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Total Fee: $ Date Received: -ac3-D <br /> Entered By: Permit#: AfZ 763.3 <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> O� All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> n ------------------------------------------ ---------------------------- ------ w=a- --- <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOS SITE ADDRESS: -3310 Wk T 6z-r0WM 2P ZIP: <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes [Ut No If yes, a special event permit is required with Police Department and <br /> City Council approval 60 days prior to the event. Non permitted <br /> events will not be allowed <br /> r1 tstt <br /> NAME OF OWNER: `t M� SK41 Tt1 PHONE: (home) !�l 2- 41L/- 5-924 <br /> �d (work) <br /> MAILING ADDRESS: �� Old (R9 STAI CITY: W Z*rAZIP:5-S 39J <br /> CONTRACTOR: I PHONE: `7(p3- S�'Z-gaup <br /> CONTACT PERSON: CRKtS MOBILE/PAGER: -X,3' co-otooK <br /> MAILING ADDRESS: 3440 S- 4-41 w 4`( 10 Aa CITY: Pe-yyNoy?K ZIP: S-s- Fy./ <br /> STATE LICENSE: # BC- 202&64sZ EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New X Addition Accessory Stricture <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): ZIP (:�,YyJ N l) 20 X y q V 1 N� l <br /> Poe <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 2 ) <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 /> :f-� <br /> APPLICANT'S SIGNATURE: '� �� DATE: �a� <br /> 9 <br />