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Total Fee: $ 62CO3 • 1 3 Date Received: 4 C 7 5 -33 <br /> Entered By: _ 5'YX-_ Permit#: 5 / .Z`-/ (o,/ <br /> 0' 4 t CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> 1,kJ- tiliAn <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) COWNEB�R CONTRACTOR <br /> JOB SITE ADDRESS: a 5 012,0N O 0 KC 11--4-1212 -KO 0 ZIP: 5 5 'S&' <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> E Yes ZC No If yes, a special event permit is required with Police Department and <br /> City Council approval 60 days prior to the event. Non-permitted <br /> events will not be allowed. <br /> NAME OF OWNER: f IC 1+0E L O. 5 EN E01 C-T" PHONE: (home) 9 S.9- 1-13- -Ziii <br /> (work) 615 a- et a 8-aW <br /> MAILING ADDRESS: -1-s AKN BALL Rte N CITY: (061'21)-M ZIP: SS 391 <br /> CONTRACTOR: MI e hae( .5,EN-G-0 I Cr PHONE: q5,, -4 o -Z/9 I <br /> CONTACT PERSON: MOBILE/PAGER: (.O!a-`T(5 - 7 80( <br /> MAILING ADDRESS: 1-S 1~lz Po T3LE 12V N CITY: (,U a TP)- ZIP: SS 317 <br /> STATE LICENSE: #N/1i EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: GC I EEF) IN) S PHONE: 65f- iO --PO\ <br /> MAILING ADDRESS: 1354 V 611/arid 1`W-, CITY: 41,taut ZIP: S51 of f <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New ,)( Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): I"4 (,0 11-nsE Cd fit.)S1(O C77 ak) U,L <br /> .1 <br /> STORIES: 'l SQ.FEET OF EACH FLOOR: '1 itelt tStO /,+2b <br /> NO. OF BEDROOMS: "1 GARAGE STALLS: ATTACHED 2,lDET ED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 550i 0 OO <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: r7/Z' JE4ATE: " <br /> \tc9 <br />