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Total Fee: $ -�C�f 4 '�i% Date Received: ����D� <br /> Entered By: ,�- '� Permit#: ,Qo 9 7�q <br /> CITY OF ORONO — BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print a[1 information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> J�B SI•I•E E�D�SS: ]080 N.Brown Road ZIP: 55356 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ YCS Q✓ No lf yes,a special event permit is required with Po/rce Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service wil!be required unless applicant demonstrates <br /> suffrcient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: Er'c�.B°�� PHONE: (home) (9s2)4�6-o3so <br /> �WOCk� (952)249-0817 <br /> MAILING ADDRESS: �080 N.Brown Road CITY: Orono ZIp: 55356 <br /> CONTRACTOR: Homeowner PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <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 detain: Basement remodel,add bathroom,and egress window <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: �soo <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED ✓ DETACHED <br /> .� <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ (,i, 60� <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 o the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start wit ut a permit;and that the work will be <br /> in accordance with the approved plan. <br /> � � �� / <br /> APPLICANT S SIGNATURE: � � DATE: I l <br /> 31 <br />