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CiTY OF ORONO � 6124730510 09/29/97 13:53 �1 :02/03 N0:028 <br /> �, : <br /> � ?otal Fec: $ Datc Recxived: <br /> � � Eatered BY: `�'� _- <br /> Permit�: �� `� �-=;�--� �� <br /> CITY OF QRONO - BUII,DING pERMIT AppLICATION <br /> A1! isitorm�don mwt be aubmitted in fWU before ptaa review wilI be started. <br /> (plrase prini a11 ir�'ornrntion) <br /> ..�___ _____-------- <br /> 'T� APPLICANT IS: (ctrclt on�) OWNER OR CONTR,ACTpR �--- --- <br /> JOB 3ITE ADDRESS: ZSO OC..fJ C2YSTal, ��q`( �.0.ZIp: <br /> NAMTi OF OWtvER: Jo t�,t� ���1MPSo�,�, PHONE: (home) �7�J' o`��I`j <br /> MAILIlYG ADDRFSS: 2 SO OLO C�Q.YSTI���RY CITY: t o Ro�j 0 ZIP:,�,�'3 S(�. <br /> CONTRACTOR: ��K� Cou�T�R.`�' ���1.t��s2,5 pgoNE: y7`�- 7�2� <br /> C4NTACT PERSON: �bE� p.. MOBII,E/pAGER:_s'it� - 5�(S 7 ,�t� <br /> MAILIIYG ADDRE.SS: 33�1 S�co�l• T CTTY: �cc£.LSto2 ZIP: 55331 <br /> 3TA�TE LICENSE: � Z?�`�Co <br /> ARCHTTECT/ENGINEER: PHONE: <br /> MAILIIYG ADDRESS: CTTY: ZIP: <br /> NA,.'1�: REGISTRATION�Y <br /> TYPE OF WORK: Ncw Addition Accessory Stivcttu�c <br /> Move RemodeUAluratioa�C _ Land A,lteration <br /> PROP0.4FD VVORK(dtscrtbe fn ci�tat�: R'�.W1oV E l.e.d.�t.�►J� Sit.`C ►.�c.�tdT F��Au�� ��J or'lE�.t��� <br /> �S}o ►�u-r��,la ,�T aw�o ►�1 AQ.� w,QEo 'To �Y.fST�M� Sw�Tc�l�,�lt� <br /> 9TO�S� SQ.FEET OF EACH FLUOR: <br /> . NO. OF BEDRUOMS: GARAGE S3'ALIS: ATT. DET. <br /> ESTIlViATED CONSTRUCTION VAY.UATION(tuludia�Innc�: $ • � <br /> I hereby apply far a buildi�g permit and I aclmowlai�e thac the ir�formauon above is complete aud <br /> accurate; that the work will b� in conform�ance with the ordinancts and codes of the Ciry and with <br /> the S�te Bufiding Code; thst I understnn�d thia is not a pecmit and work is not ro start withvut a <br /> pernalt; and thai �te work will be in acco e with the approved pian. <br /> APPLICANT'S SIGNATURE: �%G� DA1E: �`Z`� ' q S <br /> NOTEI PatQd� af^, gomes tyents require :eparate ptnnu approya!by Polke Dapam�mt a�rd <br /> Clty Councll 60 days pr�or to tAt sv�nt. Nvn�s,�nla�d sverirs wiJ!Ro�ba allowed. <br />