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4 •4!".. . CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ ,,,.2./. /5 Date Received: <br /> Date Approved: <br /> Entered By: /If <br /> Permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> ®fid ZIP: 5-63 a t <br /> JOB SITE ADDRESS: BOOS L�6G,tFk�c. <br /> � <br /> pp (work) <br /> NAME OF OWNER: KENT L 1V/N { `Oliktb I`6( M • PHONE: (home) 473 , 0 /'g <br /> MAILING ADDRESS: 5 4 t i CITY: L 04G 1-4-&,1g. ZIP: <br /> CONTRACTOR: - PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # — <br /> ARCHITECT/ENGINEER: - PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition DOGK Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : Rz PL46 be 117VS7i4!C <br /> STORIES: SQ. FEET OF EACH FLOOR: 4 Piet-Ok 4 7 0 5q P`r <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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 /> APPLICANT'S SIGNATURE: cry, %'rf�►l/� 4rt.(„ DATE: <br />