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Total Fee: $ Date Received: c�- <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 /> THE APPLICANT IS: (circle one) ER R CONTRACTOR <br /> JOB SITE ADDRESS: l a'ao 1&tat cc wa k --cm0 ZIP: 6C55'6 <br /> 55'6 <br /> Will this be a P ade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑Yes SO If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bats service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: A(�adz PHONE: (home)(Se- y-41_ Ya <br /> MAILING ADDRESS: CITY: d-7%C ZIP: S ,� <br /> CONTRACTOR: VJ, IW Q/1 �'1 PHONE: 6 Y6 d � <br /> CONTACT PERSON: "i.—IL 0( Ion MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: KV GLS PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Sidin , Windows) <br /> 'V 1"Lv <br /> PROPOSED WORK(describe in detail). <br /> &I hrdl" oe o <br /> dwt <br /> STORIE SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $��07 <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 work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATU DATE: <br /> 31 <br />