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, <br /> � <br /> Totul Fcc: g 33/• 4� DatcR,cccived: ����' 0� <br /> Entered By: Permil#: /�-D �'`�"�I l� - -- <br /> C�TY OC' ORONO - BUILDINC PERMIT APPL�CATION <br /> All inform�tion must bc submittcd in full before pinn review will bc st�rtcd. <br /> Ui/eus�e print nl!information) <br /> THE APPLICANT IS: (ci�cle one) OWN CR OI CONTRACTOR <br /> JOB SiTE ADDRESS: � �J�� T V L v�v4� �,Q,¢iG �r�v� L.�p. SS 3`� I <br /> Will this be n Pnrs►cle ot'llomes,Remodelers Showc��sc Aome or ot}�er Displ�y Ilome? <br /> ❑Yes �Vo !f ves, a specia!event perrnit is rec�urred,vtth Pnlrce l7epnrlmen�and Clrv Couner/approval <br /> GU daw prior to the event. Sltuttle bt�s.cervice ticill he reguired un/ess applrcam den�onstrares <br /> su�crenl on-st/c parkinb•r's m�ar'lable. Non pern�irred eventc u>i!/n�t he allrnned <br /> NAME OF OWNER: � ti �`►�►-�nn{ �G�,Nr►Gl< Sc�c�cti►� P.I_I.O.N�:: (home) <br /> (work) <br /> MAILING ADDRE55: �3�D�v.�.�- �,v.e�.�- Drw�C:l'I'Y:w .�.� ZIP: �j` <br /> CONTRAC'I"OR: (.V�ssr�4�, l�onS�rw��l��n�,,,_�nG, PLl.ON1L: 7 3'`l3`i-oZuZ <br /> CONTACTPERSON: ._J��+ic Kw�.sl�;t-� IVI.Of31:LE/1'AGER: <br /> MAILINGADDRESS: (1J3K �,.,��I.,(t�.c�fi ►�16 C:I'fY: Ha�.ls„Ic� ZIP: SS3oy <br /> STA'T�L1C�NS�: # (?�C�2�Z y,ss 30 3 EXPTRATIONDATE: 3-3►—o t� <br /> ARCHTTECT/ENGINEER _��� _�IrHONE_ <br /> � <br /> MAILING AADRCSS: CI1Y: ZIP: <br /> NAME: RCGIS'1"ttATiON: # <br /> TYPE OF WORK: New Addition Accessory S(rucCure <br /> Movc llomc Remodel/Alteration �_ <br /> PROPOSED WORK(describe in detai�:_,rcc�J��G;r� ����u�S � h � �„�-f��_ <br /> 6`OP.hinwS <br /> sTox�s: sQ.r��T or rAc�_�.��.�oo�t: <br /> NO. OT B�DROOIV�S: GARAG�: S'1`ALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding��iad): $ I I , �� S 0, O U <br /> T hereby apply for a building pennit and 1 acknowledge tl�at the infonna.Cian abovc is completc and accurate; <br /> thatthe work will be in confonu:uice�vifli the ordinwces and codes of thc Cil'y and with thc Stat�Duilding <br /> Code;that I under.stand this is not a perniit:�nd work is notto sla.rl wilhout a pcnnit;and th3[the rvork�vill be <br /> in accordancc�vith the approved pl� . <br /> l.� <br /> APPLICA,N'�"S S.I.G.1�1ATU.RC: DATE: �—2g��S <br /> 31 <br /> �aa/Z00 'd 6Z�lb�b�9Z(X'd�) NOIl�fl�1SN0� OHO�SSOa� Zz:OI (�fll)50aZ-8Z-Nfl� <br />