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OC1� 15 �D00 1 : 19PM HP LRSERJET 3200 p. l <br /> Oct-lfi-2001 08:40am Prom�ItY OF ORONO +�522484616 T-000 P,002/D03 F-509 <br /> Total Fee; $ -�'� ��� ___`` Date Received: �--���` �/�i� <br /> Enteted By; �I" t'ermit�: ; � <br /> ! � 'l �,: <br /> CITY�F ORIONO - BUII.D]1VGr PE�T APPLICATIUN <br /> AJl information must be submitted in f1�ll befo�'e plan review wiU be started. <br /> (please print all �nformation) <br /> T� A�PLICANT IS: (circle on�) OWNER 0 CONTRACTOR <br /> .�OB SY'YT ADDRESS: D ��� /rYlS ZIP: S���a�- <br /> ���� <br /> NAME OF OWNER: r l� ��_ P'HONE: (home) �5`�-`��a - `�� '7`-- <br /> (work)__ -� <br /> N1AYY.YNG ADDRESS: �yo �"�e..sf Arms La.�e CITY: o rcn o ZIP: <br /> CONTRACTOR: �-K�.'ood �°��� � Pxar�: �5 d-`�8.3-a o�a- <br /> CONTACT P'ERSON: GL�ir1"►')l,i,n�I -� M4BILE/PAGER; <br /> � MAII.YNG-ADDRESS; iaq8s Pr Dheea- Tra.,� CITY: Ec�en I�ra���e. ZIP: 5s��{7 <br /> �c 0� STATE LICENSE: � �o��S�r U <br /> 'Q Q <br /> � � ARCHITECT/�1VCrINEER: PHONE: <br /> � Q IN <br /> � MAiLYNG ADDRESS: CTT'Y: Z1P: <br /> � N�; . REGISTRATION# <br /> TYPE OF WORg: New Addii.ion Accessory Suucnue <br /> Move �emodel/Alteration Land Alteration <br /> p�tOPOSED W4RK(descnbe rn detai�: �e- ��F �"�U S� � �a-��rQ9�- <br /> STORIES: _ SQ.FEET�F E.ACS FLOOR: <br /> N0. OF S�DROOM3: GARAGI� STAY.,Y.S: ATT, DET. <br /> ESTIMATED CONSTRUCTION VALUATION(ex�yuding lan�: $ 1 —) � `t'��� <br /> I hereby apply for a building pernut and I ackn�wledge that the information above is complece and <br /> accurate; thac the work will be in conforrnance a�ith che ordinances and codes of the Ciry and with <br /> the Stace Building Code; rhat I understand chis is not a perruit and wQrk is not ta start withouc a <br /> permi�; and t2�►t the work will b� in accordance with che approved p1an. <br /> ApPLTCAI�3'T'S SIGNATUI�E: 'GL ���.� AA1'E: I�- I �D-0� <br /> NOTE! events require sepa�ate permit a,pprova�by Police Department and <br /> � City Cou»ci� 60 days prior�o the event. Non•perniitted events w�61 rtaR be allowed. <br /> , � ; �1..-h ��.,rtiu�- ��- � w-e_. w��P <br /> ��.e c�� c� f� <br /> r _ � .. : , �.c -7 �; D� ��,--f-, <br />