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� 09114s'2q64 13:02 6516344129 TCSP PAGE 02 <br /> Tutal Fee: $ ?d3. 95 DateReceived: 9`�1��� 7 <br /> Ente�red Sy: � ,,�� __ Permit#• flh 7� <br /> C[TY OF ORONO� B�ITIL.D�NG PERM�T APPL�CATION <br /> All inforaa�tao�a�must be subuaitted in fal�before plan rev�ew will be s�arted. <br /> (plea�se piant all infor�nution) <br /> —l..-. — <br /> THE,APJPLICAI�TT IS: (circle one) OWNER U CQNTRACTOR <br /> JOB SITE ADURESS: '�,�I(Yl.T���.�►,�cx�`� , �: .�`� `� `� I, <br /> Will tl�as be a Parade o�'Hames,Remodelers Showcase Hame or other D�s�lay Home? <br /> ❑Ye8 �.NO ,�f'yes,a special event permit is reguired with Police Deparrme�zt and City Cvuncil approvoC <br /> 60 day�prior b the ev�nl. 5'hultle buv.vervice wiJl be r,equired unless applicuntdemonstra�s <br /> ,a�cient on,site parkir�g is avuilable. ,Non-permitted evenriy wil!nor be allowecl <br /> �1AME OF OWNER: �o r'►�a- �r��.� Pa._�A��o r, _PHQNE: (honae) �I 5a-N'T3- Oo��� <br /> MAI[.INC ADAItESS: �' � CI'�X: �c �.���IP: 5��i I <br /> �'�.Q.�v t- _I e w o od � <br /> CONTR�A.CTO�: T.�� C'_�.�.:� � :.,�-,, ��-n�-`e.ss'c o,c1�s P�ONE: l��1_�,�-,�5;'�I�H <br /> CQNTACT PERSUN: A n� m n�� ��� �'IOBILE/PAGER: <br /> MA�LING ADD�.tESS: r:r�� Tr��S��< <l� C�TY: �k��P�_�--1 ZIP: ��S�I+�E <br /> ST,ATE LICENSE: #_��03� ��� EXPIRATIQN DA'�'E: ��3�,o� <br /> ARC�TITECT/ENGINEER: PHONE: <br /> MAIL��iG ADDRESS: CITY: ZIP: <br /> �A�; REGISTRAT�ON: # <br /> TXPE OF'WORK: New ,A.ddition Accessory Structure <br /> Move Ham� Rezxaodel/Alteration ,.� <br /> PROPOSED WORK(dese�lbe in detai�: (� �.��e a- re r,� �c� � ���=►nc� <br /> � <br /> S'�.'ORIES: SQ.FEET OF F.A,Cki FLOOR: <br /> 1�T0.OF BEDROOMS: GARAGE STALLS: ,A,TTACHED DETACHED� <br /> ESTIMATEY�CONS'�'RUCTION'VALU,A,T�ON(exctuding aa�d): $ ,.����� a`' <br /> I hereby ap�ly for a buildin�pemnit an.d Z ackt�owledge that the in£oxmation above is co�p�ete and accurate; <br /> that tlae woz�c wi11 be in confomaarzce wath the ordinances aaad codes of the City a►xd watk�tl�e State Building <br /> Code;that�wnderstand this ia not a pezxnuit and work is not to stazt without a permit;and tlxat khe work will be <br /> ita accordance wath tk�e appzoved plan. <br /> A.PPLICANT'S SIG�iATUItE: � DA,TE: �1 �^ <br /> 31 <br />