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� <br /> Total Fee: $ �8 7• �S Date Received: �����r D � <br /> Entered By: Permit#: A /I5(o0 <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 information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR) <br /> JOB SITE ADDRESS: 131 cne�y cnase Z�: ss�91 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ YeS ❑✓ No Ifyes, a special even�permit is required with Police Department and Ciry Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> su�cient on-site pa��king is available. Non permitted events will not be allowed <br /> NAME OF OWNER: Leah M°y°e°r PHONE: (home) (9s2�n�3-3��� <br /> (work) <br /> MAILING ADDRESS: 13l Chevy Chase CITY: orono Zjp: 55391 <br /> CONTRf1CTOR: Scherer Bros.Lumber Co. pgpj�i; (952)277-1600 <br /> CONTACT PERSON: Beth Rudnicki MOBII,E/PAGER: <br /> MAILING ADDRESS: ]0751 Excelsior Blvd CI'j'Y: Hopkins ZjP; 55343 <br /> STATE LICENSE: # �023936a EXPIRATION DATE: o3i3 iios <br /> ARCHITECT/ENGINEER: 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 /> PROPOSED WORK(describe in detain; Replacement of nine windows,four sash.,and two tiltpac. <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ lb,�s�.00 <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 w rk is n to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: �i( DATE: o9i2sio� <br /> 31 <br />