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Total Fee: $ Date Received: 7—ZO "O-� <br /> Entered By: Permit#: OBq$Z... <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: �ZPj �N,�1U� C�25G �'. ZIP: 55� 1� <br /> Will this be� P�rade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes }�NO If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> suf�cient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: ��I'(� ]��.�f V PHONE: (home) �SZ-`{��O' ��i��o <br /> (work) <br /> MAILING ADDRESS: (Z� Gk�I Y�,�,a� fJR, cITY: c�on,o zIP: ��J <br /> CONTRACTOR: C HA�(,E� A(LE l� T�ES PHONE: �C� 3'S�- S`l�� <br /> CONTACTPERSON: ��� ��Nrap�r7�. MOBILE/PAGER: _C�12- �,yS- 5 ZQ� <br /> MAILING ADDRESS: 23Zp �u�Nwa�d vu. �J. CITY: �(�rndv'M� ZIP: �� <br /> STATE LICENSE: # S�� 20 Z�f.p�(� EXPIRATION DATE: 3�3/�Z 00� <br /> ARCHITECT/ENGINEER: C/1QCC��ipORF� PHONE: CaI Z• ��5�•SZ� <br /> MAILINGADDRESS: 23Z0 QVlNwooO Cn1 N CITY: PcXrnocfiN ZIP: �� <br /> NAME: REGISTRATION: # �$�¢Z <br /> TYPE OF WORK: New Addition X Accessory Structure <br /> Move Home Remodel/Alteration � <br /> PROPOSED WORK(describe in detain: � ��( �rQq�? �1d(�,������ ���lrt� <br /> i �i� � <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �p�jy g(�Q. � <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 ardinances 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 will be <br /> in accordance withthe approved plan. <br /> APPLICANT'S SIGNATURE: ` DATE: 7��� O�_ <br /> i <br /> 31 <br />