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,4 - L <br /> I CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ � Date Received: a-/- G2 <br /> Date Approved: <br /> Entered By: <br /> Permit f: /Z "7 <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL 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: ( fS`S GL�i�i � �`� F�I�. ZIP: <br /> (work) <br /> NAME OF OWNER: Tki) V�'" '-S nPHONE: (home) <br /> MAILING ADDRESS: ��j j L�;; T�'�'i C�_� 1^�)• CITY: � RAII J ZIP: <br /> CONTRACTOR: a/W i tC C" L,;,,{S z0C,_-714jLJ PHONE: 1* L � <br /> MAILING ADDRESS: dS pon'jC.b+-go CITY: ZIP: <br /> STATE LICENSE: )f..l <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION <br /> TYPE OF WORK: New Addition Y Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : Fg-p r l-sol &X (S7-f lyG Pd/'-Cj4 <br /> S StO:3idr4 PO&0_W CSF �`l�il�i �12C <br /> STORIES: I SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <br /> I 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 /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATIIRE: �"�`�� DATE: ���� A , <br />