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Total Fee: $ la SS3• I Date Received: <br /> Entered By: Permit#: O (' <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 /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) (ED1011 CONTRACTOR <br /> JOB SITE ADDRESS: ZS&4T WA W-D. ZIP: SS3S� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> 1AYes ❑ 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 /> NAME OF OWNER: 0ever,i.l Geore, PHONE: (home) (0 a- ?4Ce -&3y 3 <br /> (work) <br /> MAILING ADDRESS: CITY:Yyv u 14,fir- 967 ut e_ <br /> CONTRACTOR:j>ChAftAk1k -.7. PHONE: — 3&(P—93443 <br /> CONTACT PERSON: 141 „ Slonk MOBILE/PAGER: - &4 — Z183 <br /> MAILING ADDRESS: 1:5 jWjb6j22Kj CITY: jjp4pjrF_A $.ZIP: <br /> STATE LICENSE: #�p.,. EXPIRATION DATE: W, AE <br /> ARCHITECT/ENGINEER: JF^- Z %CV, •per"(- PHONE: <br /> MAILING ADDRESS: !( It 3• CITY: ftN5 ZIP: <br /> NAME: REGISTRATION: # 4341 w <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): N,c/ g=c*4ST4KVCMCf4 19%VMI 1T A.L— <br /> "ON O—. SGTr Cg2hWMD.KMeN E���NLAi { l►Ib CaOC-1 A[b S YST�+IA <br /> STORIES: Z SQ.FEET OF EACH FLOOR: Gi�dG•FI'y <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED_%, DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ I • �M <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 /> i <br /> APPLICANT'S SIGNATURE:- i DATE: y 7--e�)s <br /> 31 ,��'�'z <br />