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Total Fee: $ ,� Date Received: �l- Z`�-v� <br /> Entered By: Permit#: A ! t��9 <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 /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> � -� '-_l <br /> JOB SITE ADDRESS: �"�> . '��� � ��S�(� ��l �C ZIP: `� I � <br /> Will this be a P�fade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ YeS �NO If yes, a special event permi!is required with Police Department and Ciry Council approval <br /> 60 days pria�to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> suff cient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER `(j`���� C�^i�'�U,,Y�l�9 �!�' "�HONE: (home .5 v�- � 7� -7� �/ <br /> �'n (work)`f5.�1-�3`f� -/) `F a <br /> MAILING ADDRESS: ��e�}�Scc:u �r CITY:� • �c� ZIP: ,5.5,�l <br /> .. `T� <br /> CONTRACTOR: N` f-{ (�' � PHONE:`1.S;;i � `i�6 `{ - K�� I <br /> CONTACT PERSON: � � ,,L;ct n 5 0 ,-� MOBILE/PAGER: y,5;;�- �f �5� ' ��(k I <br /> MAILING ADDRESS: 7,v` � Lr.�c� �f� '��' d CITY: (,�;c��-�����c,�� ZIP: ,��- � � r� (" <br /> STATE LICENSE: # v EXPIRATION DA'TE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home �mode Alteration (ie: Siding, Windows) � L �, J'1 <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detai�: ���rn v c� � �� �- �� � <br /> STORIES: r SQ.FEET OF EACH FLOOR: � �G G <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED <br /> � — <br /> � � <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �(�, �� <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 permit and work is not to start without a permit;and that the work wili be <br /> in accordance with the approved plan:" -\ ---� , �� � <br /> ; ! �✓���_:, I l <br /> APPLICANT'S SIGNATURE. ` Ct�%�L�� ��� U o� `� � � <br /> ATE: �f <br /> , <br /> f' <br /> 31 <br />