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Total Fee: $ ��j S � • L� Date Received: � � / G�Ci" <br /> Entered B � <br /> y� ��� (7-f Permit#: -��.��i�'Oy <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> _ <br /> -- �— - <br /> THE APPLICANT IS: (circle one�OWNER R CONTRACTOR <br /> JOB SITE ADDRESS: 3�2.�{ C �pC��}�'C� � (�fC� ZIP: �J��S7o <br /> Will this be a P rade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Z'es ��TO If yes, a special event permit is��equired wit;i Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allowed <br /> . n,, <br /> NAME OF OWNER: �(1VV� � I Y I�1/�Q/1��{" PHONE: (home) q S Z -'`�7(o 'Z z`�� <br /> C (work) 9 S 2.- 9 Z�•3� 3 y <br /> MAILING ADDRESS: ��?�� C �Dt��. J� CITY: (�C� ZIP: �S 3�6 <br /> CONTRACTOR: � PHONE: '�1�SZ"`-{7(v 'Z2,`� <br /> CONTACTPERSON: TOYY� C�, MOBILE/PAGER: !P (ZrSU Z-lo�{S y <br /> MAILING ADDRESS: 3�Z`� � �-'�- CITY: (,�c.(� ZIP: s^S�vs`� <br /> STATE LICENSE: # EXPIRATION DA <br /> ARCHITECT/ENGINEER: ,� (QQCe, � }e��A��-0 PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition �C Accessory Structure <br /> Move Hoine Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may r�quire MCWD review and permits ! <br /> PROPOSED WORK(describe in detai�: Q',Q�Q(,(.7�L�/y�. (�� f Y'�-µ.�- /��'�.GL ��, <br /> ���o�a_.. <br /> STORIES: �- SQ.FEET OF EACH FLOOR: ��d D <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED �. DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ la�0 D d� 0 d <br /> I hereby apply for a building pennit and I acknowledge tl�at the information above is complete and accurate; <br /> tl�at 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 pennit and work is not to start without a pennit;and that the work will be <br /> in accordance with the approved plan. <br /> � <br /> APPLICANT'S SIGNATURE: �/u-� DATE: �����O � <br /> 31 <br />