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Total Fee: $ DateRe ved: <br /> Entered By: Permi : 00 Q � 6 o Y 5 S� <br /> CITY OF ORONO - BUILDING PERMIT A <br /> All information must be submitted in full before plan review will be started. <br /> (please print«l[information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle oize) OWNER OR CONTRACTOR <br /> JOB SITE ADD�SS: � � 3 a �3 a 1��f P�� � R� Z�: �s� 3� j <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ YeS ❑ NO Ifyes, a special event per�nit is required tit�ith Police Department and City Council approval <br /> GO days prior to the event. Shuttle bus service will be required unless applicant denionstrates <br /> su�cient on-site parking is available. Non perrnitted events will not be allowed. <br /> NAME OF OWNER: J a c k� ' /t/�U 15 (-' PHONE: (home) �f 7l-74 Y / <br /> 1(work) <br /> MAILING ADDRESS: ��3 •� �j�?1 C��r Pk� CITY: �Q aTG► ZIP: `J � 3 g � <br /> Pella Windows and Doors <br /> CONTRACTOR: 15300-25th Ave. North, Ste. #100 'HONE: �Sa 3�S-�0�I 7 <br /> CONTACT PERSON: _ Plymouth, MN 55447 GER: S n�, � ����r J o�u s <br /> MAILING ADDRESS: _ License # 20165884 ZIP: <br /> STATE LICEN�E: # �63-745-1400 �ATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NANIE: 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 cletai�: � 1 f`00 L.�! d�0(,v <br /> �'rn(n� m���s in ��rr s-��n� ��� � n� <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED D�TACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � � a 5 <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 plan. <br /> APPLICANT'S SIGNATLJRE: � DATE: � � � � <br /> � <br /> 31 <br />