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r CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Date Received: <br /> '1'b��al Fee: $ A ',7, O <br /> Date Approved : <br /> Entered By:- iii Permit n: [ ,94Y2-) <br /> ALL INFORMATION MUST BE SUBMI'TT.ED IN FULL BEFORE PLAN REVIEW WILL BE STAR'rrU <br /> (See Check-off List Enclosed) <br /> Tyr; APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: / 2 S 4_.)1/ , //0-e.`.) ZIP: 5-573-C <br /> l <br /> (work) <br /> NAME OF OWNER: 7//7 - 4 i2.S <(,A., t..- <br /> PHONE: (home) <br /> MAILING ADDRESS: %- //o-c-i--- CITY: /0-''c y /'¢ke ZIP: 5335 <br /> CONTRACTOR: ( <br /> / ''Y /3, / / PHONE: <br /> ,fit/inc/7 e, <br /> MAILING ADDRESS: _i-g72 (—)c--5 7- CI`T'Y: t,1/Ce Tier Siff ZIP: .5.-36, <br /> STATE LICENSE: # 7 '/ S- <br /> ARCHITECT/ENGINEER: /1/0-7A..-!t PHONE: <br /> MAILING ADDRESS: <br /> CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Alteration <br /> eMove <br /> Demo Remodel/Alteration Renovate X <br /> PROPOSED WORK (TiesTibedala <br /> in detail) :Wil <br /> I 0("- (e.fita 1 r- <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ .S1,0 — S C'C C <br /> hereby apply for a building permit and I acknowledge that the informatio <br /> above is complete and accurate; that the work will be in conformance with th <br /> h <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; an. <br /> chat the work will be in acc rdanc Tfaith he approved plan. <br /> APPLICANT'S SIGNATURE: ' . 1/ <br /> '7 DATE: I.L:11 <br />