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TotalFee: $ DateReceived: �.� � i�t' <br /> Entered By: �},;��'� Permit#: j��;; ' ��i 2,� <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 /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: �/�� �{��ryu.��>��f f� �,. zip: ��3 � � <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ �'eS �.NO If yes, a special event permit is regui��ed with Police Departnzent and City Council approval <br /> 60 days prioi�to ihe event. Shuttle bus service will be reqz�ired unless applicant demonstrates <br /> sufficient on-site parking is available. Non pe��naitted events will not be allowed. <br /> NAME OF OWNER: �t�igS .�_�'Z'T"I �-j PHONE: (home)� -�j,5"2 -Z(Z- ! �--%Z <br /> �-- <br /> (work) <br /> MAILING ADDRESS: �� /Yl-� CITY: Q,�p�J ZIP: <br /> CONTRACTOR: �t1�S-��_t�a�' �b PHONE: �iz-3$�' �S�y7� �'`�v�� � <br /> CONTACT PERSON: ��- MOBILE/PAGER: 5 �;/�-3�3•/�'j. <br /> MAILING ADDRESS:� 2 � l,� CITY: y�7/�-,q ZIP: ��3 zfS S <br /> STATE LICENSE: # a�� /p/Z EXPIRATION DATE: 3- 3�-�7 <br /> ARCffiTECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home RemodeUAlteration (ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detai�: /J/C'c�l �t�l,��4 G� <br /> STORI�S: Z, SQ.FEET OF EACH FLOOR: /��� �� <br /> NO. OF BEDROOMS: _� GARAGE STALLS: ATTACHED DETACHED� <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � �O, p�v <br /> I hereby apply for a building permit and I acknowledge tl�at the infonnation above is complete and accurate; <br /> that tlle 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 permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: � ��G��� DATE: S —�G- O� <br /> 31 <br />