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; CITY pF ORONO - BQILDING PER�iIT APPZ,IC�TION <br /> l . <br /> p i <br />�, � � Date Rece?ved: <br />' Total Fee: S - <br /> Date A��rove�: � <br /> Entered Bv: ��(°.�� Permit� �`��� � - - _- <br /> =NgOR2�iATION MIIST BS SIIBMITTED IN FIILL BEFORE PI�AN RE�TIEW WI7�L BE SgARTED <br /> AT,T• (See Check-off List Enclosed) <br /> � APPI,IC�NT I5_ � <br /> circle one) OjdNER or C�NT_�ACTOR <br /> � �� ��',' (ZC� i�/O ZIP: <br /> Jos sz� a�nx$ss: �� �� l�� ��t2 <br /> (wor}c) <br /> / PHONE: (horne)`�73 ���� <br /> NAME: OF OWNP.R: ��� �. i �� �� C Lf�-.�.4-7��<�v � <br /> CITY: ZIP: <br /> MATI�ING ADDRESS: <br /> lYl N S.D, ��-Z a 1 � �F <br /> / PsorrE: `r�T� d��� <br /> � ( -- � -l�k-� 0 2 s �/v <br /> CONZ'RACTOR- I V J <br /> CITY:�p i' i.�•� ��'�G�� ��t�ZZP: S S 3 �� <br /> MATI,ING ADDRESS� 7 `�7 `� ��L��`o <br /> STA2'E LICENSE_ � <br /> PHONE: <br /> ARCHZTECT/ENGINEER= <br /> CITY: ZIP: <br /> MATI,ING ADDR.ESS_ <br /> REGIS�RATION � <br /> NAME: <br /> Accessory Structure riove <br /> T`�PE OF WORK- New Addition Land Alteration _ <br /> D�o Re.*nodel/Alteration <br /> Rer.ovate /��� <br /> .� __ � � �, S� p;�i� <br /> PROPOSLD WORR (describe in detail) : " �S � n� <br /> STORZESs� S4- ��T OF E�CH FLOORs <br /> NO. OF BF•DROOMS: <br /> �GE STAI.I�S- ATT. DET. <br /> c,w <br /> EST3MATED CDNSTRQC'rION VALIIATION (eacludin4 land) - $ 1 �b U, - <br /> hereb apply for a building permit ae wo � wili be ia conf rmancef withtthe <br /> I y Code; that T_ <br />� above is complete and accurate; thaa ahwi�h the State Building e�it; and <br />� ordinances and codes of the City <br />� understand this is not a perntit and work is not to start without a p <br /> that the work will be i ccordance with the approved plan- s - ' <br />� � Gv��� DATE s �-"�� � <br />€ APP�ICANT'S SIGIIATURE= <br /> f���,.�-.r, <br />