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CITY OF ORONO AUI`i,DING PERMIT APPLICATION <br /> Total Fee: $ Date Received: <br /> Date Approved: <br /> Entered By: -off Permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> --- <br /> -------------------------------- <br /> ------------ <br /> THE APPLICANT IS: ( circle one) or CONTRACTOR <br /> JOB SITE ADDRESS: �100 ZIP: SS3 s <br /> Ive, <br /> NAME OF OWNER: ,4 xLl � Y S, N e-� s� /PHONE: (home) <br /> MAILING ADDRESS: 4/0 d <br /> I.v, 0 ,4" D r• Sv CITY: �o,�. .,L lT ZIP: <br /> CONTRACTOR: 0 WAIS 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 Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : e- v <br /> s <br /> I <br /> STORIES: f �- SQ. FEET OF EACH FLOOR: 5 7a `;� <br /> 7 <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ le-k' `� J -- <br /> I hereby apply for a building permit and I acknowledge that the informatior, <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; <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 /> DATE: �- <br /> APPLICANT'S SIGNATORE: J /9- 9 <br />