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Total Fee: $ 3 z g� � �$ Date Received: d <br /> Entered By: -R(� Permit#: ,�� R <br /> �;IY`�,yq S— I 1 - 01 <br /> CITY UF ORONO - BUII..DING PERNIIT A►PPLICATION <br /> A,ll information must be submitted in full before plan review will be started. <br /> ' (please print all information) � <br /> THE APPLICANT IS: (circie one) OV�NER OR CONTRACTOR � <br /> JOB SITE ADDRESS: ,37/S� ��v��ti'S�� �� ��: . <br /> rTAME OF OWNER: �,4qLP�,2�5'7� �,C!� <br /> ��NPHO: (home) ------" <br /> (work) ?63- �3- d��'G <br /> 1�IAILING ADDRESS��' � y�333 - CTTY: � ZIP:6i�/Z <br /> CONTRACTOR: ' c�Q��f'l'Rf 5�' /�G�. _PHO�IE: �(3- �3-a�a� <br /> C0��ITACT PERSON:�fJ�R�C E /�u�.� 1�IOBILE/PAGER: r'��- ,���'- �'�s% <br /> MAILING ADDRFSS:��� y7�3� CTTY:QL ZIP:� <br /> STATE LICENSE: # �C � ��5-53 <br /> ARCHITECT/ENGPIEER: ,�'�'i'S��y� _PHO\�: _ <br /> MAILPi 1G ADDRESS: CITY: ZIP: <br /> Nt�1V�: REGISTRATION# ' <br /> TYPE OF WORK: New � Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: ��Ps�F�cJ�� �u>N/w'u-s�- � _ <br /> {�F tU ���vs� - <br /> STORIES: �_ SQ.FEET OF EACH FLOOR: /�r D ���-� <br /> NO. OF BEDROOMS:��_ GARAGE STALIS: ATT: D�_ D .. �,=. ,�-:. ;i._, - <br /> ESTNi IATED CO�'STRUCTION VALUATIO� (exclud.ing land): S .�'■'� �?+� <br /> I hereby apply for a buildina pernut and I acknowled�e that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Buildina Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in ordance with the approved plan. <br /> APPLICAi�1T'S SIGNATLTRE: , DATE: �--//—C�/ - • <br /> NOTE! �Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be altowed. <br />