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• M <br /> � To�al Fee: $ Uate Recei�ved: <br /> Entered By: Permit#: <br /> �� bP� <br /> C�T'Y aF ORONO - BL1II.,DINCY PER.�.VaIT APPLICATION ���� <br /> All inFormation must be submitted in fu]i before plan re�iew will be started. <br /> (pleas�prinr all inforn�ation) <br /> TH� APPLXCANT �S: (circle one) OW?v"ER CQNTRACTOR <br /> ' � 553�� <br /> JO� S�TE AD�?RESS: � �IP: <br /> N�,.� OF OWN�It: ._�p PHO�: (home} q�Ja -�-�'��"�og`t"� <br /> (work) <br /> �YAILT.��ADA�SS: �� � �R1t�� g�CI'�'X; ZIP:,�s� <br /> ' ___ 4 _ <br /> C�h"�'RACTOR:�� ;n ^ _ PHQ�: SI� �-1�D� � <br /> C4�T'I'ACT PE'I�SON: L�So� r 1VIf3�YLE/PAG�It: <br /> I�IAT�..ING A17DRESS: �11�8 �„i CSL� �.�__..._..G�': Zl�:�,��' <br /> S'�ATE LICEN'SE: #�(��"`tt�c�� <br /> ARCT�I'T'�C'T/ENGIIV��I7: � ._...T PHONE: <br /> 1�7AILI�i rG�Ai�D�SS:�� _ _ CYTY: ZIP: <br /> Nru1�E: _ �REGTSTReiTI41�#�^ __ . <br /> T'YPE O�' '�VORT�: New Addicion Accessory Structure <br /> Mpve Remodel/Altezation Irand A.it�ration� <br /> PROPOSED ti�O�T�(describe in detain: _ <br /> � ., <br /> STORIES: SQ.FE�T O�'�ACH�q4�t: <br /> NO. O�' BEDR40MS: GARAGE S'�'AT.LS: ATT. � D�T•__ � . - <br /> ESTTNIA.TED CONSTRUCTI(?N VALUATYON (excluding land): $ <br /> I hereby apply for a building permit and Y a,claiovv�,edge that the information above is co�plete and <br /> accurate; thac the work will be in conformance with the ordinances and codes of the Ciry and with <br /> the State Buildi.ng Code; that T understand this is not a permst and vsrork is not to start without a <br /> permit; and that the work will be i.0 accordaace with the approved plan. <br /> A�'P�ICA.i\'T'S SIGNATYTR�: DA1'E: ' <br /> NOTE! �de o Homes events require separate permif appraval by Palice De,partment and <br /> City Councrl 60 days prior to the event. Non permitted events will not be allowed. <br /> ..............................................�--�-�--.............--��---.......................--�--............--��-----....-�--�----�--..............-�---..............----��-----�-------�------------�--��--- <br />