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j <br /> Total Fee: $ �' '`� , Date Received: -_7 D� <br /> Entered By: Permit#: <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: 6 4 5 MW KA M QDAID ZIP: <br /> NAME OF OWNER: TEMPLE 1 S IZPtEL PHONE: (home) <br /> (work) (012 37N--0305 <br /> MAILING ADDRESS: 7,3Zy EMUSW AVE,S.CITY: MI1VA)EAPDI.I S ZIP: yp <br /> CONTRACTOR: DIYER S I FlE CDNST LY_,j_M PHONE: &12 CrUl--7233 <br /> CONTACT PERSON: D,4V F SCM FFff_ MOBILE/PAGER: (D12 19105 - (01 Z 3 <br /> MAILING ADDRESS: -]c711) MNy -7 CITY:ST.LWn PAA ZIP: 5 5 t4 <br /> STATE LICENSE: # 31041 <br /> ARCHITECT/ENGINEER: WAL5}} glSttDP PHONE: &II 336- 819q <br /> MAILING ADDRESS: 92DSG6 DND AVE. S. CITY: MINNEhFDUS ZIP: SS4D2. <br /> NAME: M IGH/SEL 514 IEL.DS REGISTRATION# 12 400 <br /> TYPE OF WORK: New _ (X Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK (describe in detail): MEW 5ADV%R/TD1 L t7 FACILITY <br /> ME CAMP T&W <br /> STORIES: I SQ. FEET OF EACH FLOOR: 1pow <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 100,COD. <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in7400 <br /> dance with t appr ed plan. <br /> APPLICANT'S SIGNATURE: DATE: <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 9 <br />