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CITY OF ORONO <br /> �► BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O,� SO <br /> Mailing Address: s--� ,� <br /> !`/ 9 Permit number: <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address --_ Rived by: <br /> 2.1 <br /> S� L� 2750 Kelley Parkway ±� -�0Ian review fee: <br /> �gKESHOR� Orono, MN 55356 ; ? <br /> Main: 952-249-4600 o al Fee: <br /> Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 75 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes IX No <br /> /f yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will e <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> State License# Z Expiration Date: 3 Z <br /> Phone: cell &lZ 80 office (L • Z 1l <br /> Mailing Address: 775 A T. UITC E531 — City: t"IIWNIf.�l.l�j ZIP: O <br /> Contact Person: �[-'�fZ. C4Zy l,4 Applicant is: ontractor / Homeowner (Circle One) <br /> Email and/or Fax: p115TEY2_ C <br /> PROPERTY OWNER INFORMATION: <br /> Name: <br /> Name: 7SGZ 1E7- zlizo"11-4 <br /> Phone (day): •7i <br />