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, Total Fee: $ C� ' S� Date Received: �-���710� <br /> Entered By: n -� Permit#: �'r- I � 35 <br /> CITY OF ORONO - BUILDING ERMIT APPLICATION <br /> All information must be submitted in full efore plan review will be started. <br /> (please print all in rmation) <br /> ..---------------------- ---------------- ------- --------------------__-----__--_._._.�._ <br /> THE APPLICANT IS: (circle one) OWNE O CONT <br /> "1'"1�V � . <br /> JOB SITE ADDItESS: 1 '� , Zip; <br /> Will tbis be a Parade of Homea,Remodelers Show ase Home or other Diaplay Home? <br /> ❑ Yes ❑ No Ifyes, a special everrt permit is require with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus s rvice will be required unless appliccmt demonstrates <br /> su�cient on-site parking is available. on-permitted events will not be allowetl <br /> NAME OF OWNER: .� 1�- 1 � �� CGI.'U�IONE: (horne) �' ���J( <br /> (wark) . <br /> 1VIAILING ADDRESS: CITY: ZIP: <br /> Renew^al By Ander n <br /> CONTRACTOR: 1920 County Road "C" West _pHONE: <br /> CONTACT PERSON: Roseville, MN 551 3 � AGER: <br /> MAILING ADDRESS- License #2a13098 : ZIP: <br /> STATE LICENSE: # • 651-264-4777 JN DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Additio Accessory Structure <br /> Move Home Remod Altera.tion(ie: Siding, Windows) � <br /> Any earth move nt may equire MCWD review and permits ! <br /> PROPOSED WORK(describe i�t detai�: �� <br /> r <br /> � <br /> STORIES: SQ.FEET OF EACH F OOR: <br /> NO. OF BEDROOMS: GARAGE STALL : ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(e luding land): $ �i ��''' <br /> I hereby apply for a building perrnit and I acknowledge that e information above is complete and accurate; <br /> that the work will be in conformance with the ordinances codes of the City and with the State Building <br /> Code;that I understand this is not a pe i, d work is not without a permit;and that the work will be <br /> in accordance with the approved plan. ' <br /> r � <br /> APPLICANT'S SIGIVATURE: E; <br /> 3] <br /> Z 'd 06T9�L9iS9 lI 213d Q B S �1 WdZz �B LOOZ GZ �dd <br />