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09/15/2006 13:51 763-559-0148 ENPATH MEDICAL PAGE 03/06 <br /> Total Fee: $ f 2-49 Date Received: <br /> Entered BY: Permit#: /y_ <br /> CI'T'Y OF ORONO -BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plain review will be started. <br /> (please print all information) <br /> ----- _ ____----------------------__-- ----__--�--- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: 3640 Togo Road ZIP: 55391 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑Yes 0 No if yes,a special event permit is required with Police Department and Ciry Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufeient on-.cite parking is available, .Non permitted events will not be allowed. <br /> NAME OF OWNER: Michael Novok PHONE: (home) (952)906-0870 <br /> (Work) (763)577.2250 <br /> MAILING ADDRESS: 3640 Togo Road CITY: Orono ZIn; 55391 <br /> CONTRACTOR: NIA. PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: NIA PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition ✓ Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding,Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORD(describe in detail): Deck <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: 350 <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ z ooa,00 <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 its conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a pennit 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 SIGNAI'IJRE:`�^"�` '' DATE: 09/15/06 <br /> 31. <br />