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<br /> Toxal Fee: ��,�q ��' � DateReceived: ..� 12-- Zvv�7 _
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<br /> Lnterecl By: �]_Vt� � Perinit#:�jC�7(�`J�
<br /> CI�['Y O� ORONO - BUILDING P�12MI'I' APPLICATION
<br /> � �SII infoi-mation mi�st be subrnitYed in t'uli befo►•e plan revie�v ��r°ill be starYca.
<br />�� (��lecr�se��t•itit all in fo�v�r�rtio�i) �
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<br /> 'Tf�.� APl'�ICE4N�1' ��: c�rcle o�re O WNTR O C'O ,TRAC�
<br /> � � � � ' �...?� ..... , __
<br /> �r���iz�r,�vDi�ss: � �� U��� � d � L L zi�: SS 35�
<br />� � � Will this be �� Paracle oi'Iio��ies, Ren�odclers Showcase I�ome or o4lier Dis��lay Home?
<br /> ❑ �es �l°do If ye,s, a spec•ial ereiil pernrrl rs reqtrired rni[h Police Depai•GiT�e��t and Crry Caz�nci!n;:proval
<br />� � 60 dcrt-.�'prror 10/he e��enG Sliutlle bz�s service�i�ill be�•eyzrii ed uraless nppliccnrt clemonsU•ar��
<br /> � sarf icier�i o��-siie paricit�g is cri�uilable. ��'o��-perrrrit/eclei�er��ts ivzll nu�Ge all�>i���d.
<br /> NAIVIE OI'OVVN]CR: �� �;,`r� �,.,�� ,t,'�'- �1 V f� ��a n PIION�: (home) t;��.�_ C..�7 3 - 3 J��J�
<br /> � � (worl<) � �
<br /> MAILING ADDR�SS: �� CITY: �' ZIP: ''
<br /> (:Ol!'7CIZACT'��2: .��%r •C� h►��c.���� �io n��I�,K.�', ,i%-� PHONE: `l�3- ��g- ��.��
<br /> CONTA�'lC PERSON: SC.�� c� f�c��� �� MOBIL�/I'AGEI': �' ��
<br /> IV�AITi,iI�Tc��TuJ�t�Ss: y� 3r� c� , �v �i'�'i': �,Iti,�� �°i: 53���
<br /> STAT�LIC�liTS]C: # �,L, �����`�^7 fy L`�PIRATION llAT�'�: 3 3 �"
<br /> EIRCHIT'EC'�'/�IiTCTINI:L�2: �,J�� X C.l��.,, C�.,�ep�5 P�-IOI9�I;: `16�5 - ��� -��`� 1)
<br /> r�A�:l.[�r(s�����SS: ��I , �L, L.�,�.,,,i,� ��� . !��: c�r��: �l�.,� Ih�L zr�: ���
<br /> �t���: ���{:����rr�����.��: #
<br /> � '�'�'P�' �� �VC9�2_��; New IIom� �ddition X Accessory Struct�n-e
<br /> � Nlove 1-Ioi��e Remodel/Alteratioil (ie: �icling, Wi�ldows) _�_
<br /> Any earth movement may requir� MCWD review and permits !
<br /> �'��t0�'��S�ll�/�12��(d��scribe iez�fcPcei!):��_�� �_. �.,� �i �C. GI r, rntikt, ,'-�
<br /> �� ����1 h��,t�.,�e,-,� �i�C� �,4d � ��� � �:; -I�n (30,��, o ha���r,
<br /> s�o����: 1 ��.a�,�,��o��:��x��,�o��: � ��I�j --
<br /> I�10. OF ��I)1���I��: G����� s'�'�1L�,�: ��'1'1 f�CI-�➢':�� ���,���C�-���
<br /> ��;��'�:I�i1����+.���'���1�"�'���J�"�.���@� ������JA�'��l�i(������aac�fl�a������c�): � E�4 �ot� _
<br /> I hereby apply for a buildin��permii and 1 acl:no�-vledge tl�at the informat�ion above is complete�anc(acc�u�ate;
<br /> that the w�orl: ��-ill t�e in conl�ormance with the ordinances anci codes o�Ft}���.e Citv and ��vith the StaCe 13uilding
<br /> � � Code;that 1 understand this is not a}�ermit anci�vorlc is not to st'art�vilhout a permit;and that tho worl:��vi I I be
<br /> i❑ accordai�ce �vit�h the appro�Fcd plan.
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<br /> �°��'�'��L;f�'I''��9C�1�'.�"���l�Z�?: �;; � ���g�.: �' �1- �
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