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rs CITY OF ORONO - BUILDING PEP-MIT APPLICATION <br /> Total Fee: $ 10, a I Date Received: <br /> _ Date P__n_oroved <br /> Wintered By: ' _ �� <br /> Permit a � <br /> : �� <br /> ALL INFORMATION MUST BE SUBMITTED IN F7TT•7• BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ----------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: v �s ZIP: �S S <br /> (work) B� G � <br /> _IAMB OF OWNER: VL,,Z( K7 C-_(7ZPA-%2lCff PHONE: (home) <br /> :TAILING ADDRESS: }�`� 5 ����nTG`ci� CITY: Lo,, 6 LAK o ZIP: <br /> CONTRACTOR: PHONE: <br /> 'LzILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION Q <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : !.i EC'\ <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ;STIMATED CONSTRIICTION VALUATION (excluding land) : $ OU <br /> 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 /> :rdinances and codes of the City and with the State Building Code; that I <br /> nderstand this is not a permit and work is not to start without a permit; and <br /> hat the work will be inaccordan <br /> DATE: <br /> ce w' h the approved plan. <br /> _PPLICANT'S SIGNATURE: <br />