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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ S, / Date Received: <br /> Date Approved: <br /> Entered By: <br /> Permit#: Y <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> THE APPLICANT IS: (circle one) OWNER or CONTRALTO <br /> JOB SITE ADDRESS: �® -rc Y1 10, V Levi LX. I ouVl/1 ZIP: ,j53/7 <br /> II eIi I n I (work) <br /> NAME OF OWNER: 1i}1 I i'0.t�� �,ri1Y'IE:V bLtl l PHONE: (home) -1,�-36 69S <br /> MAILING ADDRESS: ilb 96 -rowl . V-1 euJ LA CITY: MOLLVI& ZIP:,65 10 <br /> CONTRACTOR: Mew w De-5 L d vis 6� I"C l Gl .INIC . PHONE: 412-5.2022 <br /> MAILING ADDRESS: `�7�� N. Olffr- Dr . CITY: I'IQL RA, ZIP: 151531,,L/ <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration 7T— Renovate Land Alteration <br /> r <br /> PROPOSED WORK (describe in detail) : <br /> STORIES:_j SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 11 ,746 , 06 <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 /> APPLICANT'S SIGNATURE: -� DATE: `7Io� Q/ <br /> (Please fill out the rever side of this form) <br />