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CITY OF ORONO - BIIIZDINC PER��iIT APPLIC�TION <br /> ,��„ r,v Date Rece?ved: <br /> Total Fee: $� � — <br /> Date A�nroved: ' <br /> Entered Bv: :/�' Fermit�:��;.�`� _ - <br /> p,T.T. INgORMATION MIIST BS SUBMITTED IN FLTI�L BEFORE PLAN REVIEW WII�I, BE SZs�RTID <br /> (See Check-off List Enclosed) <br /> ------------------------------- <br /> --- <br /> � p,ppI,ICANT IS: (circle one) ONi`IER or CONT.�.ACTOR <br /> JOB SITE ADDRRSSs <br /> �e�� �a�►���-�a (�� � zzP: 5535 � <br /> (work) 9y� �`t�`3 <br /> NAME OF OWNERs <br /> �.Z.�T�1 .� • C�F�S N �f� PHONE: (horne) c('1t�- '73�13 <br /> MA=I�ING ADDRESS: �Ia o..r�� <br /> CIZ'Y: ZIP: <br /> PHONE: <br /> CONTRAC'rOR: � <br /> CITY: ZIP: <br /> MATT•ING ADDRESS: <br /> STATE LIC�.�NSE: � <br /> �- PHONE: <br /> ARCHITECT/ENGINEER: <br /> MAZI,ING ADDRESS: <br /> CITY: ZIPz <br /> REGISTRATION � <br /> NAME: <br /> TYPE OF WORR_ New Additian <br /> Accessory Structure Move � <br /> D�o Re.*nodel/Alteration� <br /> Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : <br /> (�c o;� �-,� L o..., 5�oT S <br /> o c t.�, „� v tV d r <br /> STORSES: SQ. FF.E'� OF EACH ��R: <br /> NO� �F B�ROOMS: G�iRAGE ST�S: ATT. D ET. <br /> ESTIMATED CONSTRIICTION VALIIATSON (eacludinq la.ndl : $ <br /> for a building permit and I acknowledge that the iriformation <br /> � hereby apply that the work will be in conformance with the <br /> above is complete and accurate; Code; that I <br /> ordinances and codes of the City and with the State Building e�it; and <br /> understand this is not a permit and work is not to start without a p <br /> =hat the work will be in accordance w' the approved plan- . ' <br /> DATE: 2-f <br /> APPLICANT'S SIGNATURE: <br />