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•• CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ / _ (1-5 Date Received: / '7- <br /> Date Approved: <br /> Entered By: 'yA Permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circleone)11 (OWNER or CONTRACTOR p. I <br /> JOB SITE ADDRESS: c;\ © O rr W 0 0 0 k i I �?�� ZIP: S-5 3 l l <br /> (work) (-/ 73 -5 67// <br /> NAME OF OWNER: LOO (DVV\\\ CC)U "A rt c i IA D PHONE: (home) Y 7 S'-/ 7.5`1 <br /> ADDRESS: a a C7 CO . h.; 11 I2 CITY: U../ 2 o A ( I C ZIP: ss.3 9 <br /> MAILING Q <br /> / <br /> CONTRACTOR: C �G-�I U 'e 9U I I DE'2 S PHONE: (173- 3 6 .r 3 <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition V Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : ni c 103.e �`� GJe R 6 e ioC4J <br /> _ - ,vN1 i! ? 31 - j C 11 <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> • / oci <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 6T, b d O <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: DATE: 9\ 7 9 Y <br />