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� C?TY 0��' ORONO - BIIILDING PERMZT APPLICATION <br /> � Date Received: � �" � " y y <br /> Tota)_ Fee: $ <br /> Date Approved: <br /> Entered By: -�^'�� f��7y �- <br /> Permit tt: <br /> AT.T• INFORMATION MDST BS SIIBMITTED IN FULL BEFORE PLAN REZ7IEW WIZS� B$ STARTED <br /> (See Check-off List Enclosed) <br /> -------------------------- <br /> TgE APPLICANT IS: ( circl.e one) OS�ER or CONTRACTOR <br /> JOB SITE ADDRSSS: /3 S�� ����'� /� D S- ZIP: S -�3�3 <br /> (work) <br /> NAME OF OWNER: C / o � v PHONE: (home) <br /> MAILING ADDRESS: �0 �bX L � CITY:G�1��8�/ ZIP: 5 s�3 z3 <br /> CONTRACTOR: S/f�' p$��� <br /> IKAII�ING ADDRESS: .S'/�/- CITY: ZIP: <br /> STATE LICENSE: n ��•�� <br /> _ PHONE: <br /> ARCHITECT/ENGINEER: <br /> MAILING ADDRESS: <br /> CITYs ZIP: <br /> NAME- REGISTRATION n <br /> TYPE OF WORR: �iew Addition Accessory Structure <br /> rlove <br /> Demo Remodel/Alteration Renovate Land Alteration�_ <br /> PROPOSED WOI2R (describe in detail) :_ /',�����-� � 6 o x iz_o � ��-����`�j <br /> ir�-e-� <br /> STORIES: SQ. FEET OF EACH FLOOR.s <br /> NO. OF BEDROOMS: GARAGE STAI.Z.S: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALIIATION (ezcluding land) : $ <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 �n71thathI <br /> ordinances and codes of the City and with the State Building �°eZmit; and <br /> understand this is not a permit and work is not to start without a p <br /> that the work will be in accordance with the approved plan. <br /> / l / � / <br /> APPLICANT'S SZGNATDI2E: QG✓�rn �/�}--Gr���'':`y''� DATE: / / y`� <br />