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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ �� a . t71 Date Received: <br /> Date Approved: <br /> Entered By: <br /> Permit A: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL. BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ----------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNE or CONTRACTOR <br /> JOB SITE ADDRESS: S�o D1'fl1 r'I Ue. Z-I�P�:: <br /> (work-) 337- 93 24 <br /> NAME OF OWNER: I�G�eY� t 11C� � w 1 C' k PHONE: (home)4/2 <br /> MAILING ADDRESS: OtA /LOIS br• CITY: �Du ZIP:SS�3�� <br /> ��' 9cw- otos~ <br /> CONTRACTOR: /0/W SM/f4 �O�J.SJ I'LLC/l�fZ .�-//C PHONE <br /> MAILING ADDRESS:_V /21-ok ZIP: ssya� <br /> STATE LICENSE: $ 000 7!2S-9 <br /> ARCHITECT/ENGINEER:y� +PilP1I . ccl PHONE: �7" <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition ✓ Accessory Structure Move <br /> Demo Remodel/Alteration--*G Renovate Land/Alteration <br /> PROP SED WORK (describe in detail) : "'y <br /> a• ar <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ `f : ij <br /> I hereby apply for a building permit and I acknowledge that the informati=on <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> r <br /> APPLICANT'S SIGNATURE: A, L.�il DATE: 3 <br />