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VDate <br /> ^,nTotal Fee: $�7, �.� s ��/ Received: /o /� / ��Entered By: rmit#: 41 n1910 <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All inilbrmation must be submitted in full before plan review will be started. <br /> lease print all information) <br /> -------------------------------------------------—------------ ----------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OROCONTRACTOR <br /> JOB SITE ADDRESS: Ilk? ZIP: s�' 39 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes Q 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:rkz v.. PHONE: (home) cls Z y 1 X11 w 39 <br /> (work) <br /> MAILING ADDRESS: k to CITY: ZIP: <br /> CONTRACTOR: PHONE: L,-S-1 '?b Q- Le(vu <br /> CONTACT PERSON: Wt,-Lq_er,_ MOBILE/FA-GE2: (_ol2. B(.,6 <br /> MAILING ADDRESS: CITY: S;. rtZIP: SS'i Ztv <br /> STATE LICENSE: # 999 9 EXPIRATION DATE: 9,31 -00 <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):'_ c►-ji- FI►�y�i i <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ tP3,0"-1 <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: ('`' DATE: I Z`{ -G L" <br /> 31 <br />