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CITY OF ORONO - BUILDING PERMIT APPLICATION <br />Total Fee: $ Db Date Received: i <br />Entered By: <br />Date Approved: <br />[ 5 <br />Permit 1QL55 <br />ALL INFORMATION MOST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STA MW <br />------------------------------------------------------------------------------- <br />TEE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br />JM SITE ADDRESS= 4o4Ei� <br />NAM OF OWNER: & R.!'re-HEJ 05G rt <br />MAILING ADDRESS: 45 ff4j J0A'-f- Co�.+J CITY: ORNO <br />(work) <br />PooNE: ( home) 913- (09,91 <br />CONTRACTOR: 0V\WJ(-(-J`JZ 60?-P. PHONE: <br />[MAILING ADDRESS: 1v Z S- MVP u-UP . CITY: <br />ED 4"/P• <br />ZIP: <br />eat- Z224 <br />ZIP: t;SI357 <br />TYPE OF WORK: New Addition Accessory Structure Novo <br />Demo Remodel/Alteration Renovate Land gyration-7 <br />PROPOSED WORK (describe in detail): 5MP-P 0%4 �x'�s�i..l(e PN1LTMa4ATErerJr` <br />F110% 'A (AV*TiDJ - To A�Efor Ai-&V, qw 0&a^11e,t /AoO6q- � T �� <br />SIM28:SQ. FEET OF EACH FLOOR: <br />20. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br />EB'PZlIATED CONSTRUCTION VALUATION (excluding land): $ <br />I hereby apply for a building permit and I acknowledge that the informatio: <br />above is complete and accurate; that the work will be in conformance with th. <br />ordinances and codes of the City and with the State Building Code; that : <br />understand this is not a permit and work is not to start without a permit; an( <br />that the work will be in accordance with the approved plan. <br />APPLICANT'S SIGNATURE:": 5 �J, z DATE: 1 - 30` %o <br />(Pleas;-filf out the reverse side of this form) <br />