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f <br /> Total Fee: $ ��- �• ��> DateReceived: ��//�Q(,� <br /> Entered By: !/ ti�`�.._ Permit#: ���;��;��y� <br /> � <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (p/euse print al!informntion) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> _--.....: .._,_ <br /> -- _.._. � ��� <br /> THE APPLICANT IS: (circle one) OWNER OR�NTRACTOR _% <br /> JOB SITE ADDRESS: �� ���J �'�� �vti ������� �Z ZIP: <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other llisplay Home? <br /> ❑ YeS �,No /f yes, n specia/event per�rrit is reguii•ed with Police Deperrtment and City Cozmcil npprova/ <br /> 60 days prior to the event. Shutlle bus service x�ill be required an�less app(iccrnt den?onsb-ates <br /> scrfftcient on-siie parking is nvailable. Non-permitted enents wrll not be a!lowed. <br /> NAME OF OWNER: ��- ,, .��� ��5� PHONE: (home) <br /> � (work) �1� -_�-�-c::�y 3 <br /> MAILING ADDRESS: ��S� �-; Q.,,� '���I CITY: ����; ZIP: <br /> CONTRACTOR: � sl-� . � � ��- � �= PHONE: � 5.�� �1 � ",�`�`��� <br /> CONTACT PERSON: � � w MOBILE/PAGER: (���;� ����,- ��� <br /> MAILING ADDRESS: � I �CITY: �,:� �. -z ZIP: S�3�l <br /> STATE LIC�NSE: # "Z v �� � y EXPI12�T10N DAT : �J�3/ l �-7 <br /> ARCHIT�CT/ENGiNEER: PHONE: <br /> l�A��i1�1G A���SS: ['ITv� ZIP: <br /> NAM�: REGISTRATION: # <br /> TYPE OF WORK: New i Iome Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may iequ MCWD reviewnand per ts ! <br /> PROPOSED WORK(rlescribe in detain: --!�-�: ;, �� �^ �, I(� - ��<�� <br /> STORICS: SQ.FE�T OF�ACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHCll DETACH�D <br /> ESTIMAT�D CONSTRUCTION VALUATION(excluding land): � j�F c��:�., .-, �� <br /> [ hereby apply for a building permit and l 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 tinderstand this is not a permit and work is not to start without a permit;and that the work wi(1 be <br /> in accordance�vith the approved plan. <br /> AYPLICANT'S SIGNATURE: v " DAT�: �'—�a ' �(� <br /> 3t <br />