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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> f , <br /> Total Fee: $ TW a Date Received: <br /> 27Date Approved: <br /> Entered By: 93-(4,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) or CONTRACTOR <br /> JOB SITE ADDRESS: 7(-(5 O R' i+i' " 0 pprILK- 14) ZIP: <br /> (work) 55 <br /> NAME OF OWNER: G/ -% 4711.0t.72 PHONE: (home)'Y7(' - <br /> MAILING ADDRESS: `7-' p,e CITY: � - ZIP: S-SlY5 ,.. <br /> CONTRACTOR: TJ(k PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: IPHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration e, <br /> PROPOSED WORK (describe in detail) : COMjL-E7 SLOP Ce74/6-7Z,'rv6 <br /> ..5)/t1 ( ,VC Z 7C c,r.9o.s <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: DATE: <br /> �ta s 1}- -tom bo�-oAA toe-Lre s4a,r �, I I <br />