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Total Fee: � Date Received:C`c:�(i� <br /> Entered By: Permit#: �/�i� <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 /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTO <br /> JOB SITE ADDRESS: Z-�� C� (..:�ti� fG�ncr� l/�o� ZIP: S��� <br /> Witl this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �NO If yes, a specia!event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: I�ev�^ `'�T�c,( PHONE: (home)�Z' 413- O$7�' <br /> (work)9S2• 9�S-395�' <br /> MAILING ADDRESS: �70 1.:�� Qrc�•.r� CITY: �('ar�p ZIP: SS 3 1� <br /> W� <br /> CONTRACTOR: ��. �d` PHONE: 71o3 2$b-'Zy2�t <br /> CONTACT PERSON: MOBILE/PAGER: Sar�e <br /> MAILING ADDRESS: S � �c+p CITY:S�•la..'S �i��ZIP: S9a'tlo <br /> STATE LICENSE: # 2oS 9S0/O EXPIRATION DATE: �log <br /> ARCHITECT/ENGINEER: ____�r�� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure v <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement m y require MCWD�?�g vie�`^� and permits! <br /> PROPOSED WORK(describe in detuin: _�.;�� q 22� X�y� t"� nD � _ <br /> STORIES: � SQ.FEET OF EACH FLOOR: 3 /�p <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED� DETACHED Z� <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��'� <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 is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: f Z/ � <br /> 31 <br />