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,,-- C�TY OF ORONO � 6124730510 09/24/96 14:00 (� :02/03 N0:522 <br /> . ' <br /> Tara1 Fee: $ Date Received: <br /> Entered Hy: '�' - -- - Permit�+: � ,' <br /> CITY OF URONO - BUILDING P�RMIT APPLICATION <br /> AU in�ormatlon must be submitted ln full before plan review wiil be started. <br /> � � (please prin�all information) <br /> THE APPLICANf IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: ��fSb �0 ; �-�� ZIP: S��Sb „ <br /> � NAME OF OWNER: L�0 r ra�� � l�v'e�rna,�-, PHONE: (home) �{7S-D9ys <br /> � (work) � 7a -syY,� <br /> MAILING ADI}RESS: o�5�SO occn �cle �►�-. CITY:�La.(��. ZTP: 553 Sk <br /> , <br /> CONTRACTOR R�,��a,l �v �-ad�e�s�_ P�#ONE: �ora Sva-y 7.�� <br /> CONTACT PERSON: �Jb l�e,�,� Q�� �r� MOBII.E/PAGER: l��a/S5�{-a 8 s y <br /> � � 11+IAYLING ADD�tESS: 3.S�b- ?3"� H��-e /� C. CTTY: ��d L c. �ZIP: ,�S�t 3�-- <br /> ��'AT� LICENSE: // �200 0 63 � <br /> . ARCHYTECT/ENGINEER: N� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATIUN# <br /> TYPT O�' WORK: New Add"uion Accessory Scructure <br /> Movo Remodel/Alteratian -� Land Alteration <br /> PR4POSED WORK(describe in detai�: c Q w;��Ov� �r�a�v <br /> ��vol���. - Q�..� _ <br /> STORIES: SQ.FEET OF EACH FLOOYt: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> FSTIMATED CONSTRUCTIQN VALUATYON (excludfng lan�: $ � �'I�a, �U <br /> I hareby apply for a building permit and I acknowledge that the inforntation above is complete and <br /> accurate; that the work will be in conforcnance with the ordinances and �odes of the City and with <br /> ' the State Building Code; that I understand 's is not a permir and work is not ta start without a <br /> permit; and that the work will be ac r ce w the approved plan. <br /> APPLICANT'S SIGNATURE: DA1"E: l� 9 `'-c �' <br /> NOTE! P�H��s eve regufre separate permit approval by Pol�ce Departntent atd <br /> G�ity Council 80 days prtor to e event. Non perm�Itted eveRts will rtot be allowed. <br /> Received Time Sep, 24. 1 :42PM Print Time Sep. 24. 1 :43PM <br />