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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee : $ �� C� Date Received : <br /> Date Approved: <br /> Entered By: <br /> Permit#: <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 ) 1OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: V � C-0 /lbR) jI�1 e m) /-iy ZIP: �5 <br /> (work) <br /> NAME OF OWNER:- r>h r1 R 1,Q r(\ PHONE: (home) r-) <br /> MAILING ADDRESS: '3.1bC) Alt)P,4 IAF J2AI AVF CITY: (L)nY7_)9 • rn ZIP: 55,391 <br /> CONTRACTOR: Tomah PHONE: 4_21 _211 (m <br /> MAILING ADDRESS : E3`16 MD/2+l+EV_Aj #gVECITY: W19YZIq�f} ZIP: 15!53 <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : AM Porgy C.\ 0l,l <br /> ttoP-A , S i DE �-)OuSC <br /> STORIES:-�- SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : roc <br /> hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> Drdinances and codes of the City and with the State Building Code; that I <br /> inderstand this is not a permit and work is not to start without a permit; and <br /> 7-hat the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: J44 DATE: ') 1 <br />