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APPLICATION FOR WILDING (ALTERATI(N F, ADMIT1JN) PERMIT <br />VILLAGE: OF ORONO <br />Owne r' s Name � &'-4 flu i 1 de r' s Name�- <br />Address G ,�i,ti? ' _ Address <br />Phone _ - - -- - -_-- ` Phone / �- �� j/ <br />Lot Block Addition_ - <br />Location of Lot: Corner Lot _ Inside Lot Lakeshore Lot <br />Lot Dimensions: Front hear Side Area <br />Structure Setbacks: Front 'i;, ' Rear Side Lakeshore <br />We elands: Yes No Area if any <br />Special Provisions: Variance: Yes �_ 'Vo — Type: `-���• hn(-r-M-, <br />Date Approved <br />Lot Changes: Split Comb. D-v. Date <br />Applicant attach to this form two Certificate of Survey of lot and proposed building <br />location drawn on these surveys. Also attach two sets of building plans. <br />Plan check and site inspection before permit is issued. Residential - 2 days, Com- <br />mercial and Industrial - 2 weeks. flan Check Fee must be submitted with application. <br />Plan Check Fee - Residential 50% Building Permit Fee <br />Commercial f, Industrial - 65; Building Permit Fee <br />Description of Building: <br />To be used as: <br />Dimensions. Front _ _ Depth y'�� i height <br />Sq. Ft. 5 Y Cu. Ft. <br />Front Depth height <br />Sq. Ft. _ Cu. Ft. <br />T of Constriction � • c_.. <br />)'Pe (.st lthated "oct <br />Estimated Completion Date: 1 / <br />IM urAersil ned hereby makes application for a building; Hermit for the worm a- herein <br />Op cified, agreeing to do all work in strict accordance with the ordinances of the <br />Vi11W of Orono and nil inns of the State Department of Building end herehv declares <br />that all facts and rep resent.jt ions stated in th i q alip l i,.-at ion are• t nu and orrr� t . <br />