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Total Fee: $ ��' Date Received:R�h�d� <br /> Entered By: Permit#: =—t'l0 A 3 <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) OWNER OR ONTRACTO <br /> JOB SITE ADDRESS: /6 y0 —Fo wrn b nc Q1 n r orP ZIP: �534fb <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ YeS M NO 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 /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: Ch(X-k ((�C.� P C- PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: /6,96 "Tac.,ti)i roc RJ CITY: O m,n ZIP: -S'5 341D <br /> CONTRACTOR: PHONE: 966? 755 3301ck <br /> CONTACT PERSON: �,L; t1�Alr,m/�n,G MOBILE/PAGER: 61 A 79/ 32 FT <br /> MAILINGADDRESS: y35a -r „na a,e CITY: �A r ZIP: 55364 <br /> STATE LICENSE: # g 4 7 9 EXPIRATION DA <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration(ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits <br /> PROPOSED WORK(describe in detail): C N r)nerf')Hj fle,19S fa✓ <br /> lGS <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ J odo, 00 <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 SIGNATURE: 'icy% /� %L� ��c 5 DATE: 9 S e) <br /> 31 <br />