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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ ) �j` t Date Received: <br /> Date Approved: <br /> Entered By: <br /> Permit#: 5-71-2" <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ThE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: c/(v D ZIP: <br /> (work) -I/7k <br /> NAME OF OWNER: //3,4:--6, Y PHONE: (home) -/7.3- <br /> MAILING ADDRESS: ;:: r./A-K3d 6 ZIP: <br /> CONTRACTOR: � PHONE: <br /> MAILING ADDRESS: S/ CITY: 0'7-4� ti ,_-L. ZIP: <br /> '?s <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: <br /> "--`��---.� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOS= WORK (describe in detail) : /�,._:Ze <br /> --T <br /> STORIES: 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 /> DATE: /7- ,� <br /> APPLICANT'S SIGNATURE: <br />