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�� ��e G ��� <br /> � � � � s �.�- a�-� . q,-��o <br /> � �� <br /> . , � <br /> � <br /> _ Total Fee: $, �� Date Receiv�d: � � Q' <br /> Entered By: �%-��� � � , Permit#• ,���,°`��' ' �' <br /> CITY OF ORONO - BU1L��N� PERMIT APPLICATION <br /> All information must be snbrt��t�d in full before plan review will be started. <br /> (�f�ase print al/inforircation) <br /> THE APPLICANT IS: (circle one) OWNER R CONTRACTOR <br /> JOBSITEADDRESS: 27O CRESTVIEW Av� ZIP: �5 3rJG� <br /> Will this be a Parade of I�mes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �NO If yes, a special event permit is required with Police Department and Cdty Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> suj)acient on-site parking is availahle. Non-pernaitted events will not be allowed. <br /> NAME OF OWIVER: �..eWl 5 �Q11{'�$�q PHONE: (home) '16, -�Q47� <br /> (work)(012-868-l 660 <br /> MAILING ADDRESS: 7O S D MRaUA vR.#(« CITY: MAPC.C- C�RavEZIP: 5��69 <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: C1T'Y: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: i C PHONE: 7�3 - SQ- �-[(''.SC� <br /> MAILING ADDRESS: 2 CITY: � (�p ZIP: 55��'� <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home RemodeUAlteration ( <br /> PROPOSED WORK(describe in detain: 5 EE �TT�}SNF_(? <br /> STORIES: Z. SQ.FEET OF EACH FLOOR: 5 E E /�"f'r�Cf(E U <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED�_ DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $_� 5 Q,��(7 <br /> I 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 wark will be <br /> in accardance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: �� l— �S <br /> 3� <br />