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� <br /> CITY �F ORONO - BUILDING PERMIT APPLICATION <br /> iotal Fee: $ ,_� ��`� 1 3 Date Received: //���� <br /> Date Approved: <br /> � <br /> Entered By: 1._� ��, , <br /> Permit#: � � -J '� <br /> AT•T, INFORMATION MDST BE SIIBMITTED IN FIILZ BEFORE PLAN REVIEW WILL B$ STARTED <br /> (See Check-off List Enclosed) <br /> -------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER orc�CONTRACTOR <br /> JOB SITE ADDRSSS: . - ' , , � . ' � " ZIP: � � <br /> (work) <br /> NAME OF OWNER: . ' ' ' , , , ' - ' _ " PHONE: (home) : � � <br /> MAILING ADDRESS: ' •• " CITY: �, ZIP: `�' <br /> ,. '�- <br /> CONTRACTOR: PH��= <br /> MAILING ADDRESS: _ ' " ' CITY: " " ZIP: <br /> STATE I,ICENSE: '� , <br /> ARCHITECT/ENGINEER: %- PHONE: �' �- ' <br /> MAILING ADDRESS: ' CITY: . ZIP: <br /> NAME: � REGISZ�2ATION # <br /> TYPE OF WORR: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : ' - " F ` <br /> STORIES: SQ. FEET OF EACH FLOOR: -- ' �"�'"` <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. � DET. <br /> , <br /> ;c=� `. <br /> � ;�. �� � <br /> ESTIMATED CONSTRIICTION VALIIATION (excluding Iand) : $ ����� ' <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances 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 will be in accordance with the approved plan. � <br /> APPI�ICANT'S SIGNATORE: ' � � ,� ' % - :J ` ,' � DATE: . , <br />