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Total Fee: $ 1-71,75 Date Received: <br /> Entered By: Q M Permit#• 12112-01 <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) rO�W/NER OR CONTRACTOR / <br /> JOB SITE ADDRESS: ILO T r lj, 11 lct 7/24r,/ ZIP: �-�3 -11p <br /> Will this be arade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes 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 /> suicient on-site parking iiss available. N/on pd. <br /> Non-permitted events will not be allowed <br /> NAMEOF OWNER: IJt /� k<,yt Aa,-^s4al/ PHONE: (home) 7X2-473A/,? <br /> / (work) SZ- Z/L- 34S <br /> MAILING ADDRESS: 12 0 T,u��v16 7lLatCITY: 14W —ZIP: <br /> 1 <br /> CONTRACTOR: K00T Co, iU./�. PHONE: A0-S'S�0-D�J� <br /> CONTACT PERSON: -$O h MOBILE/PAG <br /> ii <br /> MAILINGADDRESS: 7� 7atVae fig. CITY: Aa ZIP: 3�Q <br /> STATE LICENSE: # 20172 /53 EXPIRATION DATE: 3-31-D8 <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 MWD eview and yez%ts! <br /> PROPOSED WORK(describe in detail): Qr �� 1S 7KQw" <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ F-30 <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: t DATE: 7 3D-D 7 <br /> 31 <br />