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� ' <br /> t C=2*y pg ORONO - BIIIZDING PER�-IT APPLIC�TSON <br /> - . Dat� Received: <br /> Total Fee: $ �G���� - <br /> Date A�oroved: � <br /> ,� � <br /> Entered Bv: /'� Per_nit� �5 - _= <br /> TION MIIST B$ SDBMITTED IN PLTLL BEFORE PLAN RE�7IEW W�� B$ SgARTED <br /> AT.T• INF�RM� ($eo Check-aff List Enclosed? <br /> circle one) O��ER or CONTQACTOR <br /> T� p,PPLICANT I5: � ,� <br /> • - � C �; -, '�- �' � <br /> ZZP: <br /> JOB SITE A�DRSSS: (work) <br /> � PHONE: (home)�7�-/„ 7 7/ <br /> N� OF Owrr�t: Or ''1 / <br /> cITY: � �,���r,.F, zIP: JJ 3�� <br /> 2�..ASZ�ING ADDRESS: O� ��`' ` ��� , <br /> , . PHorrE= �7��- ��1 � <br /> CONTRACTOR: � J �ik ��,1 ���c <br /> CITY: lVa �i����'��cf��� ZSP: SS �/7 <br /> HA.II,ING ADDRESS: <br /> ! -,•-,�� ni _ �'/ ..:r�i �� �F- � <br /> STATE LIG.�.C..�NSE: T <br /> PHONE: <br /> ARCHZTECT/FNGINEER: ZIP: <br /> CITY: <br /> MATLING ADDRESS: <br /> R.EGSSTRATION � <br /> N�- <br /> Additian Accessory <br /> Structsre Move � <br /> �,.Y�,E �g Wpgg: New Renovate Land Alteration <br /> D�o Re_*nodel/Alteration <br /> � c� r�,�_�,; Dd r „�q <br /> PROPoS� WORR (describe in detail) = <br /> x���, � ��-�c� ! <br /> STORIES: S4- FEET aF EBCH FLOORz <br /> ��� STAT•T.S: ATT. DET. _ <br /> NO_ OF BEDROOMS: <br /> � I.and) : $ �.-� C`.�_, `=- <br /> ESTSMATED CANSTRIICTION VALUATSON (eaclndinq e that the inf o�ation <br /> I hereby anplY for a buildinq permit and I acknow7.ed�J <br /> - that the work wi 1 I be in conf o�C de�'' th th= <br /> above is complete and accurate, and With the State Building e�it; and <br /> ordinances and codes of the City <br /> understand this is not a perniit and work is not to start without a P <br /> that the wor]c wil.l be in accordance with the aporoved plan.- _ • <br /> '� / � '�( �� %'� �r DATE:?-�_./�----- <br /> �'�` �_��l.y /� '���/ <br /> APPLIC�NT'S SIGNATQRE: ��� . <br />