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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ W � . Date Received: <br /> Date Approved: <br /> Entered By: <br /> Permit#: L/ J <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) or CONTRACTOR <br /> <Qy5 (� i"��� <br /> JOB SITE ADDRESS: Zw'n Vzo� ZIP: 5535(0 <br /> D P� " (work) <br /> NAME OF OWNER: 1 Q� I L�-"I PHONE: (home) IL/73-E; 105 <br /> MAILING ADDRESS: ZPO� CITY: 0,,-&40 - ZIP: SS35 (o <br /> CONTRACTOR: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure_ Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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 SIGNATURE: DATE: 1 ► �C�w" `�����Z <br />