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Total Fee: $ , • <br /> Date Receive, IJ(1 ( /y.3 <br /> Entered By: f} l007(1- �,Q , Permit#: �7 / /03 <br /> '-"Zr CITY OF ORONO -J3 lING PERMIT APPLICATION <br /> j\\ l information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNE R CONTRACTOR <br /> JOB SITE ADDRESS- D C-H/1kb PA/2-16- RD ZIP: <br /> /ICI, Lo - 3t oc'- F <br /> NAME OF OWNER: rn /--.I o NK) it .4 I— PHONE: (home) ( 2- -q76 -9390 <br /> Cro (work) hoz M&1• lbL/ 7 <br /> MAILING ADDRESS: t l O D wtx-1 P,- WVk CITY: (Y) GE ZIP: 5;351 <br /> 6(2-01166- <br /> CONTRACTOR: <br /> (2-01166CONTRACTOR: Ti " Mf}/u PHONE: 62? . 79 8 7593 <br /> CONTACT PERSON: I i rn M t1 J S MOBILE/PAGER: (o l Z • eb 7 • 7S5'3 <br /> MAILING ADDRESS: q ZO 5 (0 D i 9 CITY: 2-..O t6TO ZIP: 5 535 7 <br /> STATE LICENSE: # <br /> C \` ARCHITECT/ENGINEER: PHONE: <br /> J ' MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration X <br /> PROPOSED WORK(describe in detail): j fak v'l.o - ail-ached pia n <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: • GARAGE STALLS: ATT. DET. <br /> ESTLMATED CONSTRUCTION VALUATION (excluding land): $ <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />