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/ <br /> Total Fee: $ 1 3�, 2 Lp iflo I ate Received: • 14 ! 05/ L <br /> Entered By: (OM- �, - Permit#: 1 01 .}7/ , <br /> CITY OF ORONO - BUILDI►:erwERMIT APPLICATION <br /> S <br /> All information must be submitted in full before plan review will be started. <br /> \ • (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: Zoo Ot-C , CJ (21" . ZIP: 5S 39 I <br /> Will this be a P rade of Homes,Remodelers Showcase Home or other Display Home? <br /> [I] Yes / No If yes, a special event permit is required with Police Department and C'itt•Council approval <br /> 60 dm's prior to the event. Shuttle bus service will he required unless applicant demonstrates <br /> sufficient on-site parking is mailable. Xon permitted events will not he allowed. <br /> NAME OF OWNER: I.a,A,g) f'S1191 GttSaia.0 PHONE: (home)9S2 <br /> (work) <br /> MAILING ADDRESS: Mrki O d-() RI). CITY: ZIP: 55 3 or.-.2. 0 I <br /> CONTRACTOR: sWi,eYi- ' (capve .rnA PHONE:'152- 4 73. 5935 <br /> CONTACT PERSON: 2,1FAir vB)r-r. 1 DEki," MOBILE/PAGER: Ci 2 414 570 <br /> MAILING ADDRESS: /g 3 4o mfiviver0A4,4 aturXITY: 1v.9.(247a9- ZIP: 5;391 <br /> STATE LICENSE: # 372 EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: cult; Cl 17744 &love PHONE: 6(2 VIA 7.S7.S <br /> MAILING ADDRESS: '20/2.44e /let/ ,47 CITY: j itnimi 2A/by ZIP: 63-30.s- <br /> NAME: <br /> 3-3osNAME: 2rieg... E-4 REGISTRATION: #q//- /y 3-ca76- <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration(ie: Siding,Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detail): vivo giving 4i O/✓VrV f3', /, r&--v <br /> X519 r -OtIIVE . <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 3CVO <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: 'i DATE: 246-DCS p� <br /> 31 <br />