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Total Fee: $ /OL7 b 71 Date Received: 9-21-041 <br /> Entered By: Permit#: X D 7 71 <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 R CONTRACTOR <br /> JOB SITE ADDRESS: Moos WPrYZPMA (3Lvp. ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ No 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: (,USN\ P 12•e+>G*-j Ezj2 LL- PHONE: (home) <br /> (work) 115 1• "1�1'�• ►340 <br /> MAILINGADDRESS: CITY: ZIP: Gz�-,3,,'y <br /> CONTRACTOR: o V.; PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: S-MV j Ftct-V-L. P-�ck4 PHONE: <br /> MAILING ADDRESS: 4159 ULsoN M@A F+w Y CITY: Xl Kc, ZIP: 4z�Z <br /> NAME: 5TEt/E Fi c-j4T1Z_, REGISTRATION: # i L-Me, <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): p-M PAINT' P-0 1h1G <br /> APD W iPPLXCIS <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 50,Ovv <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 'nances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and wo is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. f <br /> APPLICANT'S SIGNATU DATE: '1A 6/o 4- <br /> 31 <br />