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t/"v <br /> led <br /> Total Fee: $�/ &v 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 O CONTRACTOR <br /> JOB SITE ADDRESS: 2 OO ZAZ Sly c \ ZIP: SS 3Ct <br /> Will this be a Par de of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes o 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: A Z ( au(, rh G PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: 200 k( 4174-li (id. CITY: 1nlcohn ZIP: €S31 I <br /> CONTRACTOR: 1 e.rr G elrlarta (CAI Ir-dC,-c IL. PHONE: <br /> CONTACT PERSON: S cal{ Andfi.rscn-, MOBILE/PAGER: <br /> MAILING ADDRESS: 2,1OzS Co»UN era. f31'.ci CITY: lZc o.rs ZIP: 55 37( <br /> STATE LICENSE: # 9s`F`- LOGO EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: Mtllev bunwldd(C {�rollit.e PHONE: <br /> MAILING ADDRESS: 17.S N. 3 rck "s CITY: h Ip IS ZIP: 591E0 l <br /> NAME: Joh N Le..e.k.. e— 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,1'Y1C1,i¢.. ey4sh vtoq C e_c.0 hc,,. <br /> s Ick 0C. but tei.Ivtc.1 v.Q,pkca_, w t 111 Iviq cOkc . <br /> �J1 <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ OS'o.000 <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. 2 ` <br /> APPLICANT'S SIGNATURE DATE: <br /> 31 <br />