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> -- <br /> Total Fee: $ ��L � S Date Received: . � b <br /> Entered By: �� ��� ��>f..�j �//5%L�, Permit#: �'�c_s`>`�[.� <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 inforrriation) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR/AcicNi��T� <br /> JOB SITE ADDRESS: 23y5 aLA�►�E AV ZIP: SS 3�� <br /> URo�� M <br /> Will this be a 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 /> sufficient on-site parking is available. Non permitted events will not be al[owed. <br /> ae�� <br /> NAME OF OWNER: 1/E(2,t2o�J 1,J�uE�Ess PHONE: (l�e) 612. 72 0• oDsz <br /> C t�o� 2E►re r�� (work) 7�03. 595. sosz. <br /> MAILING ADDRESS: 19 55 s9T" AvE I�le�-rtt CITY: �I �YM o,rN ZIP: SS''1 H Z <br /> CONTRACTOR: �s��►-� 1 PHONE: �1�• 4°3• `IZ`l9 <br /> CONTACT PERSON: CHfZ�S '�av is MOBILE/PAGER: �I Z .�sl.8671 <br /> MAILING ADDRESS: q973 VAu.EY V�E� �o CITY: FocN �r ru+�RiE ZIP: nnnJ� �53y`I <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: ��si�a � . �Qg �t��s,n�a PHONE: 952, qo3.g25'� <br /> MAILINGADDRESS: �q73 YA�.�.�Y v�sw ua� CITY• �p� �"��E ZIP• s�My <br /> NAME: o� �,,� i S REGISTRATION: # I 2-�{L7 <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration _ ( <br /> PROPOSED WORK(describe in detain: MCD�F,(�CQT►eN o� EX�ST�n�6 c.Ec� S�Tr- , <br /> �(o� ANTEn�NAS w�cc. � RDP�c7 Te� Ex�sT►rJ6 �/kT�2 '�'ewE.R. C.3� <br /> �X�ST��►L ft�`Er+n11�S w t�.�- �i� R�.�acn�"�� <br /> STORIES: � �t SQ.FEET OF EACH FLOOR: nJ �l� <br /> NO. OF BEDROOMS: N�A GARAGE STALLS: ATTACHED�,� DETACHED�/A <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��� OOO <br /> 1 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 ordinances 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 with the approved plan. <br /> _--- <br /> APPLICANT'S SIGNATURE: DATE: 3 , 3D. o� <br /> 31 <br />