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Oct 30 2007 3: 43PM HP LASERJET FRK p. 2 <br /> 1� <br /> Total Fee: S �8� (� Date Received: I D <br /> Entered By: Penn it A/1(03.5 <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 O CONTRACTOR <br /> JOB SITE ADDRESS: 1?3910 wa t e rt3jx) Ill 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 CYty Council approval <br /> 60 days prior to the event: Shuttle bus service will be required unless applicant demonstrates <br /> sgrxient on-site parking is available. Non-permitted events will not be allowed <br /> NAME OF OWNER:-'1 ri`�1 m Q YtI l') PHONE: (home)GISo?-y'7��--)d1 o <br /> MAILING ADDRESS: 0�= 'l['a'�.c2�r 1�)Qd CITY: (work) s-s <br /> _ icy. ZIP: <br /> CONTRACTOR: v PHONE: l�I <br /> CONTACT PERSON: S MOBILE/PAGER: <br /> MAILING ADDRESS: LQAa 11n in,,r-tj&� CITY: Ynk2IS ZIP: S'ky0(o <br /> STATE LICENSE: #Q0I04Cc o a EXPIRATION DATE: - 31 -D 8' <br /> ARCHTTECT/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 detall): ' <br /> WLqdjjA-A (no <br /> STORIES: SQ.FEET OF EACH FLOOR <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): S <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. n <br /> APPLICANT'S SIGNATURE: &�d��P iLO DATE: f1(J'' '0:2 <br /> 31 <br />