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C '�- D 7 <br /> Total Fee: $ �D/ ��1 � • � DateReceived: � <br /> Entered By: �� ����/�j�;� Permit#: /�/UB�o�o <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (�ilease print al!information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: �535 Bohn Point Road Orono MN ZIP: 55323 <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 Ciry Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> suffcient on-site parking is availab/e. Non permitted events will not be allowed. � � <br /> NAME OF OWNER: Aaa'T'LaFa�r� PHONE: (home) (9s2�a�t->>s6 <br /> (wOCk� �952)345-0289 <br /> MAILING ADDRESS: �535 Bohn Point Rd CITY: Orono Zip: 55323 <br /> CONTRACTOR: Douglas Miller Home Repair Inc. PHONE: <br /> CONTACT PERSON: Troy Miranowski MOBILE/PAGER: (612)282-1256 <br /> MAILING ADDRESS: 3413 I 16th Ln NW Cj'j'Y: Coon Rapids Zjj�; 55433 <br /> STATE LICENSE: # 20390897 EXPIRATION DATE: 03/31/08 <br /> ARCHITECT/ENGINEER: N�A 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 /> PROPOSED WORK(describe in detai�: F'"'sh Base"'e°t <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: �loo <br /> NO. OF BEDROOMS: ° GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 6zo,000.00 <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 permi±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 SIGNATURE: -:�.�, •� � `�-- DATE: 3 - 3C���4 ) <br /> 31 <br />