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M CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ /'57, ,�'.- Date Received: <br /> Date Approved: <br /> Entered By: 'Ci,) <br /> Permit#: 4)76,3 <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) ' or CONTRACTOR <br /> JOB SITE ADDRESS: .3--;',1C V �2//% ��' 4/ ZIP: •� S 5 <br /> (work) .C5'% 7-3/22 <br /> NAME OF OWNER: Ys�z ' ��!'-�% It.-,y PHONE: (home) 7 ‘%2';( ' <br /> MAILING ADDRESS: .3-2.� CITY: l�.. 2.14ZIP: S= " <br /> CONTRACTOR: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure_ 1 Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : <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:/-2-- / %j,-,L <br />