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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ U' 6)6 Date Received: <br /> �99 Date Approved: <br /> Entered By: `'21.A) <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: -NS. OV-4.14AR-D P14f.1L. 2,40 ZIP: S 535 <br /> (work) <br /> NAME OF OWNER: sem/ PHONE: (home) 4/73-4/012_ <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: .V 1.44:DsM PHONE: q7Z-Y 7 Z/ <br /> MAILING ADDRESS: [(•o Ei4s-rv l c7,`' CITY: 'Lou N 10 ZIP: 55 3 4.Si <br /> STATE LICENSE: # ANOh % t) <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> MAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure , Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : ADT) P- 3Er-W. —re, e- of- mime <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> 25:- <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 3000 • <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: ,f///q5/ <br />