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‘P.12' <br /> Total Fee: $ Ili(0,) 15 Date Received: b - /3- D 7 <br /> Entered By: CJ' Permit#: Am// -I <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 ONTRACTOR <br /> JOB SITE ADDRESS: I zco et:NDLv`, JOt ZIP: SSS 39 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> nYes rNo Ifyes, 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: atkilA AN►t3�jtD PHONE: (home) 9 5Z 413-i l l'4 <br /> (work) <br /> MAILING ADDRESS: I LSO �1.t.5 CITY: OZOIVID ZIP: SS ( <br /> JG <br /> CONTRACTOR: -.I. :,, PHONE: qsz -O <br /> CONTACT PERSON: ( <br /> t."-- <br /> MOBILE/PAGER:..(pt L. Vat-SS:1 p <br /> MAILING ADDRESS: 71 .O.TzeK, 7e`'E CITY: Eat c t ZIP: Ste( <br /> STATE LICENSE: # SCS'? EXPIRATION DATE: m L 7.0091 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home -emo e el/A tera 10 i.: Siding, Windows) <br /> Any earth moveme -.. re MCWD review and permits! <br /> PROPOSED WORK(describe in detail): LC Co futtlisto rnititu tboat�'s I �oF <br /> IN.)10 a meds. \ L 4 LA.00o Pi Ce 't"c <br /> Co4k�. <br /> STORIES: ( SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED DETACHED O <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 1 aot00 • <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 approve. : . . <br /> 011 <br /> APPLICANT'S SIGNATURE: N4 i;_ *_ etS DATE: ___(41(a_____ <br /> 31 <br />