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Total Fee: $ �'`j-Q � Date Received: �'=`� �f� <br /> Entered�By: !�- Permit#: //���`f <br /> CITY OF RONO - BLTII.DING PERNIIT APPLICATION <br /> All information must be submitted in full before plan re�iew will be started. <br /> (please print all information) <br /> THE APPLICAI�"T IS: (circle one) �OWNER QR CONTRACTOR <br /> JOB SIT'E ADDRESS: :���-�-'� �l� ���C� r 1 � ZIP: �� ��� � <br /> C-. <br /> NA1�IE OF OtiVi\'ER����v`�t��t'll'1� ��`�-��r��PHONE: ome) � ' ��� <br /> (work) � _. ,. .�-- <br /> �IAII..PtG ADDP�ESS:,-���-�-� �C�LSC v�-- CITY: �.—X� Z� IP: ���� I <br /> CON'TR.ACTOR: �������-���`{' `����" �� � �-� PHONE: <br /> COi�1'I'ACT PERSON: MOBILE/PAGER: <br /> MAII�I�'G ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGItii TEER: PHO�tE: <br /> i�ZAILING ADDRESS: CITY: ZIP: <br /> �Jp,ME; REGISTRATION# <br /> TYPE OF WORK: New �ddition Accessory Structure <br /> Move �Remode Alteration ��< _ Land Alteration <br /> �_.__� <br /> PROPOSED`VORK(describe in detain: �e-����- `� ��`��C'� C��U`'r��-� <br /> STORIES: SQ.FEE'���'EACH F�QQR: <br /> NO. OF BEDROOMS: �AR.AGE STALLS: ATT. DET. � <br /> �.__ __ <br /> _ ___ <br /> � L:'_"..�:\ � �J�, <br /> ESTI1-i IATED CONSTRUCTION VALUATION (excluding land): � �-�, ��-�-' � <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Buildin� Code; that I understand this is not a pernut and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICAitiT'S SIGNATUREF�=�. ��_�:� �_�\�-`�.=��. DATE: `� '''F C" � <br /> . <br /> NOTE! Par d H m events re �re separate permit approval by Police Department and <br /> S <br /> City Counci160 days prior to the event. Non permiited events will not be allowed. <br />