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Total Fee: $ Date Received: <br /> Enteted By: Permit#: <br /> • <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <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 91f6-0.11;11V—ACT—es"--)'OR <br /> CONCR <br /> JOB SITE ADDRESS: 4 O Cl G-Oiic, v? ( ZIP: S'S 3 9 I <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ No If yes, a special event permit is required with Police Department and City <br /> Council approval 60 days prior to the event. Non permitted events will not <br /> I be allowed. <br /> NAME OF OWNER: L c O'- h cJ. o PHONE: (home) 9S2 - 9 3 O <br /> (work) <br /> MAILING ADDRESS: 440 O(dLor,5 L/ Ra CITY: ttiG.r 2 4 •A I ZIP: cy'3 9 � <br /> CONTRACTOR: /O p LI R 0OCI ki 5 PHONE: 9S 2-9i QO SS <br /> CONTACT PERSON: Sic -L Iii //'e• MOBILE/PAGER: G 12- 3.2 g- 9 <br /> MAILING ADDRESS:eqOO w-cs718 CITY: (arr,,n s c4, ZIP: SS4 2 C <br /> STATE LICENSE: # ,2_oa2 /5 453 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Accessory Structure <br /> Addition Move <br /> Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detail): Icon,- a 41 /\ < ysao <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> a° <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ / 1, 4 42L2 <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;that the <br /> work will be in conformance with the 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 that the work will be in accordance with <br /> the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br /> C - /9- �I <br />