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I Y7t t—1 I I Ur UN q IU t <br /> i <br /> CITY OF ORONO -- BUILDING PERMIT APPLICATION <br /> Total Fee: $ 7 7� (O Date Received : <br /> Date Aooroved : <br /> te='e� Fay: <br /> Permit: <br /> ' r <br /> ALL MIFOWIATXON MUST BE SUBMITTF-D IN Pt= B=ORE PLAN REVIZ14 W=j Jar S7`M=D <br /> (See Check-off List Enclosed) <br /> ----------------------------------------------------------------------------- ------ <br /> 7HE Al'F.LIGANT IS: (C-ircle one) 01MER or CONTRAGTOFt� <br /> JOB SITE ADDRESS: L �D i t/n �I n � �� ZIP: <br /> (work) <br /> NAME OF OWNIM: c)m `� �� e. Ct/1 /�� S r pHoNE: (home) <br /> MAILING ADDRESS: /0�L' �CWY) /In Q. �a CITY: /-O�Rin ZIP: 5- <br /> CONTRACTOR:—I •��/�Ge�P'.�1FT PY10NE: <br /> MAILING ADDRESS 3//0 J ���1�NG /�Il�l= � CITY: �l-S ZIP: <br /> STATE DIC2 ISE: 'Tar �G17� a 72 <br /> AFZCF3STECT/F.NGI21EIIt: <br /> PRONE: <br /> 2 :JNG ADDRESS: CITY: ZIP= _ <br /> 14A E: REGISTRATION Q� <br /> TYPE OF WORK: New Addition ACcessor-f Structure Move <br /> Dea10 Remodel/Alteration ___� Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : <br /> ���e r» f b✓�c l.�dr.t�� -4- One [Y_�?I u�f{.r5 _ <br /> STORYES: SQ. FEET OF '3-.ACEI FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (e3cludiny land) z S c 2 <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 Z <br /> understand this is not a permit and work is not to start without a pe=:Lt,• and <br /> that the work will be in accordance with the approved plan_ <br /> Al .ICA.HT I S SIGNATURE: DATE: I-e/Z9 9 `/ <br />