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�ep-25-2009 11:26am From-CITY OF ORONO +9522494616 T-813 P-002/002 F-006 <br /> Total Fee: S � Date Received: i'laZ 5 <br /> Entered By: __ Permit#• d��a9-4 <br /> CITY OF ORONO -BUILDING PENT APPLICATION <br /> ,FID information must be submitted in full before pian review will be started. <br /> (please print all infarmation) <br /> THE APPLICANT IS: (circle one) OWNEROR6ONTRACTO <br /> JOB SM ADDRESS: &4 U 'fin hy ie o Lane zw- 563('0q <br /> WDJ this be a Parade of Homes,Remodelers Show►ene Home or other Display Home? <br /> Yes ❑No gyes,a special eve,u permit it regrrtrad with Police Departmew awl c Ity Council approval <br /> 6o days prior to the event. shunle bur service will be repir ed unless applicam demonsmares <br /> sgffloient onsite parAing is available. Non-permltted evens wilt not be allowed <br /> NAME OF OWNER: ` PHONE: (bane) 5,Q_z-543 <br /> 4 lWO&! <br /> MAIL114G ADDRESS: CITX: 21P: 56,81. <br /> CON RACTOWMan-Ray Inc __PRONE: 763-544-3646 <br /> CONX'ACTPERSON: John Bewgr MOBILTu/PAG R: _612-386-6259 - <br /> mAUXKGADDRESS:�801 Boone North CITY: Golden Valles: 65427 <br /> STATE LICENSE: #:. ..0005111 EXPI.RATION'DATE:_ <br /> ARCHITECT/ENGUM&' PHONE: <br /> MAMING ADDRESS: CXTY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORD: Now Horne Addition Accessory SUmctwce <br /> Move Home Rernodel/Akeration(ie: Siding,Wmdows) _'�4_ <br /> Any earth movemeza.t may require MCWD a;e^viGw and p@2 mi.ts I <br /> OPOSED WO (describe in detaiq: <br /> R <br /> STORIES: SQ.FJMT OF EACU FLOOR: <br /> NO.OF MROOMS,. GARAGE STALLS. ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): S 4� D D. <br /> I hereby aPpl�for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in oouformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a mit and work is not to start without a permit;and that the work will be <br /> in acoordance with the approved plan, <br /> APPLICAIWS StIGNATUItE: DATE: _. 0 <br /> 31 <br />