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Dec-�e-2001 03:3TPm From-CITY OF ORONO +9522494616 T-377 P.002/003 F-527 <br /> . � <br /> ^ To[al Fee: $_ ��� �v Date Received: /��� �� `'� <br /> �� Entered By= Perrnit#: �- � 7� _ <br /> � CYTY OF RONO - BUI�.DING PERMIT APPLICAT�ON <br /> I y���� <br /> All information must be submitted in 1'ull before plan review will be started. r ���� <br /> (please pTint all infornzation) <br /> . . . <br /> ----------------------T__-------•-----T------------ -----------------..�,�.��__,.���T--- <br /> ----------------------�T--- :��:. <br /> THE APPLICANT TS: (circle one) O'WNER OR CON�'RACTO � <br /> JOB SITE ADDRESS: a��D p�n���d;L A Vc• ZIP: 5535� - �J7��I <br /> (�c17'G(� <br /> NAME OF OWNER: Cct(V�-r� �e/�rzb r lQ� P�IONE'_ (home) �l� <br /> � (work) -�i S�. �-( 7 ( - gS� I <br /> M�:?�G.4DL�RL�S�: a�f aU 1,�[r�z�d���I,TY_ �-�'o n.a _�IP: 5535Co <br /> CONTRACTOR: Pr���e �hs�, �`z-�. PHONE: 7�3 � 77-� i�l <br /> CONTACT PERSON: Tae l N s�ra rr, MOBII.E/PAGER: ��� �� �- 04 �� <br /> MAILTNG ADDRESS: �"� Sp S En�e W ,y SS CYTY: Roc�t �" ZIP: 55373 <br /> STATE LYCENSE: # 000�{a�f!� <br /> ARCHITECT'/ENGINEER: _ P���= . <br /> MAILTNG ADDRESS: CITY: Z�: � <br /> N�: ^ REGY5TI2ATION'#� <br /> TYPE Qr WORK: New Addit�on Accessory SQucture <br /> Move Remodel/Alt�;ration � Land Alteration <br /> PROPOSED V'VORK(describe irc detail�_ Re-Taof c..c e'� .��a � "�"��'f a 6a�'e <br /> Sa nc�u� r �S 1n�e-s� �ci� -r� e,�' r�c,7 o v� o v'e r Q 5 5 7��hZ s, <br /> O r Or e�' �z. <br /> STORIES: SQ. FE�T OT EACH�`LOt?�1t�,: <br /> N'O. OF BEDROOMS: GARA'Gl�, STALLS: ATT. DET. <br /> �gTIlV1ATED CONSTRUCTIQN VALUATYON (excluding lanc!)= $ s�i g��" G� <br /> I hereby apply for a building permit and I acknovcrledge rhat th� informaiion above is complete and <br /> accurate; rhat the work will be in conformance with the ordinances and codes of the City and wirh <br /> the STate Building Code; that I understand r.his is not a permi[ and 'uvork is not to start without a <br /> permit; and that the 'work will be in a�cordance with ihe approved p1an. <br /> APPLICANT'S SIGNATURE: S ���`� DATE: � a ` � � ` � � <br /> NOTE! Parade_of�,� everets require separate permit approva�l by Pnlice Depdrtment and <br /> Cily Council 60 days prior to the event. Non permitted events will not be allowed_ � <br /> �.�( '� �9� �z-tZ-o� �J`� <br /> T����, � �-��_ �NJ�/ /�. 12/18/O1 TUE 15:36 [TX/RX NO 5051] <br />