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XPERMIT <br /> Total Fee: $ Z.l ' eceived: �7SEntered By: TZI� t#• '7/���CITY OF ORONO - BUIAPPLICATION <br /> �b S art fi 1,e In <br /> All information must be submitted in full before plan review wi I be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR <br /> JOB SITE ADDRESS: 3 A,�,0 kno d ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes No Ifyes, a special eventpermit is required with Police Department and <br /> City Council approval 60 days prior to the event. Non permitted <br /> events will not <br /> be allowed. <br /> NAME OF OWNER: Demk l&m. M&A BSA a� UI*F PHONE: (home) /•OS79 <br /> (work) 9Sz• 7�.So ' 3 3SS <br /> MAILING ADDRESS: _/2035- CITY: J11 + ZIP: SS30,S— <br /> CONTRACTOR: PHONE: 9S:L• 4{73 • AO 8 9 <br /> CONTACT PERSON: MOBILE/PAGER: & <br /> MAILING ADDRESS: p W y CITY: JvAj La Ke-ZIP: SS 3-re <br /> STATE LICENSE: # 103p// Z EXPIRATION DA E: <br /> ARCHITECT/ENGINEER: 86n Fl*'-' baSln h PHONE: 7,3 - 7.00 -poo y <br /> MAILING ADDRESS: 7/00 S j. /✓e CITY: 1aJh L+ ZIP: JCr�Cyjr <br /> NAME: �y REGISTRATION# <br /> TYPE OF WORK: New x Addition Accessory Structure <br /> Move ome Remodel/Alteration <br /> PROPOSED WORK(describe in detail): N LcAs JZ,6 5 <br /> STORIES: _ '�- SQ.FEET OF EACH FLOOR: L L 16,1? <br /> NO. OF BEDROOMS: �_ GARAGE STALLS: ATTACHED 3r D 9 TACHEyyD_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ og " <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 t start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br />