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Total Fee: $ ( ' II , ( A Date Received: -,24-( � <br /> Entered By: $?/ L Permit#: ,A vg 10GI <br /> ' CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> ti <br /> \``i J, All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNE ' OR CONTRACTOR <br /> JOB SITE ADDRESS: [00 I , L51 T( 1i L, ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ' <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 be allowed <br /> NAME OF OWNER: 1042 P2.1 ( 1 f N(, PHONE: (home) <br /> (wo <br /> MAILING ADDRESS: (DZ7- IN< (j7 Sl• CITY: &kl (5K4 ZIP: Z,/Z,2-(4S— <br /> MAILING <br /> CONTRACTOR: (O 1P Q.I N L:71 SJ C. , PHONE: <br /> CONTACT PERSON: It 12 EN W N) MOBILE/PAGER:9C7Z'2a 2 24 <br /> MAILING ADDRESS: Sp 7 Z Ut< kwj S'(, CITY:Ckf t451C- ZIP: 5 (9) <br /> STATE LICENSE: # 20 2 77201 EXPIRATION DATE: sj [/0 ko <br /> ARCHITECT/ENGINEER: b1 P i'+-�>+�Nls.,+(� �C-5� �, LLL PHONE: 7 ; -3z 7u2_:_e2c2cLei <br /> MAILING ADDRESS: 9 i00 TA i T!M 012‘ f, IVf CITY: L (W F ZIP: j4c1 <br /> NAME: -ism( REGISTRATION: # <br /> TYPE OF WORK: New x Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): bt)i LIMN( GJ1N t frrMl L'{ }-tut(E <br /> STORIES: 2_ SQ.FEET OF EACH FLOOR: I<'I= 2+4 04 2° <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED 3 DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 0d 1000 <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 SIGNATU DATE: 81,4x- <br /> 31 <br /> 1,4 -31 <br />