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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ �� c� Date Received: <br /> Date Approved: <br /> Entered By: fL' <br /> Permit-4: <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) �IC;TNER or CONTRACTOR <br /> JOB SITE ADDRESS: C� Tom �`a yjdz- ZIP: <br /> (work) <br /> NAME OF OWNER: K + ly-c� a �' PHONE: (home) <br /> MAILING ADDRESS: `76� �o u waw CITYZIP: S—S 3S <br /> CONTRACTOR: V- / K - PHONE: 22-��2 <br /> MAILING ADDRESS: S ( � a A U.CITY: P 1 (S. ZIP: <br /> STATE LICENSE: # �� © /L/ Z•� <br /> ARCHITECT/ENGINEER: U `� e PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration_ l Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : 2 V'0,0 <br /> V 2 �V, 64 L u�S e CcJ <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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 permt; and <br /> that the work will be in accordance with the approved plan. <br /> DATE: 4- 30- 73 <br /> APPLICANT'S SIGNATURE: <br />