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FROM : FAX N0. :612331337355555 Aug. 28 2006 11:46AM P1 <br /> �9� Cd���� as <br /> � �'� Total l+ee: $ -� 70 � Date Re�eived: ���8—D� <br /> � Entered I�,y: Permit#�: ,4 /oa.7/ <br /> (" - <br /> CITY OF URONO -BUILDING PEYtMIT A�PLICATION <br /> All information must be submitted in full befure plan rc�;ew will be started. <br /> (��lease ptirix all 7rifor�nalio��) <br /> --------------------....,._________________�.....�_--------------------------�----__��_�-_-----�--------------- <br /> THF.APPLICANT 15: (clrcle�ne) OWNI; OR CONTPIACTOR <br /> �� �'�1�i�9�.� 7IP: <br /> .10B SITE ADDRFSS: ��� ��''gs�� ��3�� <br /> Will this be a Paru.de of Homes,Remodelers Showcase l�iome ux;�ther Display Home7 <br /> ❑ 1!Cy �O !f yes,a.special�vent perm!!!s regulred with Pulice D�partment uncl Clly CourieA upprnval <br /> 60 days prinr tn thc evc:nl. Shu�tle bus�service wlJl be reyi►ired unless upplicun!clr.mur�slrqle,r <br /> su,�J'iciNnt un,slle parking is avpilqble. Nun perrn!!!ed��ien6�w111 nn1 allowed, <br /> , ��G'� �(�v PI�ONE: dia�S ��f,��?sS�� <br /> NAM�UF OWNER: ���• (. omc) <br /> or�1��a !/ — 3�� <br /> MAILING ADDRCSS: ��C�� C�/IS'�;r�y � ��� C.[TX: � - °� .. 2TT: _��,�� <br /> CONTRAC i Olt: ��ll�r- PI�.()NC�� i � �7_������ CE'c-c 1� <br /> CONTACT P�RSON. �E ' MOIiiLE/P�CER: <br /> MAILING ADDR.N:55: C1TY: ! ZIP: <br /> STATE LICE.NS�: # EXPIRATION�DAT�;: <br /> ARCIIITECT/ENGTNEER: � ' PHON.H�: <br /> MaY�.ravc�nnx�ss: � CITY: 71P: <br /> NAME: REGISTRiA,TION: # <br /> TYPE Or WQItK: New I-Tome Additiou .___ � Accesso..ry Stru, ture <br /> �:,,-- ��---� <br /> Move�-Ioz�e T Rem.odel/Alteration(�e: Sidin indows,l� � <br /> Any earth movement may require MCWD r��iew and permital � <br /> / P OPOSED WOR (describe�n�letai�: C�' /�� �%-� �/s��---- � �✓�S �� �� ) <br /> �d-t� �Z� �, s �" �z n� .tJatic.., �s�/�o.,wt-) <br /> STURI E;S: r SQ.FEET O.F.EAC]�1.I+LOOR: 'v4 / <br /> NO. OI+ BEDROOMS:�_ GARAG�S'1'AI.LS: ATTAC `+D DCTACHED ✓ � <br /> ESTIMATED CUNS'rRUCTION VALUATION(excludin�lt�nd�: $ �Oo0. �O <br /> I hcrehy apply for a building permit and 1.aeknowledge thnt tlie infon.�atiorl ab�ve is eomplete and accural'o; <br /> tl�at the work will be in conformanee with the oxdinances and codes of the ICity and with cho 5tatc Iiuilding <br /> Code;tliat I understand this is not a permit and work is npc to stFut 'thout a�permit;and lt�aC 1:he work will be <br /> iii accordance will�lho approved plan. �' <br /> APPLICANI'5 SIGNATURE: �'�R� � '� llATE: � " ° � <br /> 31 <br />