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R�CEIV�� <br /> r <br /> ' D�� '� 2009 <br /> C1TY OF C�R�NO <br /> Total Fee: $ � �3• � � Date Received: <br /> Entered By: Permit#: ����-�J- � <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 inforniatio�z) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTO <br /> JOB SITE ADDRESS: ��� � �Q� R� d 9 C R o crC✓ z�: � 5 � 91 <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 Departnzent and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant cfemonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: ��0/1 Ge rr�a�n 5 u � PHONE: (home) �5� • 4nSYj <br /> (work) <br /> MAILING ADDRESS: ��� � $� Y �� ��� CITY: ZIP: <br /> CONTRACTOR: Pella Windows and Doors ,H��: 45��3Y5 •G o 4 7 <br /> 15300-25th Ave. North, Ste. #100 <br /> CONTACTPERSON: _ plymouth, MN 55447 G'�� Jed� Cil {_/di� nA� S <br /> MAILING ADDRESS: _ License # 20165884 ZIP: <br /> STATE LICENSE: # �63-745-1400 �ATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATIQN: # <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 WO K(describe in detai�: �J G�i 11 [�ol.v 5 '' � `��5�j /`e Q!!t Gc />1 l!l� <br /> � v �s �n a ,� , � n <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �y 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 /> 1.� �� /o �i <br /> APPLICANT'S SIGNA � DATE: <br /> 31 <br />