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Cfr 1 2 r �d <br /> -Z 4,,,,/�" ) <br /> Total Fee: $ `570' 6267 Date Received: CI-(�-°S <br /> Entered By: (5/14.._ Permit#: A 0(-At�1 <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 OR CONTRACTOR <br /> JOB SITE ADDRESS: 52-S 0 J'C .rd f a,/t' ZIP: S S3 S(, <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes RNo If yes,a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER[ c v.eki 2e_5)-rat PHONE: (home) a C 2--`I16. 036 S- <br /> (2 ! (work) 41 it-`-(16-62'2.6 <br /> MAILING ADDRESS: ( #- )t CITY: ZIP: <br /> CONTRACTOR: ( S e �..,-�) PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure ?'C <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): 45 22-d t "A 94-0 Opt c <br /> STORIES: Csv---L--- SQ.FEET OF EACH FLOOR: b 0 O <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED 9 <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 20,000 <br /> I hereby apply for a building permit and I .43 owledge that the information above is complete and accurate; <br /> that the work will be in conformance wi - ordina = and codes of the City and with the State Building <br /> Code;that I understand this is not a perm' d work is not to art without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: nib, DATE: R � l° <br /> 31 <br />