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Total Fee: $ T• ! Date Received: `f-S-DT <br /> Entered By: flikt Permit#: A O$'S 73 <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) Perk <br /> OR CONTRACTOR <br /> JOB SITE ADDRESS: .7yo Orchal ( Perk KJ dtdNd ZIP: SSj.lj <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> DYes ❑ No 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: 4fo,v(' l Y t-p er PHONE: (home) (j '10/, <br /> / (work) <br /> MAILING ADDRESS:-7110 �rc +�,�of 1 �( �f� CITY: Q'tofu ZIP: S,S'311 <br /> CONTRACTOR: ce/r /r i Etv�t r h*' PHONE: L1!7 6 <br /> CONTACT PERSON: (Soo/ r MOBILE/PAGER: <br /> MAILING ADDRESS: )90 etc-hsrA AI CITY: Oro"" ZIP: Ss Ice <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 /1 XI. 54•I <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): 11 X /�. c+ r aY 54 e t <br /> I <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 60� <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: a,T)2,„ DATE: _l / /dS <br /> 31 <br />