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Jan-06-2D04 11:33am From—CITY OF ORONO +A522A94616 T-5A4 P 006/008 F-608 <br /> Total Fee: $ g 8 •3 � Date Receivetl: � '�O' �� <br /> Entered By: Permit#: 0 <br /> , <br /> � CITY' OF �RON4 - BUII.DINC PER1ViIT APPLICATYON <br /> All information must be submitted in fuA before plan review will be staRed. <br /> (please print all i�{forniation) � <br /> T� pppJ,ICAN'T YS:� (circle one) OWNER OR CONTRACTOIt • <br /> JOB SIT�ADDRESS: . 22-�✓ � ZII':. 5 <br /> NAl1�OF OWNER: L.Ol1 s �!LL GLC•r� PHONE: (hame) `152• �Q� 82°�� <br /> � (work) <br /> MA�LING ADDYtESS: CYTX: ��_.� <br /> C4N'TRACTOR: � �J PHONE:_��2• 5'Ef��?l <br /> COy'TACT PERS4N: MOBXY..IiJPAGER: 52• 2 2 • 2 G� <br /> MAII,�NG ADDR'E.SS: . CTTY: �IP:�QS <br /> S'Y'�a1'E LICENSE: 1�_ 7� � <br /> pRCHTi'ECT/ENGri�TEER: P�YOi�tE: <br /> MAILING ADD1tESS: CiT'Y: ZIP: <br /> NA.�IE: R�GISTRATION f� <br /> 1`YPE OF WOltK: New Addition Accessory Structure�� <br /> Move Remodel/Alreration�_ Land Alteration <br /> $h�E1�/��1`� <br /> PR�POSED Vt►ORY�(describe in detain: <br /> li�_ �u�r� � <br /> sTon�s: �NraSQ.�T o�EAc��.00�:��� ��tr- uN rrit��n s�It�, <br /> NO. OF BEDROOMS: .� . GARAGE STALYS: ATT. ^� 1�ET. <br /> E�S'I'L�IATED C�NSTRUCTION VALUA,TION(excluding land): $ ��7� �.�d <br /> I hereby apply fox a buildin�permit and I acknowledge chat the information above is complete and <br /> accurate; that the work will be in conformance with the ordinat�ces and codes of the Ciry and wich <br /> the Siace Building Code; that I uaderstaad this is not a pe�mic and work is not to start without a <br /> pernnit; and thac the work wilI be in accordance with che approved plan. <br /> '�� DATE: <br /> APPLYCANT'S SIGNATURE: � ��y�� - <br /> NOTE! events reg ' separate permit approvai by Police Department and <br /> City Council 60 days prior to the event. Non peryniaed events will not be aAowed. <br /> 5 <br />