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Oct 22 07 11 : 41a Todd Fultz 6513420532 p. 1 <br /> Total Fee: s <br /> Entered By: Date Received: <br /> 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 OR(CONTRACTOR <br /> } <br /> JOB SITE ADDRESS: acin t , tv asZ <br /> ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> n Yes to lyes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service gill he required unless applicant demonstrates <br /> sufficient on-site parking is available. Non-permitted events will not he allowed. <br /> NAME OF OWNER: , ),A.,; S 1 e' t PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: 3.c1 tr. it}z L vt zLC.ITY: tro,, ZIP: 1 '5'5-35-14, <br /> CONTRACTOR: T u-o-1rv, PHONE: <br /> CONTACT PERSON: � , Q ,� 1-{LA MOBILE/PAGER: C;/22. <br /> MAILING ADDRESS: �Z0 S At,,,A kre 75,t '- CITY: ZII': 5sc't2. <br /> STATE LICENSE: # k Si t1.-( EXPIRATION DATE: .")/31/0 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windows) X <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detail): ?.p <br /> STORIES: Z SQ.FEET OF EACH FLOOR: I cir0 -_ <br /> NO. OF BEDROOMS: -T GARAGE STALLS: ATTACHED ,x,. DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ,/a <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 1 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: tr -t ` ="E DATE: 10 I f�Z'tt <br /> 31 <br />