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�?iG-25'2008(MON) 14:57 ALPHA (FAX)6516444616 P. 002/004 <br /> - _ , <br /> Total �cc: $ � � DatcRcccived: O �� <br /> Enter By: I'ern�it#: D <br /> CTI'X OF ORONO -BUiLDIl�I G PERMIT APPLICATYON <br /> All information must be submitted in full bcfore plan review witl be startc . <br /> (please print u/l infurmatinn) <br /> T� PPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> .i0i3 TE ADDY2CSS: �"��J / rl��N� �,�� ZLP: <br /> Witl t i� be u Parade otHom�a,Rcmudclers Showcase Humc or otlier Aispl�y Ho e? <br /> ❑ e� �No /f pes,a spe•cial c��enr permi�is recluired irirh Police l7epartmcnl an�!Gilp Gou i!approra/ <br /> GD duys prior to!he evenl. $hu11lc�bus ren�ic��M�i1l be rcquired u��/ess upplicu�rr emonslrares <br /> su�cien�nn-silr purking is avai/ahlc. Nun-per�rriticd cvc�ts ivill n�t he allm�� . <br /> NA OFOWN�R: ����1� �D 1�� PHONC: (home) <br /> (work) <br /> M GADD1tC$S: S39 K�N� �4V c��: o�oNo zrn: <br /> CO CTOR: S G PI�ONC: 6 — - 0 yp <br /> CON ACT PERSON: MOi3LGE/PAGER: 3 - —6 3S7 <br /> G ADDRESS: Z ►V T C1TY: ZIP `s s—r� ,� <br /> STA LYCENST: #_o�0 6 3 I Z 9 v EXl'lltAT101�T AATE: 3-3! o <br /> ARCi TECT/ENGI'N�CR: PHONC: <br /> MAl INC AADRESS: CITY: _ ., <br /> N 1t�CISTRATION: # <br /> TYPF OF WOR1C: New Homc Addit'ton Accessory Struciu <br /> Move t•lome I�rmodel/Alte�ttiun(ic: Siding, Windaw ) �_ <br /> Any earch movement may require MCWD review and ermits! <br /> PROl OSCD WORK d�'crihe in detai�: <br /> J �I 0 � ' • �, s cG ►n�►.a , ' <br /> STO S: � SQ.FE�T 4F rACH FLOOR: 6�f� <br /> IYO. F BEDROOMS: GAI2ACC STA�,LS: ATTAC�U AETA 'H.�D <br /> �STI ATED CONS1'RUCTION VALUATION(c,xcluding land): 3 . � <br /> 1 liere apply for a building permit and I acknawledbe that tlit information�bovc is complete d aceuratc; <br /> thlt th work will bc in canformanca with thc ordinances�»d code�s nf lhc Ciry and with che St e Building <br /> Code; iat I undersrand this is not a pc.�rmi�and work is not to stan withdut a perni ii;and that the ork will he <br /> in acc dancc with the approvzd plsn. <br /> APPL CANT'S SIGNATURT: �l llATE: �� � <br /> 3i ' <br />