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1 <br /> Total Fee: $ r78�- -7 5 Date Received: I/A-&,1,2 8/ <br /> Entered By: Permit#: o207J 8' — <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 /> ----------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR <br /> JOB SITE ADDRESS: M015 ID S-' Vjs)y'\6YVW'r2 Q.d ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ 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: Y l AE O NC1 PHONE: (home) <br /> (work) <br /> MAILINGADDRESS: �� Q5 �WYNAYY\'A/2 CITY: p(20Njo ZIP: <br /> CONTRACTOR: �.k PHONE: -7 1o3-a3i-T?17 <br /> CONTACT PERSON: MOBILE/PAGER: 76:3 - a?-k-7 71-7 <br /> MAILING ADDRESS: P O f30k 104+ CITY: A(.['���VILQ- ZIP: J12- -36) <br /> STATE LICENSE: # 2 0 5 Ylo q Zct EXPIRATION DATE: -1 O 9 <br /> ARCHITECT/ENGINEER: 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 /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detail): Re-- (Zc>o 1= <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> — <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ CPO j ()OO OG <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 wo not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: - DATE: 2-( Z&CS <br /> 31 <br />