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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee 5t $ / 75.93 Date Received: <br /> Date Approved: <br /> Entered By: ;('� Permit#: �T3 At, <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 or CONTRACTOR <br /> Jos SITE ADDRESS: I O —to",KGW 0. f OC k(z(5,AQZIP:;SSQ <br /> (work) L 71 - <br /> NAME OF OWNER: � C La Y 1 <br /> Lp,� E r PHONE: (home) 70- 70 <br /> MAILING ADDRESS: I -� cI 2 d v�S P} CITY TO h K eQ, <br /> Eck *IP <br /> CONTRACTOR: T h PHONE: L/7O -2419 0 <br /> MAILING ADDRESS: 1 2 0 c n r,S Pf S4 _ CITY: c, <br /> STATE LICENSE: # 0© y -7 &Av u 90bW <br /> � <br /> ARCHITECT/ENGINEER. <br /> ..� - PHONE: <br /> /i(.,( �C C' 1rv. t <br /> MAILING ADDRESS: -�Zy Mavk,taco o, Aue.So• CITY: 2 C-_ ZIP: <br /> NAME: Er" C (t- s c k W) , REGISTRATION # <br /> TYPE OF WORK: New !/ Addition Accessory Structure Move <br /> Demo_/ Remodel/Alteration Renovate Land Alteration <br /> "Re <br /> PROPOSED WORK (describe in detail) : -- is I <br /> � oy e GY +h � L�oc► c 2 G.h� <br /> STORIES: SQ. FEET OF EACH FLOOR: 1.0 6K <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. 3 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 /> ,inderstand this is not a permit and work is not to start without a permit; and <br /> chat the work will be in ac dan with the approved plan. <br /> `LICANT'S SIGNATURE: DATE: <br />