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1 r <br /> Total Fee: $ :3(), 0 Date Received: /O� O Ca <br /> Entered By: ., Permit#: p/0,) )9 <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) @--71 --DEIU.)R CONTRACTOR <br /> JOB SITE ADDRESS: If 25 `/c)j LLoriD D1i2 . _/ ZIP: 5 ';3 Se <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> _ Yes ❑ No If yes, 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: L,01' 1-u wt /D.e() 5 fi PHONE: (home) C-j S 7y 5 t-190 7 <br /> (work) c _A a(/ '-/l'Lac,/ <br /> MAILING ADDRESS: \ 11 Ota I)2.j CITY: LootV Lake_ ZIP: 55356, <br /> CONTRACTOR: =c�;r ' PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detail): t^v,e\ooc f c,4 e c & .c tc tic -rc(5 ly <br /> C <br /> 0C-5S-V'S S \st s) Co0A- < 5 A c-Q Ake n) <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 00 <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 of to start w. out a permit;and that the work will be <br /> in accordance with the approved plan. ; <br /> APPLICANT'S SIGNATURE: / •� DATE: /0/17/66'7 <br />