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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> l <br /> Total Fee: $ ` Date Received: <br /> C)71 <br /> Date Approved: <br /> Entered By: <br /> Permit#: L j3 79 <br /> ALL INFORMATION MUST BE SDBMITTED 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: I 006.q: () e-CitkR-4\ � ZIP: <br /> (work) <br /> NAME OF OWNER: 1 '1P.,t-i 4- C! -1C�� PHONE: (home) <br /> MAILING ADDRESS: I kC O e0V0 Q l t -A-�Q 1 k CITY: O ONC ZIP: 5539 I <br /> CONTRACTOR: PlLjI 4- 600J0 7. C ., PHONE: 379 4-34-9 <br /> MAILING ADDRESS: I 4-6•t"A CITY: fYI Pt's ZIP: 3:51;04i <br /> STATE LICENSE: # AapLlc Foy CN,A.1.61,0,-) <br /> ARCHITECT/ENGINEER: OS err (J+ vUbsJt? ) PHONE: 4/73- <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition ✓ Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : 4a FA <br /> M Lu{ PQgw. c 407-4-14VA <br /> STORIES: I SQ. FEET OF EACH FLOOR: ...3& 0 <br /> NO. OF BEDROOMS: U GARAGE STALLS: ATT. 2/ DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ �OBU <br /> 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: 0 6 IqZ� <br />