' detail) = �</ f 0� ��/C/ /'�� l� �� <br /> PROPOSsD WORK (descrZbe in <br /> STORZES: S4• PEET aF EgCS FLOOR: ��� "/�n ' <br /> � <br /> NO_ OF BEDROOMS: G�,RAGE STALI�S: ATT. DET. <br /> /,�, �� <br /> ESTIMA�.ED CDNSTRIICTION VALIIATION (escludinq <br /> land) : $ U <br /> I hereby apply for a building p <br /> ermit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in ��nfO� Code;a1that I <br /> ordinances and codes of the City and with the State Building e�it; and <br /> understand this is not a perniit and work is not to start without a p <br /> that the work will be ia accordance with the approved p laa. _ . - <br /> �/�� DATE s u /� /� <br /> � _ ��`.� <br /> APPI,ICANT S SIGNATURE' <br />