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Total Fee: S '7 2� 5C., Date Received: 22 l/0 '1 <br /> Entered By: / Permit 4: /1 //a/ <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> r ( �JOB SITE ADDRESS: ►ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ No Ifyes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. _Non permitted events will not be allowed <br /> NAME OF OWNEIL PHONE: (home)L � I C <br /> (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: Renewal By Andersen PHONE: <br /> 1920 County Road "C" West <br /> CONTACT PERSON: Roseville, MN 55113 AGER: <br /> MAILING ADDRESS: _ License 420130983 ZIP: <br /> STATE LICENSE: # 651-264-4777 DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration(ic: Siding, Windows) <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detail): '� ok O Lx----)/ 'j r"� <br /> O <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � 1 `I 9 pD,Q 0 <br /> 1 hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved pl <br /> APPLICANT'S SIGNATURE DATE: <br /> 31 <br /> Z 'd 0619frL91S9 iIWN3d Q B S M WdBI :E L00a 81 Few <br />