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3Q <br /> Total Fee: $ (,2 Date Received: /Z,?-,;?4) t ) <br /> Entered By: /4/ /" 3 [)((" Permit#: A()I qcf SS' <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 /> ------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OI�CONTRACTORR <br /> JOB SITE ADDRESS: 6170 Wil--1-OW Vl E_W ZIP: 35'3,5--6 <br /> Will this baa Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> I I 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: LAvi 0 1—Y M iJ a-MO PHONE: (home)GI s'.2 1'7 3 -1095 <br /> (work) <br /> MAILING ADDRESS: C770 it.-341 CITY: 012-0t30 ZIP:5.5 ,3S 6 <br /> CONTRACTOR: �./F 3TYt P--EaVe I lotJS PHONE: 7( -3c1 6 o3,.`5 <br /> CONTACT PERSON: Mo._ C4 A4&)L-1-2- MOBILE/PAGER: (fl j z- 2 j -9 7 t 8 <br /> MAILING ADDRESS: /5")--- 4-rti 1.11•1= MO..CITY: ( L./Ai 4[; ZIP: 3-S41-5 <br /> STATE LICENSE: # pc_-?-c.)1-6)-7 fi EXPIRATION DATE: 3 -.3 f -z-oo 6 <br /> ARCHITECT/ENGINEER: c F 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) >C <br /> PROPOSED WORK(describe in detail): P SEM X11 Fi LSE-(- ?1-✓ E kc �-1,5E: <br /> c t F7--6-FA frit t4 1.2-6. 1.1.;- %- 136714/ CP S r-t /�i/Dc/ WO— .3 4/2. <br /> STORIES: SQ.FEET OF EACH FLOOR: /6 8-6 f : /t.1 BSM T <br /> NO. OF BEDROOMS: 0 GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 6-.., d 0 0 <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: . % <br /> IL� DATE: J )-'4---O " QS- <br /> 31 <br />