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Total Fee: $ R�9G• S� Date Received: a/�/O <br /> Entered By: Permit#: 4111736 <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 /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: 3713 Ua�o - w,vn Ad ZIP: �S 3S9 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ONO 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 d. <br /> Alermitted events will not be allowed <br /> NAME OF OWNER: �GOrAA Ay 0 /6�A1 PHONE: (home)/IV)Y73-4G7*f <br /> (work) <br /> MAILING ADDRESS: 37y'S CITY: Ormno ZIP: SS3s9 <br /> CONTRACTOR: v/n6��trr�v/u��' %`oh Lt PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: /67/0 A*t.Vk 41 CITY: ZIP: SSSS <br /> STATE LICENSE: # EXPIRATION DATE: 3/3//a4909 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration(ie: Siding,Windows) <br /> Any earth movement may requir MCwD review and permits! <br /> PROPOSED WORK(describe in detail): NOW e.&*4W <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 9 oco' oar <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 plana <br /> APPLICANT'S SIGNATURE: DATE: <br /> 31 <br />