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CITY OF ORONO - BUYLDIN19 PERMIT APPLICATION <br /> Total Fee: $ Date Received: <br /> Date Approved: <br /> Entered By: <br /> 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) OWNER Qor CONTRACTOR <br /> JOB SITE ADDRESS: (�`'` s� Tit/�/�W�� / /f�' ZIP: J! S�-23 <br /> 131 <br /> NAME OF OWNER: 7-e,';w�/-C Of - � yy, PHONE: (home) ? 4238 <br /> MAILING ADDRESS: `? �� � ��[� S' CITY: Dl/I ZIP: S � <br /> CONTRACTOR: �,/�J F�,4�?91�"�G GXL19y��5+n�✓G PHONE: <br /> MAILING ADDRESS: 34014 �'L�Com= ST- CITY: A., / ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <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) : <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 permit; and <br /> that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br /> I <br /> I <br />