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�/��O� • <br /> � <br /> �( <br />`• � Total Fee: $ � �T(�� �J DateReceived: ���3�"�7 <br /> Entered By: Permit#: /9/�l0� <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 infor�nation) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> � <br /> THE APPLICANT IS: (circle one) OWNE R CONTRACTOR <br /> JOB SITE ADDRESS: �z YS �-r�����.- �-� �•��,r• � ZIP: S ���1 <br /> Witl this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ YeS � NO If yes, a special evenl permit is reguired with Police Deparlment and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> suff cient on-site parking is available. Non permitted events will nol be allowed <br /> NAME OF OWNER I�e �CL, �% a / � PHONE: (home) �S Z Z�( H °13 31 <br /> (work) ��S Z `11 I t � � o <br /> MAILING ADDRESS: I Z`1S L, k� ����w Avt- CITY:�--���-�r� ZIP: „�S3�t <br /> CONTRACTOR: �: r � � L� I( �;Z Z�o � �"�.��( <br /> PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: � .,�.��•� .-k-� �e��i�, PHONE: ��S � �1 � y 7`1�f� <br /> MAILINGADDRESS: �jd �,.,t�� "�c��ST CITY: C�,,,�,,,z�� ZIP: SS3i'7 S,� <br /> NAME: L-K1� T`+--�:-� REGISTRATION: # z.�c <br /> TYPE OF WORK: New Home Addition � Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detai�: �� 1� , s�t c •-> F I Ew� �-n � r, . ,�.l <br /> � t,�..�. <br /> STORIES: �-- SQ.FEET OF EACH FLOOR: � y l"� <br /> NO. OF BEDROOMS: 2- GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��L-, C��C� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the 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 permit and work i not t rt without a permit;and that�he work will be <br /> in accordance with the approved plan. <br /> � <br /> APPLICANT'S SIGNATURE: r DATE: �G - � ��O 7 <br /> 31 <br />