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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Date Received: 17/,?3-19-"J- <br /> Date <br /> Total Fee: $,4,2,;?. -7/ <br /> Date Approved:) <br /> Entered By: ' " ..) Permit f: ✓71q <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 �orJ CON RACTOR) <br /> JOB SITE ADDRESS: 2-_;SID LJ e4yz rgvo/ ,107 ' - ZIP: S 3 56 <br /> 7Ei/'WTi(/4/Y) = /446/1,66W/i"- C- ocl (work) <br /> NAME OF OW : P� r4 . / (eicYorSe PHONE: (home) 4/7. - 1z-6-- <br /> MAILING <br /> /z --MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: Sr-ate/1 23/4; /71- (rP * `- e b U,1 PHONE: ! `. 274 <br /> MAILING ADDRESS: PO. &k' / 7 CITY: �v s'✓i E'- ZIP: 55337 <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: //4- PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration 1/' Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : e,U/-2v,76,Kr CI/ fe e)/ teei 77/ s-frl cc <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ /72/PQC) <br /> T 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 /> 5-1 <br /> APPLICANT'S SIGNATURE: /� -� ��� � DATE: 7 ' <br />