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Total Fee: $ �1'� 0�2 Date Received: i 0,1--)16 S– <br /> Entered By: r YL_. Permit#: w <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 O CONTRACTOR <br /> JOB SITE ADDRESS: O L TP 4 � W"l ZIP: <br /> Will this be a P ade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ <br /> Yes <br /> JNo If yes,a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> su tient on-site arking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: ` a PHONE: (home5V <br /> L� (work) <br /> MAILING ADDRESS: O l �b �l CITY: G)VU-U4— ZIP: <br /> CONTRACTOR: 4 P u`S PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: Q5b C -IMCv-IM CITY-.%,� ZIP: s� <br /> STATE LICENSE: # L J o� l S O EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(descri 'n detain: <br /> "L— �PPS.-' � <br /> ` LXw <br /> STORIES: G\-K S .FEET OF EACH FLOOR: <br /> — Q <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and wo is not to start without a permit;and that the work will be <br /> in accordance with the approved ft. <br /> � <br /> . P APPLICANT'S SIGNATURE DATE. <br /> 31 <br />