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2001-P04700 - addn/remodel/repair
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2760 Countryside Drive West - 04-117-23-12-0011
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2001-P04700 - addn/remodel/repair
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Last modified
8/22/2023 5:06:59 PM
Creation date
5/9/2016 3:03:38 PM
Metadata
Fields
Template:
x Address Old
House Number
2760
Street Name
Countryside
Street Type
Drive
Street Direction
West
Address
2760 Countryside Dr W
Document Type
Permits/Inspections
PIN
0411723120011
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Updated
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� � <br /> Total Fee: $ /��Q.o�S� Date Received: �a.-(D-01 <br /> Entered By: Permit#: �o Y 70 D <br /> CITY OF ORONO - BUILDING PERNIIT APPLICATIOl`1 <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 OR CONTRACTOR <br /> JOB SITE ADDRESS: ��O CO��CRYSID� �� (\, ZIp; <br /> NAME OF OWNER J� �j��1v PHONE: ome S - �"�`� S <br /> c� )� t `{ <br /> 2 g ► 3 (work) <br /> MAILINGADDRESS: casL� �t . �1� , crrY:���,�z�� z�:��c� � <br /> lA 2 <br /> CONTRACTOR:�� L�A IvC F. E@�a �,L C PHO�IE: � - l�j 2. <br /> CONTACT PERSON: �-���� �.t (�j Q �S�iOBILE/PAGER: �� (�'l� <br /> MAILING ADDRESS:C��(1� �J►�'j�T �, CITY: (`�l��l tJ C� ZIP:=�(�,� <br /> STATE LICENSE: # 'Z����R S� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration� Land Alteration <br /> PROPOSED WORK(describe in detai�: <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> o� <br /> ESTI�i IAT'ED CONSTRUCTION VALUATION (excluding land): $ (�, (�� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordan i the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: bE�,.. �f- I� ,�d0 I <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />
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