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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee• $ r�(11 ' Date Received: '2 <br /> Date Approved: <br /> Entered By: ' <br /> Permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ------------------------------------ ----------------------------------------- <br /> THE APPLICANT IS: (circle one) R or CONTRACTOR <br /> JOB SITE ADDRESS: 'P'100 W A T,C- ,e 7'0 wA/ ed ZIP: <br /> (work) <br /> NAME OF OWNER: lz_5LGzlesF_ A1,5-ts,01✓ PHONE: (home) lam? d; S'S,2J <br /> MAILING ADDRESS:;?LOO k1,47'EPTOwA1 CITY: AoA1j-1_A ,6 ZIP: <br /> CONTRACTOR: /A/_Z / lr?��5� PHONE: ,/76 SSS�o <br /> MAILING ADDRESS:,A! Qo i4, T,6P 7°vwN Pu' CITY:GdA•'F LAM-6 ZIP: .C's' <br /> STATE LICENSE: <br /> ARCHITECT/ENGINEER: ,.� ( E PHONE: 14 hd IF- <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION n <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Rem d 1/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : ��.IL C AX CT A P A-Gc- <br /> Ltl z 7w Flo Q 7.z,vc:- s L 4B 3x <br /> STORIES: SQ. FEET OF EACH FLOOR:NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. X <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ n� `� d <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 I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> APPLICANT`S SIGNA DATE: 7 a `�Y <br />