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CITY OF ORONO - BUILDING PERMIT APPLICATION tL <br /> Total Fee: $ Date Received: <br /> Date Approved: <br /> Entered By: Permit#: '3/ r` <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) OWNER o CONTR CCTT B2 <br /> JOB SITE ADDRESS: B3S �I 1\-) AMMe✓L Li•S ZIP: S5-32-3 <br /> (work) <br /> NAME OF OWNER: C N OCK t3 p(� C �- PHONE: (home) `17Z- <br /> MAILING ADDRESS: 83S WI N Q3PA rYlO'L:rL L,J CITY: CY-O j(.) ZIP: SC <br /> CONTRACTOR: E LA l S r LA)AS Q/J Co , PHONE:Cv I Z --SM, SI,1 <br /> MAILING ADDRESS: 7S) C 3t UCIL D2- CITY: C_rIA St/6 ZIP: SS 31 / <br /> STATE LICENSE: # COO `42-a3 <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) : REPLACE (0 OLD f )1fJb1,LLS col/ /J6-1,3, x,u r,i-LL- <br /> B,Pky Oin.)Dft&) 1&J$ IotaIN JOLAfE &X1 ST 1NU ,1,44 <br /> STORIES: SQ. FEET OF EACH FLOOR: 19Z-4) <br /> NO. OF BEDROOMS: - 2 GARAGE STALLS: ATT. X DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 7IL 3 -- <br /> I hereby apply for a building permit and I acknowledge that the information <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; that I <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 /> APPLICANT'S SIGNATURE: 'W""`- '"_ ,t -""- DATE: 7- '/ 1 <br />