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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ /T17-17/5 <br /> Date Received: /(1/4/41e/e/ <br /> Date Approved: <br /> Entered By: A permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> TUE APPLICANT IS: (circle one) <br /> OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: a(v0 ) W i 4-� ���`- ZIP: Sc3/ <br /> (work 7S° `0,21t� <br /> NAME OF OWNER:-Do� © PHONE: (home) y-72- -y// s/ <br /> MAILING ADDRESS: AL a I .,v - �� "^ CITY: O Jvr.-- -' ZIP: <br /> CONTRACTOR: l a y < 9)1 'L�^ -- "' - PHONE: 4/73.- <br /> U /� 1 <br /> MAILING ADDRESS: 31 S3 T11 tr CITY: Xfir.m.--e, ZIP: SS �`1 <br /> STATE LICENSE: # V-01 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration y Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : <br /> STORIES: SQ. FEET OF EACH FLOOR: Z 5 0 v <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. / DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ C4S o0 . co <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: _ DATE: /047 79 <br />