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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ /51 Sv Date Received: <br /> Date Approved: <br /> Entered By: <br /> Permit#: <7/2Y/ <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> 'riiif APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: 3 0 C lief e) 1-)1 a CC U► c; ,c) /Ut Ai ZIP: S 5` <br /> S <br /> (work)433� ' `, 779 <br /> NAME OF OWNER: 5V 5 ct h rn ca V C S v rY 1 e-L1 PHONE: (home) L-f? /- 3 S 3 <br /> MAILING ADDRESS: 13 2)o C tri e C{) (G ck- CITY: Or",'n o ZIP: 5S 3 6, <br /> CONTRACTOR: T. ( 13 r PHONE: V-7 ( - tyo S 3 <br /> MAILING ADDRESS: (330 e rt � I c CITY: C'Yu,z a ZIP: C S <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure '( Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : AJ.6i rye 5 k to) Li. S <br /> 0\%%?-1- 10-1. o-i j ,�. � u-L4 c_- <br /> STORIES: ( SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 2 5 ° •` r u =' I to Li. (u t <br /> ( //o.c <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: SA/ <br /> LiJ DATE: lat ( cA <br />