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From:ELDER JONES INC 952 854 4909 03/28/2007 10:48 #934 P. 002/005 <br /> 4o1 <br /> / <br /> Total Fee: S Date Recei -'. iii% <br /> .r-= <br /> Entered By: Permit#: ' /084/ 7 <br /> • <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 ibrmation) <br /> THE APPLICANT IS: (circle one) OWNER OR TN RA.CTO <br /> JOB SITE ADDRESS: ?3O g Sh Q d Goo 0 Cf Rd ZIP: S S 3 4 <br /> Will this be a Parade of Homes,Remodelcrs Showcase Home or other Display Home? <br /> ❑ Yes NrNo Ifyes,a special event permit fs 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: Pt) /(1.5 tie <br /> P S 01) PHONE: (home) Li 7/- O<(? s <br /> work) <br /> MAILING ADDRESS: 2 3"b Shet yL ,o C CITY: Gin yT n7 ZIP: S 39 J <br /> RENEWAL BY ANDERSEN <br /> CONTRACTOR: 1920 COUNTY RD. "C" WEST PR: pd Me i'P73oNE:t9 C� 3�5 -4°1(7 <br /> CONTACT PERSON: <br /> MAILINGADDRESS:- ROSEVILLE,MN 55113 ZIP: f 044 <br /> S <br /> STATE LICENSE: #_ 651-264-4777 v DATE: <br /> LICENSE#20130983 <br /> ARCEITECT/ENGINF.ER: PHONE: <br /> MAILING ADDRESS: n 1 �' 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 permitslj <br /> PROPOSED WORK(dsscribe in detail): 3 kid!ii t[p(,,,) Pe p to Ci.in i 4-I 5 <br /> LlSIAl IYi9- Op/ if) net <br /> STORIES: SQ.FEET OF EACH FLOOR; <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ' 3 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 /> AP3121./0PLICANT'S SIGNATURE: l DATE: 7 • <br /> 31 <br />