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f Total Fee: $ /�(o _ �=' Date Received: !J U y�%/ <br /> �� � �'�> <br /> Entered By: �Q,�1 � Permit#• �/ �, �rF, <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 inforniation) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> � <br /> THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR�� <br /> JOB SITE ADDRESS: /U`1G Lu��ti ���4 .��-� ZIP: �S 3�� <br /> Will this b a rade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes NO !f yes, a special ecent permit is reqziired with Police Department and City Coarncil approl�a! <br /> 60 days prior to the event. Shuttle ba�s service will be required unless applicant demonstrates <br /> scfficient on-site parking is availabfe. Non-permitted events wrll not be allowecf <br /> NAME OF OWNER: C.7�� ��z�oe.-�, PHONE: (home) �J�Z-`I�G. - %/y <br /> ^ (wock) <br /> MAILING ADDRESS: �'�C;�� I��t��C? �l'�� CITY: �c����2 c� ZIP: �-5_y� <br /> CONTRACTOR: I���h�.�c ,..,µ-�;,,.,� I-,�-, /�%�� ���r �F PHONE: �lSZ� z�3 -c:��c�y <br /> CONTACT PERSON: i;�, ���t c� MOBILE/PAGER: u�Z-`sl�i� z�d�' <br /> MAILING ADDRESS:�7 3C�� (.'Ee�.- �-e S CITY: C-����i.�i l� ZIP: , L �� <br /> STATE LICENSE: # ��' - Z��y4-C,K� ?s! EXPIRATION DATE: 3 3i- c� 7 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Altecation (ie: Siding, Windows) `�� C <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detai�: ���(�;« ;�'j�� �i�-c� <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTII�IATED CONSTRUCTION VALUATION(excluding land): $ /G'�c'Ut� <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 Buifding <br /> Code;that I understand this is not a permit and work is n o s rt ithout a permit;and that the work will be <br /> in accordance with the approved plan. <br /> ,l <br /> APPLICANT'S SIGNATURE: DATE: ��� ��' � <br /> .. <br /> 31 <br />