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Oct-18-2004 10:08am Fros-CITY OF ORONO +9522494616 T-023 P.001/002 F-48T <br /> T9t�J Fee: $ Date Re�eived: <br /> � Entered By: PerYpit#• <br /> CY'x'Y O�' ORON4- BUYLDING PERMIT APPLICATIOI� <br /> Ail information must be subrnitted in full before plan review will be started. <br /> {ptease print all infor�atian) <br /> THE APpLICANT IS: (circle one) O�VNER CONTRACT <br /> JOB SITE ADDYtESS: �� l�C-� �w d _ ZIP:�S� <br /> Will this be a Pa de of�omes,Remodelers Showcase�ome or other Display Howe? <br /> � y� No If yes, a special event permit is required with Pnlice Depanment and City <br /> Council approval b0 days prior to the event. Non permitted events will not <br /> be allowed. <br /> � ,/ P�ONE: (home) ��2 '�O 8`� � <br /> NAME OF OWNEx: l/��(/ � /1� (work <br /> M.AII.Yl� <br /> G ADDRESS: 5 �.� ' ����� ZIP: 4?�� <br /> . ��e.r,� r f titi o.�an�-✓ts p�or�:��5t� �$�l-Od I�/ <br /> CONTRACTOYt. <br /> CONTACT PERSON: MO�ILE/PAGER: <br /> MAYLING ADDRESS: � b�1 C�TY:��M i zYp: 55 3 <br /> STA'rE LICENSE: # �� <br /> ARCHITEC'T/ENGYNEER: px��' , <br /> MAIY.ING ADDRESS: CI'TY: �= � <br /> N��: REGISTItATiON# <br /> 'Y"YPE OF WOI2K• New Accessory Structure <br /> • Addition Move <br /> RemodeUAlteration Land Alteration <br /> PROPUSED`WORK(describe in detail}: <br /> S'Y'ORIES: SQ. �'EET OF EACH FLOOR: <br /> N4. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONST�tUCTION VALUATION(excluding land): S <br /> I hereby apply for a building pecmit and I acknowledge that the inforniacion above is compleu and accurate;that the <br /> work will be in conformance wich the ordinanees and codes of the Ciry and with the State Building Code; that I <br /> understand this is not a perrrut and work is not to scan without a penruc;and that[he work will bc in accordancc with <br /> the approved p1a:►• <br /> � <br /> , DATE: �C� -f8 �- � <br /> APPLICAN'T'S SIGNATLJ ��' <br />