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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ 9(J, ,Z.L. Date Received: <br /> Date Approved: <br /> Entered By: ' ,11,44) �,- <br /> Permit#: , <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check—off List Enclosed) <br /> THE APPLICANT IS: (circle one) <br /> I OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: %v�Q W / Id k u K 1 k ` ZIP: csj 3 6 4/ <br /> (work) L/73~fid 2// <br /> NAME OF OWNER: e F PHONE: (home) 534 <br /> MAILING ADDRESS: / (.1) cA vS.. \ CITY: )14 o ZIP: -5- 5- 3 " <br /> CONTRACTOR: Sc C. "1' c o S^t Y C,_c`F ko-• PHONE: /— 33/ / <br /> MAILING ADDRESS: 3? / ' ic) CITY: Yi pJ , ZIP: sj54/6 ; <br /> STATE LICENSE: # <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 Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : /lsec, ) <br /> A- <br /> -7 QJ (C)-Q--/j? <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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: /A' 4' <br />