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� • k �/ <br /> �. �� ��) <br /> Total Fee: $ /�� � Date Received: �O- �7-G�/ <br /> � Entered By: �� %-� Permit#: ��C� �C�_ <br /> ; - -, � . <br /> � .y,.,.:, � , -� : i <br /> � �. <br /> CITY OF�ORONO - BUILDING PERNIIT APPLICATION ,.� <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> --------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) WNER R CONTRACTOR <br /> JOB SITE ADDRESS: /973 �l�G cr�e s s �pjh-� �QbQ�ZIP: .SS,.3 9/ <br /> NAME OF OWNER: Qy��Q�/ �ra�ers l:Dr��ior�PHONE: (home)(�,�/-(�$fj-�/.�lP <br /> (work) �"/-y'U,7-/8/�/ <br /> MAILING ADDRESS: �c�lo L.'e..y[%ei�t,.r �- CITY: F�l.c,�•� ZIP: /a <br /> CONTRACTOR: �+2�/ (��o'�Q►'S �4 V15�v'c�i o✓t PHONE:_(�,TI-9U,7-!S/� <br /> CONTACTPERSON: �c. MOBILE/PAGER: (o/a-aS0- �6'7'�0 <br /> MAILING ADDRESS: /o�� �Xi� (�,D�cr CITY: � � G ZIP: ��s�3 <br /> STATE LICENSE: #�00 S�,13�7 <br /> ARCHITECT/ENGINEER: �vX_ � Qe�i4�n PHONE: (�,�'/-8'9�-3990 <br /> MAILING ADDRESS: �f/5S D/a�S%(,�•�/'k�torie.l�ITY: � /ll�t ZIP: ,3"5/��. <br /> NAME: 6r,;, ,, b n REGISTRA ION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration� Land Alteration <br /> PROPOSED WORK(describe in detai�: � ��,�r W� ,�o W 5 -t- (J�GIL <br /> .�� u� <br /> pls Gl�l?�4G - <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �s6 U.bZ� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE DATE: �a� -D� <br /> NOTE! Parade of Homes events require separate pe � ' approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />