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Total Fee: $ _ - Date Received: di�nw <br /> . S <br /> Entered By: i L E) 4\(\'0 ! Permit#: iqO 5 cj <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) ( OWNER R CONTRACTOR <br /> JOB SITE ADDRESS: 12-�o W 11�-H-1 OSi TPA L, ZIP: 5.5 3C`�- <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes 17I'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-permittedallowed. <br /> /' events will not be <br /> NAME OF OWNER: A\11 L7 '\J E 1 PHONE: (home)'(52-/"471'7772, <br /> �H=. (work) 6tt 232 SS3� <br /> MAILING ADDRESS: CITY:c -zHo ZIP: 536'- <br /> CONTRACTOR: TOM M I-4-(M E-1-1J i NQ T(-1-IS6 5DPHONE: 612/3oo -22-5C <br /> CONTACT PERSON: TOtt Ml H MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: / <br /> ARCHITECT/ENGINEER: 1� � � PHONE: 612/ 33Z." <br /> MAILING ADDRESS: 53o -1• 3"g-- CITY: /4LMMyoPooi SZIP: SS*4 <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home emodlteration <br /> PROPOSED WORK(describe in detail): {��r1or-Y&L. 3 r-OO(' S <br /> ANS Mo )=. J4F04 61 7 (DcbT(c?,_D <br /> STORIES: 2 SQ.FEET OF EACH FLOOR:-21,900 TC 1Z <br /> NO. OF BEDROOMS: 5 GARAGE STALLS: ATTACHED 3 DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ *15pj 000 <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 SIGNATURE: =� P ATE: a o S <br /> 31 <br />