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CITY OF ORONO - ,BUIL]?ING PERMIT APPLICATION <br /> Total Fee: $ 71, 16 Date Received: 4/,*5-' <br /> Date Approved: <br /> Entered By: • „Li) <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 /> JOB SITE ADDRESS: /005 t1D 4.0,0g /.k' 12_17ZIP: 55.3 ? <br /> (work) <br /> NAME OF OWNER: -0 d /nI D ,/5/*P PHONE: (home)4t7C• / Z a 7 <br /> MAILING ADDRESS: ailing, /UOS o.v,G 04 S LAASH//CITY: Wify14.9 ZIP: 5539/ <br /> CONTRACTOR: 0/.040..R„ 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 Accessory Structure Move <br /> Demo Remodel/Alteration )‘ Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : B$G k / ox <br /> STORIES: - SQ. FEET OF EACH FLOOR: <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�C �J►9,411 (i IQ/St-0J DATE:Y 4-13-(6 <br /> ay <br />