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cj.kG(lit <br /> 1 <br /> Total Fee: $, aU 3. Date Received: <br /> Entered By: Permit#: <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER 016NTRACT. OR <br /> JOB SITE ADDRESS: ZOO l'\49(1214114 Bic'C( W ZIP: SS 3a <br /> Will this be a Par de of Homes, Remodelers Showcase Home or other Display Home? <br /> IYes 10 If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non-permitted events will not be allowed <br /> NAME OF OWNER: Vi#'(Z, 1.141-1 411{ au(, l�e., PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: Z.00 Wp A g tJci W. CITY: Wr -tg17; ZIP: 5'S31 <br /> CONTRACTOR: 1 Glrr G e i&vi (crt hrmc s IL. PHONE: <br /> CONTACT PERSON: S co{{ Ar&.r$cAn MOBILE/PAGER: <br /> MAILING ADDRESS: Z(O? S' Cov►►htLitt. 13 CITY: tZc a.rs ZIP: 5537 <br /> STATE LICENSE: # 5"e- too° EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: Mille(t)ur.utdd(c (` mrl,ikc re_. PHONE: <br /> MAILING ADDRESS: 123 N. 3rd S6,24-tet CITY: 61 p is ZIP: 5910 t <br /> NAME: ohh Le e_t.. - 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):TQ.Y1'IOUe... extsh ng dQdC o-t riC✓k1 <br /> S Lck oc buticlltic„( lr¢,pft4Ce _, w t Kt, i cte c..1. <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 0.50.000 e- <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—� ' DATE: <br /> 31 <br />