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Nov 16 07 02: 31p Todd Fultz 6513420532 p. 2 <br /> 6152- -,1'11 -L-1(e lL <br /> Total Fee: $ J 71 O Date Received: 1 I—!k—0 7 <br /> Entered By: Permit#: AJ/&9 <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 ORCONT.RACTOR , <br /> JOB SITE ADDRESS: (} <.J �v .'.. -- ('ii Lek.A4 ZIP: 5j c;> <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: nl) j (_,k,p ;,, -'.Ut.eivz PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: t?.5 �).r. Ann�. L,,4-,Q__ CITY: (ii,o ZIP: 5,.z-;(,_, <br /> CONTRACTOR: ,.) 1\--\ ue-r-t v PHONE: (-(13-•3 25 5-5-6 k.-2) <br /> CONTACT PERSON: .T\,;L9 c,� MOBILE/PAGER: <br /> MAILING ADDRESS: t 12 i;u S•i,11,4r•.tv "Wa,( CITY: Lo ti.L t:(mow , ZIP: >M;v <br /> STATE LICENSE: # geLit 5 L.!'-i EXPIRATION DATE: /i l/u i;j <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) K <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detail): � e,K k--- <br /> STORIES: <br /> -STORIES: SQ.FEET OF EACH FLOOR: I SW , , <br /> NO.OF BEDROOMS: `, GARAGE STALLS: ATTACHED X DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 8 r-70D <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 he <br /> in accordance with the approved plan. <br /> —�_ rtil <br /> APPLICANT'S SIGNATURE: `„�;. �-4L <br /> . DATE: I I /1 .. /G / <br /> 31 <br />