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CITY OF \ORONO - BUILDING PERMIT APPLICATION <br /> Tata i Fee: $ / ' O LJ Date Received: � 3 - 9 <br /> Date Approved: 7 1 <br /> Entered By: � <br /> J Permit#: '5 / &' <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: OcIS r «‘ R -j ZIP: <br /> (work) <br /> NAME OF OWNER: \ t-kAwes PHONE: (home) 4liq- CiaSo <br /> MAILING ADDRESS: 2oq t-6e--f 4:11s RA CITY: 0I'D ho ZIP: <br /> CONTRACTOR: j L K 4 ....13x;‘; S L PHONE: S.S. -(1l(o S <br /> MAILING ADDRESS: 624.(01 A..a �.�l;n LA, , CITY: i1/44, le, UZIP: 5ç3(,' <br /> TYPE OF WORK: New Addition )( Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : eic,c - -1-1- o- sec: su�� <br /> a+ 64... 1:4. aAk0., <br /> STORIES: SQ. FEET OF EACH FLOOR: oat o r e,� Lt q 0 4 <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ "1000, Do <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 /> APPLICANT'S SIGNATURE: I Act' / s <br /> Pit DATE: 7 91 <br /> (Pleasefill ou 47:gr�verse <br /> side of this form) <br />