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Ju1-28-2006 09:DOam From-CITY OF ORONO +9522494616 T-653 P.001/002 F-641 <br /> �G p� <br /> Total Fee: $ J�7 �.� $'Z-J� Aate Received: 8"�� �� <br /> � Entered By: Perrnit#: Do2-/D <br /> ' � <br /> • CIT'Y OF 4RON0 - BUT�..DING PERMTT APPLICATT4N f��� � <br /> .; � ����i�ti� <br /> All information must be submitted in full before plan review will be started. `'��','�,� �,�� <br /> (please pnnt alt inforrnation) . -t� � �� <br /> T�iE APPT.YCANT IS: (crrcle one) 4WNE'lt OR ONTR.A.CTOR <br /> JOB SYTE ADDRESS: �-f 30 GNL"-1�- <�LA-�= 7.YP: �S�G`� <br /> Will t is be a Par�de of T�omes, Remodelers S6owcase Home or other Display Home? <br /> �Yes ❑ No If yes, a special event permit is required with Police Deparrment and City <br /> / ` <br /> Council approva160 days prior to the event. N'on permirted events wi not <br /> be allowed. <br /> NAMEOFOV�'NER: �C.L�� a-N+��-Y Sat—« PHONE: (home) 1���-3�8-�l3�� <br /> (work) <br /> MAILIN�ADDRESS: r�t 3� �-,��� r���= CITY: o�N d �Yp: � <br /> CONTRACTOR: V�uL l� /-foJ�c�S PHOIYE: �°102. �as�- gsoa <br /> C4NTACT PERSON: �� V Q-1 T�w� MOBT�.E/PAGER: <br /> MA.ILING ADDRESS: �(e_�_S G� I,T R� CYTX: O(Lo r.9a ZIP: _ SS 3�?J <br /> STATE LIC�NSE: # a �� 7'-t$o� <br /> ARCHITECT/ENGINEER: PA�L �a4 s�� rxorrE: �l�- asd - �y oa <br /> 1VIAA�ING ADDRESS: !oa G2Prt� P�-��c.� L.x1 CYT'Y: 7�v��3�Y zIP: SS33� <br /> NANT�; REGIST�tATION# <br /> TYPE OF WORIC: New �_ Accessory Structure <br /> Addition Move <br /> RemodeUAlteration Land Alteration <br /> PROPOSED WORK(describe in detai�: <br /> S'rORIES: �- SQ. FEET OF EACH FLOOR: <br /> I�IO. OF BEnitOOMS: � CARAGE STALLS: ATT.�^ DET. Z� <br /> ESTIMATED CONSTI2YJCTION VAI.UATIOI� (excluding land): S S�S �v <br /> I hereby apply for a building permit aad I aclrnowledge that the information above is eomplete and accurate;that the <br /> work will be in conformance with the ordinanees and codes of the City and with the State Building Code; that I <br /> tu�dcrstand this is not a pc�znit snd work is not to start v� thout a permit;and that the work will be in accordance with <br /> the approved plan. <br /> APPYrXCANT'S STGNATURE: DATE: � ��—�'�' <br />