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JUN,.25',2004 12: 12 6127229754 _,p,QdGARLOCK FRENCH ROOFING #5245 P.002/006 <br /> 61?S J p <br /> Total. Fee: $_ Tag-Cr° Date Received: !�O/f <br /> el <br /> Entered.By: Mc Permit#: Ab7&4 Ll <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must he submitted in full before plan review will be started. <br /> (please print all infnrrnation) <br /> THE APPLICANT IS: (circle one) OWNER ORCONTRACTOR <br /> JOB SITE ADDRESS: 111 0 Y' FGIYm fz.oaa ZIP: G;3 _7)1-40 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> 17 Yes ISI No If yes, a special event permit i.' required with Police Department and City <br /> Council approval 60 days prior to the event, Non-permitted events will riot <br /> be allowed. <br /> NAME OF OWNER: .5015Of M(' 1 Y1( PHONE: (home) 11D3'41�-- K3to <br /> J (work) <br /> MAILING ADDRESS: 111 O \N, FOIYrti1 EOO A CITY: byll 10 ZIP: 65'3S <br /> CONTRACTOR: -cQIY1 ,- A Di PHONE: U l a-"1 113.1 <br /> CONTACT PERSON: 16,/ky\ vi 19.A.y • MOBILE/PAGER: <br /> MAILING ADDRESS: A")b\ EA* G'}- CITY: 1 G1 S ZIP: 7ri4o <br /> STATE LICENSE; # OQ('�14 a 3 EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Accessory Structure _ _ <br /> Addition _ Move Home _ <br /> Remodel/Alteration <br /> PROPOSED WORT((describe in detail): yW t1 00/4042, Amyl r {s 1r <br /> 1 l t s� (AiKok. yume <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ a-L) O( . <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;that the <br /> work will be in conformance with the 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;a.nd that the work will be in accordance with <br /> the approved plan. <br /> APPLICANT'S SIGNATURE: 4,42 DATE: ( -2S oftf <br />