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. , , �D� <br /> . • � U1�,�'V <br /> Total Fee: $ '�"/, �� DateReceived: �°-�3��� <br /> Entered By: Permit#: /-�(a/lo <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (pleuse print a!!information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER R CONTRACTOR <br /> JOB SITE ADDRESS: ;'����a�:o C'ircle Orono.Mn ZiP: SS391 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes Q NO !f ve:s,a speeiul c:vent pernrit is rey:�ired x�ith Poliee Departmefri ancl Ciry Corrnerl approi�nl <br /> 60 davs prior to dre erent. Slnittle bus sen�ice will be re y:�ired tuJless applicanl denlor�strates <br /> srt�ererN on-site parkirtg is avuilable. ;Vo�i pernrittecl everits wi11 not be allowed. <br /> NAMEOFOWNER: �a"'��H.��°x PHONE: (home) �9s�ia�t-a6�a <br /> (w�p�) 1763)47A-6757 <br /> MAILING ADDRESS: ;'����"'°°c"°�` CITY: °rono ZIP: SS;yI <br /> CONTRACTOR: ►i<,mz o�i„�� PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: C[TY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCH[TECT/ENGINEER: �""� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessorv Structure <br /> Move Home Remodel/Alteration(ie: Siding,Windows) ✓ <br /> Any earth movement may require MCwD review and permits! <br /> PROPOSED W ORK(describe in detain: Mi�;rcpairs to die house garage and tool shed Repair x�tlit attd <br /> shingl�s,r��air dcck&railings,�iaint extenor. <br /> STORIES: -' SQ.FEET OF EACH FLOOR: 5cx� <br /> NO. OF BEDROOMS: ; CARAGE STALLS: ATTACHED DETACHED ✓ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): S �•������� <br /> I hereby apply for a building pennit and I acknowledge tl�at the infonnation above is complete and accurate: <br /> that the work will be in confonnance with the ordinances and codes of the City and with the State Building <br /> Code:that I understand tlus is not a pennit and work is not[o start«�ithout a pennit:and tliat the work will be <br /> in accordance���ith the approved plan. <br /> APPLICANT'S SIGNATURE: fN��u[ �� • DATE: osi3oa�x <br /> 3l <br />