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Total Fee: $ Date Received: <br /> 'q-17L2 <br /> " (ff <br /> Entered By: Permit#: 0 <br /> A /-? aqi 3 <br /> CITY OF ORONO - 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) OWN�R OR CONTRACTOR <br /> JOB SITE ADDRESS: ( � �-� ("j y'r �t.e�� � ZIP: S3 <br /> i <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ,n 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: C � "� CT PHONE: (home) ��� �3 r'� '6 b <br /> (work) /)'/ z —,R"5'7 72 <br /> MAILING ADDRESS: 1165' W j­d)^eY- CITY• Yin G ZIP• �3 <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure X <br /> Move Home Remodel/Alteration (ie: Siding,Windows) <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detail): p(a vu <br /> STORIES: SQ.FEET OF EACH FLOOR: a v — ch S`17 u�' <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 'v I cn <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 approved plan. /� <br /> APPLICANT'S SIGNATURE: CGv DATE: �/ Z /`J !J <br /> 31 <br />