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Total Fee: $ 1(e `1 Date Received: <br /> Entered By: RD I t_FM sc� L1// Q,,7 Permit#: I <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 OWONTRACTOR_� <br /> JOB SITE ADDRESS:11 W RK(FIt ,\� Q ZIP: <br /> Will this be a Parade 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 /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAMEOF OWNER: b A�* PRVlN PHONE: (home) <br /> (work) <br /> MAILING ADDRESS:Zl'S WA rkb333 Q1 CITY: a000 ZIP: <br /> CONTRACTOR: (O fe-,�Piq PHONE: ��L �• �;�, <br /> CONTACT PERSON: Lim MOBILE/PAGER: <br /> MAILING ADDRESS:63 0u c 1WZ V,,0NG�_- ST CITY:S T ww s tq C- ZIP: ST4 I b <br /> STATE LICENSE: # 5C 35 r EXPIRATION DATE: 3-5t-L4c;l <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) C <br /> PROPOSED WORK(describe in detail): �XW Tt Lk 113.1 <br /> F/-TV�e5 <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ l � 5 <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: '� DATE: <br /> i <br /> �' 31 <br />