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Total Fee: $ 157.2.6- Date Received: I o-a -D 7 <br /> Entered By: 4"1 Permit#: P l/5/q <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 /> THE APPLICANT IS: (circle one) OWNER OR ONTAACTO <br /> JOB SITE ADDRESS: V6 0 0 Id L,onj lrikC k C) ZIP: 1c-S- 3 O3 <br /> Will this be a P rade of Homes,Remodelers Showcase Home or other Display Home? <br /> n 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 he allowed <br /> NAME OF OWNER: Al Q r /Yl PHONE: (home)(93-x) C/73— / (J ci <br /> (work) <br /> MAILING ADDRESS: 4/60 Old 1on5 Ickt 'itl CITY: _ Q r on 0 ZIP: s ,3,9k3 <br /> CONTRACTOR: &i G Ls))0+ EX71`, PHONE: (763) 6 33--,56 614 <br /> CONTACT PERSON: /Wee, M G 6t» •ig a n MOBILE/PAGER:eta l d) 36 9-33 y3 <br /> MAILING ADDRESS: 5Q3 �'u s,lc6 on ►rc, SL IOy CITY: GI e k;fr er- ZIP: 5-.5-330 <br /> STATE LICENSE: # 02 o V 6 b' S 3 EXPIRATION DATE: $/3/JO le <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 /> PROPOSED WORK(describe indet l): 'et%►r o- Le-Jar` 5{►rk4 roo•c al/1a <br /> rein/i;tL t,✓1d-/i Asv .sA:iVeS <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 100 MO <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 pennit 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: `y� <br /> .. C�� i DATE: 10 'J-0 <br /> 31 <br /> tiiti :a6pd 9T9761722S61:01 :woJJ Sb:00 L002-172-AeW <br />