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r CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: S_______________________ <br /> Date Received: <br /> Date Approved: <br /> Entered By: ,y Permit T: '7O o 4 =- - _ <br /> BEFORE PLAN REVIEW WILL BE SMARTED <br /> AT,T. INFORMATION MUST BE(See Che k FULL <br /> Enclosed) <br /> TBE APPLICANT IS: (circle one) .OWNER or(CONTRACTOR) <br /> ZIP: �� <br /> JOB SITE ADDRESS: `� (work) <br /> e.�` PHONE: (home) }l l ) - 9i88 <br /> ILa� <br /> ';..AME OF OwN�:R: '--- ZIP- cc 5 i <br /> CITY: M� <br /> MAILING ADDRESS: `��'� <br /> � , n � •••-,-.1_ PHONE: it�s �t 1 1 � <br /> CONTRACTOR: • .c�r�i ' �� <br /> S� <br /> u�, ZIP: �� o'"� <br /> MAILING ADDRESS: �31 s� T)��'� � ` CITY: <br /> STATE LICENSE: # Oao `3997 <br /> PHONE: <br /> ARCHITECT/ENGINEER: �*"— <br /> MAILING <br /> CITY:________________ <br /> =LING ADDRESS <br /> REGISTRATION <br /> NAME: <br /> Addition Accessory <br /> Structure Move <br /> Dem <br /> TYPE eWORK: New — Renovate Land Alteration__ <br /> mo Remodel/Alteration ,�- <br /> 1 <br /> PROPOSED WORK (describe in detn?1 ) : ao , <br /> STORIES: 1 SQ. FEET OF EACH FLOOR: <br /> 0 <br /> NO. OF BEDROOMS:. <br /> GARAGE STALLS: ATT. DET. <br /> land) : $ O oc <br /> ESTIMATED CONSTRUCTION VALUATION (excluding I acknowledge that the information <br /> I hereby apply for a building permit <br /> that the work will be in conformance <br /> de;a that ith e <br /> above in iscomplete and accurate; and with the State Building permit; and <br /> understandI <br /> ndianaand codesnof the City <br /> this is not a permit and work is not to start without a p <br /> that the work will be in accordance with `the approved plan_- <br /> APPLICANT'S SIGNATURE: / � / DATE: (rte - z-i - `iS <br /> dir// <br /> - <br /> c 1-- <br /> -r-- <br />