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ti <br /> Total Fee: $ Date Received: <br /> Entered By: Permit#: <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 OR ONTRACTO <br /> JOB SITE ADDRESS: 1130,57 Lj l //O W J>l u t ZIP: '9,53 -9 / <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes [:] No If yes, 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 OWNER: n)o r4A a S ik i)U l^ PHONE: (home) T9.21 Lr 7 3•/b <br /> MAILING ADDRESS: (b D 5 Wdt'DW DP CITY: 6 r e n (work) <br /> Orono zip: SS 31 <br /> Pella Windows and Doors <br /> CONTRACTOR: 15300-25th Ave.North, Ste. #100 'HONE: Sa 3kS-G d17 <br /> CONTACT PERSON: _ Plymouth, MN 55447 GER: Jbclr m £Idir Joto S <br /> MAILING ADDRESS: _ License#20165884 Zr-p' <br /> STATE LICENSE: # 763-745-1400 TATE: <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(ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSND WORK(describe in detail): 8 Wt/)Clow rl DlQCt.lYItit rn <br /> Ylstl� b <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ i' Jr^j 1 -7 3 <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 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 plan. <br /> APPLICANT'S SIGNATURES, DATE: *3 <br /> 31 <br />