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Total Fee: $ /1U / " 6t4; 1Date Received: 3 ot v I �I <br /> Entered By: (10 • ,q2; 1° Permit#: p g)3 <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: , c Vic(circlei/ one) OWNER OR CONTRACTOR <br /> / <br /> JOB SITE ADDRESS: `1 e/ 7 1v7-k ld ZIP: 553$ 7 <br /> Will this be a arade of Homes, Remodelers Showcase Home or other Display Home? <br /> nYes ENo Ifyes, 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 events will not be allowed. <br /> NAME OF OWNER: 7 ' 25 ( PHONE: (home) q. 2 V23 `- _2/27 <br /> (work) <br /> MAILING ADDRESS: tic 5/1 /1/7/e. ikiTY: 6:44"---- <br /> ZIP: S• S y <br /> CONTRACTOR: 4v4,9 PodL s/2' - PHONE: 612- 751S-2/ 7( <br /> CONTACT PERSON: Kev 4/.9-6-.4,9,,•,✓ MOBILE/PAGER: d/2 7V3=- /75- <br /> MAILING <br /> TSMAILING ADDRESS: /3733 tie %, CITY: yr- <br /> ST ATE <br /> r- <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: 4it2/✓e,- 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 require MCWD review and permits ! <br /> PROPOSED WORK(describe in detail): ,.' ,I f od t 2 <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ XiC900 • 0 U • <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 /> APPLICANT'S SIGNATURE: .., , I B (1 DATE: <br /> _ <br /> •' <br /> 31 <br />