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� <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ � �O/. �3 Date Received: <br /> Date Approved: <br /> Entered B j��? _ ,/ <br /> y' ' Permit#:r_7 �j"tG-� <br /> AT•T• INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ----------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: �-I Z'l �'N S 1�11�(1� '��-"�� ZIP: � 3"t � <br /> (work) <br /> NAME OF OWNER� �/�-����Vi`-'� ��l ST�d,�T'tDN PHONE: (home)�{-"�j-1 �Lo <br /> MAILING ADDRESS: `Q��4tJ I�J' ��� �. CIT�: R-y- ZIP: ��--7 <br /> CONTRACTOR: TiC��p^� /1-�l.C�`� C���' • PHONE: �-"�I"5 -1 1`d <br /> MAILING ADDRESS: 51ld'1� ,6�� P��C CITY: ZIP: <br /> STATE I,ICENSE: '� C�C�_'7 3S <br /> ARCHITECT/ENGINEER�-.F ��l's'�( PHONE: ���ZI -��T <br /> St�t'("E !bc> <br /> MAII,ING ADDRESS: �,Z(o 1JC�1"��- '�� �TC. CITY: I��S ZIP: SS�.OI <br /> p�„ig: �(/�`TF�'`/ F�6�VdT�Sr�.� REGI STRATION # I��(b�l`�F'� T�-i�� <br /> TYPE OF WORR: New X Addition Accessory Structure riove <br /> Demo ( Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : �MO ��S�N � V St 7''4�T OF <br /> ER I ST►N� ��JD'['N �vi�- N�/ [o�.IsT <br /> STORIES: Z SQ. FEET OF EACH FLOOR: 3�2� ���N 12'�Z��Q. <br /> NO. OF BEDROOMS:�L _ GARAGE STALLS: ATT.� DET.� <br /> ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ ��a� • <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that Z <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work wiI 1 be in accordance with the approved plan. <br /> . \ <br /> APPLICANT'S SIGNATURE: �'� �—" .�C�� F� DATE: ��• �d `�4 <br /> _ 't�-�*-���-��'R <br />