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Total Fee: $ �.� �o �,� Date Received: � 0 9
Entered By: Permit#: (`�j - 000 �
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(pleuse print a[l information)
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THE APPLICANT IS: (circle one) OWNER OR�CONTRACTOR�
JOB SITEADDRESS: � C,C: C� �'c.;c�, ��-,:��� �;�,�. �I ZIP: 553°1 �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes � NO If yes, a specia!evenl permit is reyuired with Police Department and City Coa�ncil approval
60 days prior to the event. Sharttle bc�s servlce will be reqtrired t�nless applicant denronstrates
sufftcient on-site parking is available. .Non-permitted events wil!not be aUotived.
NAME OF OWNER: 1� p,.�. ��° _ PHONE: (home)(��j%���,�-�1 -(�Ul �
(work)
MAILING ADDRESS: �j� �� Z 3r::I �S IU CITY: ��)e:�. '�/orl2 ZIP: e�
CONTRACTOR: ���-t,,,��, ,,��;�,.�-I LL�_ PHONE: (�'i j Z� �`(7 - �S`i U
CONTACTPERSON: �,;;�.� C��.,51-��f=�e�� MOBILE/PAGER:
MAILING ADDRESS: ��Iv 7 �L.�.�_,2,.�E-r, RI���I, CITY: �iV�� �c ZIP: �)Fj'-{Z.tv
STATE LICENSE: # z�,.t�'��� 3;�; EXPIRATION DATE.
ARCHITECT/ENGINEER: �'I-,r��r�i.���- �s�o,.� �: CC�. LL�. PHONE: l�i J 2� y�v -�i 7i(�
MAILINGADDRESS: �-!�`-1 Sccc-�c� j�--t�z�l-3:n�k1�'��CITY: t_x��ls;o:' ZIP: SS�� i
NAME: ��,� `j�.��r��t I-F� REGISTRATION: # ;;'_ 3 (p f�o
TYPE OF WORK: New Home �� Addition Accessory Structure
Move Home Remodel/Alteration(i.e.: Siding, Windows)
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�i + �;��1'l ,lr�.t�l il a /i;r�t� � 'l t;''� i ,i'� � r,'.r�! , �';��;�ll.
PROPOSED WORK(describe in detai�: �r�n.�u v� c>I�L. 1��-:�ire e,��l ��r���1c I-r�.c.l,�,.�
��� `/�t�.J �w'�"n'�z- 1:����, �2�—c����ZC1 ��'��0.�
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STORIES: ; SQ.FEET OF EACH FLOOR �;���;�� ���=i �ri� � �. ��r- C�S�-.
NO. OF BEDROOMS: _� GARAGE STALLS: ATTACHED_� DE ACHED�?
ESTIMATED CONSTRUCTION VALUATION(excluding land): $��, y�t�, pDU
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I hereby apply for a building permit and I acknowled at the information above is complete and accurate;
that the work will be in conformance with the o 'nances and codes of the City and with the State Building
Code;that I understand this is not a permit a �,work is not to start without a permit;and that the work will be
in accordance with the approved plan. �`�,�'
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APPLICANT'S SIGNATURE: llATE: I� Z 1� a�
9 j
/ :
31