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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> A. <br /> Total Fee: $ Date Received: <br /> � l5 <br /> Date Approved: <br /> Entered By: ZZL - Permit <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> - - ----------------------------- <br /> THE APPLICANT IS: (circle one) OWTRACTOR <br /> OWNER or CON <br /> JOB SITE ADDRESS: Q 1 SO Al , 64409-E DRIVE ZIP: <br /> (work) <br /> NAME OF OWNER: TIM / PHONE: (home)-4 11-15bj <br /> MAILING ADDRESS: g7C 11 S�fOfzE Dre', lE CITY: ' C)Ua 1D ZIP: <br /> CONTRACTOR: 114e CE}�2Pt-'�ti�2� 101Li'r 1 � C•� PHONE: <br /> MAILING ADDRESS: 1105 L'OVIC4 (LQ 19 CITY: ! �ncJl�c (3 ZIP: 55364 <br /> STATE LICENSE: # 3G2� <br /> ARCHITECT/ENGINEER: 9-LA2P PHONE: 4-7z-S'l 1 <br /> MAILING ADDRESS: dos eotio M 2A C9 CITY: ZIP:55�� <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition_ Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : ADC) 2 CAP— 4TEACHED �� LAEC, W ITS <br /> E1.cTiR�f , DI 1u� oN �� UO�i'�1 A�-nc� tTY 1Zoot�• <br /> up�rA�2s, <br /> t�aw►.iSTA� <br /> STORIES: Z SQ. FEET OF EACH FLOOR3Ned) <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 2 <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ •��7, o 00 <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 wi the approved plan. <br /> APPLICANT'S SIGNATURE: Ct DATE: ° __ R <br />