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Jun. 20. 2007 7:40AM U No. 5614 P. 1 <br /> 6,41'0/ <br /> Total Fee: $ 44. 30 Date Received: - N-67 <br /> _ <br /> Entered By: Permit#: 4i/fife? <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 /> TEE APPLICANT IS: (circle one) OWNER OR6-1TRACTOO <br /> JOB SITE ADDRESS: ,,,,2.075- t,idobec I`i l IS kci ZIP: R5 3 7 <br /> Will this be a Parade of Homes,Remodclers Showcase home or other Display Home? <br /> ❑ Yes ❑No Ifyes,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 he allowed. <br /> NAME OF OWNER: '& v‘. SW Q,Q.,y1 PHONE: (home) 75d -Y13- /733 <br /> '1 (work) <br /> c�r,"(,c <br /> MAILING ADDRESS: a )eJalow WA Its41TY: Orov o ZIP: 575-35'/ <br /> CONTRACTOR: nc l..a.Are,r A.tro PHONE: 9S,-?77-116 0 <br /> CONTACT PERSON: .`6 e • �;c jk' MOBILE/PAGER: <br /> MAILING ADDRESS: ib7sl Eze¢_(sio✓ I )UC( CITY: uepichs ZIP: 53-3.4/3 <br /> STATE LICENSE: # a Ay 3c 9 EXPIRATION DATE: 3/3,A 8 - <br /> ARCHITECT/ENG INEER: 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) ),(' <br /> PROPOSED WORK(describe in detail): <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /� 0 G <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 be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: °I- -. DATE: (o--/FO'7 <br /> 31 <br />