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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ /(00 . <br /> ) IC Date Received: 2- /.5- <br /> � <br /> Date Approved: <br /> Entered By: permit#: 6904-(01 <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 • CONTRACTOR <br /> 01-86 ' 11 <br /> JOB SITE ADDRESS:' . �� �'(` "� LH Q ZIP: <br /> (work) <br /> NAME <br /> NAME OF OWNER: JIe44 C nri lt,[I`1 PHONE: (home) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: U C '`� ' 1 �' 111 �' s PHONE: t/ 7 5-- O 1 18 <br /> MAILING ADDRESS: f (0 Cfs. •✓Zs0..j L,301 CITY: (A,) -I,7"-Ad ZIP: (J 3 9 1 <br /> `J <br /> STATE LICENSE: # 48 n <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: <br /> �� CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New )( Addition Accessory Structure clove <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : c_ <br /> STORIES: SQ. FEET OF EACH FLOOR: 3 4 "1 4 j 1 d t" <br /> NO. OF BEDROOMS: .4 GARAGE STALLS: ATT. 7t DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ (,,cCo no <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 accor ance with the approved plan. <br /> APPLICANT'S SIGNATURE: 1L.��, <br /> DATE: 7)i JET <br />