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a-= ���TY OF ORONO � 6124730510 09/24/96 14:00 [� :02/03 N0:522 <br /> �a�� F�� a Date Received: <br /> � Entered Hy: Permit�+: <br /> CITY �F ORONO - BUILDING PERMIT APPLICATION <br /> Al� ir�formadon must be submitted in full before plan review will be started. <br /> � �, (please print all i�'ormation) <br /> • _.�----------=----------------------------------------------------------r_- ��------------------------ <br /> THE APPLICANT IS: (cirele one) O�TER OR ONTRACTOR <br /> ro� sY�Annx�ss: I a� '��t�c�ocl.�� zrn: ��3SLo �'� <br /> �, NAME OF OWNER: `(��n��- l�;1\;c�y�� PI�4NE: (home) �S''01.a49 0�� <br /> (work) <br /> NiAILING ADBRESS: �'1� CITY: Occm� ZIP: '� <br /> ' �,e�,e,wa\ B� ��.e��x� , <br /> corrr�cTaR: �5� -�-3�� ��.�,�. �' � <br /> CONTACTPERSON: s�.;d1,�.���� s��3� t: <br /> � � 1�IAILING ADDIiF.SS: «6 a� s�2•����- ZIP: <br /> ��fiA1'E LICENSE: � � `'c�"s, � ao t 3oi'�3 <br /> . ABCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: C�'1'Y: ZIP: <br /> NAME: REGISTRATIUN� <br /> TYPE OF WORK: New Addition Accessory Savetura <br /> Move Remodel/Alteratian X Land Alceration <br /> PR4POSED��I�VORK(descr�be in detai�: �. (� <br /> � <br /> STORIES: SQ.FEET OF EACH F'LOO�i: <br /> 1�TU. OF BED$OOMS: GARAGE STALIS: ATT. DET. �� <br /> 11 � <br /> FSTLMATED CONSTRUC170N VALU'ATION (excludfng lan�: $ �i� '1� <br /> I h¢reby apgly for a building petmit and I acknowledge that the informaaon above is complete and <br /> accurate; that ctie work will be in confornnance with the ordinances and Fodes of the City and with <br /> . ' the State Building Code; that I understand this is aot a permit and work is not ta start without a <br /> perinit; and that the work will be in accotdattce w�th the approved plan <br /> APPLICANT'S 5IGNATURE: DATE: �-{ • ; •D <br /> NOTE! .P.,,��Ho� events requfre aeparnte permit approval by Pol�ice Depar�ment and <br /> G�'1y Coancll 8U days prior to tha event. Nvn per►r�tned events will not be allowed. <br /> Rer.aivod Tlmn Cnn 7A 1 •A7AlI Dri �1 Tim� C�� 9l 1 � A�DA! <br />