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� i�_�S- <br /> D� <br /> � <br /> 1 ' ` `I �/�-� <br /> Total Fee: $ �88y- �9 Date Received: ` f�` <br /> Entered By: Permit#: /(� � � 7 C <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please pr•int all information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: �� LI S CQ,'��C� �j�,,�� ZIP: _ S ��� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ No If yes, a special event permit is reqa�irect tivith Police Depai�tr��ent and Ciry Council c�pproval <br /> 60 days pr�ior to the eve�7t. Shtrttle btrs ser•vice wrll be rega�ired 2cnless applicant demonsb�ates <br /> su�cient on-site parking is available. Non-permitted events will not be allowed. <br /> NAME OF OWNER:��O�13 `l t�(S fi2 r� /V I e I S�Y� PHONE: (home) <br /> /t"� (wo►•k) <br /> MAILINGADDRESS: ��LI 5 �-c(✓I'yt,fivt �G� CITY: �✓Gt�/{ ZIP: SS� 3.3 I <br /> CONTRACTOR: ' / PHONE: 9 sa. Gi�y 7��� <br /> CONTACT PERSON: Ja��In � MOBILE/PAGER:Sq,,.v6, �1 2 • $lDU.d6�Il <br /> MAILING ADDRESS: �3 � a"t �r{e CITY: C XLQ�,�►a r ZIP: sS'33 ► <br /> STA'TE LICENSE: # �,G EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: ���(,r✓� �{Y1o�11� PHONE: c/7G�• -]1 Z ( � I oZ, <br /> � MAILING ADDRESS: �-�- CITY: ZIP: <br /> � NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration � <br /> PROPOSED WORK(�lescribe in detain: /�d��;(/( �� ��') C.� G�c1z-� <br /> . !� fi, <br /> j � ' �.��5 <br /> � `ra/'�s�c-� � <br /> s�o��Es: I s�.�E��r oF��cx��,00�: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTAC�-IEl) I3ET'ACHED <br /> EST'I10'IAT�I)CONS�'RUCTION VAL,UAT'ION(excluding lanci): � ��d _ Q � U <br /> I hereby apply for a building permit and I acknowled�e that the information above is complete and accurate; <br /> that the work wil I be in conformance with the ordinances and codes of the City and with the State Bui lding <br /> Code;that I understand this is not a permit 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: ATE: ld . �� .�j � <br /> 31 <br />