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• %L CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ �y'/. �J Date Received: 'j�/��9f� <br /> Date Approved: <br /> Entered By: �(� <br /> Permit#: L�7,a,YY <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) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: CbS OLb Usayf L. ha4 (zj iwau ZIP: 5S3S6 <br /> Loo-. LAk6 ,0,4 (work) <br /> NAME OF OWNER: Q2ptjn 1,PW&jlw-T SWCOL., f6z,nn %kL1 *�2b PHONE: (home) 4449 -153oo <br /> MAILING ADDRESS: 6,BS ou) CR4ST�L- &,-`. Kd� �- CITY:��j&.j. ZIP: <br /> CONTRACTOR: 1146 Gi,)-MACr,#j6 i,w L PHONE: <br /> MAILING ADDRESS:j 10l� cjr\.i 4419 CITY: Mpo-�3 ZIP: SS36y <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: 11;�\(, C �h+�"�aRS t�,,�-isiAc�r• "» PHONE: L�7a^51f� <br /> MAILING ADDRESS: CITY: ZIP: <br /> Nom: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : '(6raa 1S GoZT S OR-A66 GACA L.%D4 <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS:_ GARAGE STALLS: ATT. _ DET. _ <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $�o Coo 00 <br /> I 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 /> 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 + DATE: -7'1 q-R j <br /> APPLICANT'S SIGNATURE: ,�, � - _-� <br />