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s <br /> Total Fee: $ J Date Received: 7 Z( �D <br /> Entered By: (94,;(._ ,)j/ /-- Permit#: /%) q53� <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) OWNER ORLCONTRACTO� <br /> JOB SITE ADDRESS: /O 5 0 W//f t v/z' dr. ZIP: -05-3 <br /> S ( <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑Yes Ni 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: v s N i c lel o PHONE: (home) N/* (I/2" 339 ' <br /> q t Z► <br /> (work) M,µ <br /> MAILING ADDRESS: S jrtiY a s 4 .he v CITY: ZIP: <br /> CONTRACTOR: A-USkc.r K Ski u c.4-c e n PHONE:fic <br /> CONTACT PERSON: . 1„Q w Lw/ZS C& MOBILE/PAGER: <br /> MAILING ADDRESS: QY01 /3""t_') 4*80 CITY: Q(,aclyn P o.qk ZIP: S's 28 <br /> STATE LICENSE: # 3 2.Y-7 EXPIRATION DATE: A✓/n. <br /> ARCHITECT/ENGINEER: /MI- 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 /> PROPOSED WORK(describe in detail):, r, k b a lew►,cr►1. <br /> STORIES: 3 SQ.FEET OF EACH FLOOR: 2 00 E a i. <br /> NO. OF BEDROOMS: Y GARAGE STALLS: ATTACHED 7- DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 2.1 a a 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: 3hDATE: 1/14/a5 <br /> 31 <br />