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� n ��� <br /> W" <br /> C � <br /> ��I by <br /> Total Fee: $ �� J, /10 Date Received• ' — �`7 <br /> Entered By: Permit#: - ad <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 R CONTRACTOR <br /> JOB SITE ADDRESS: 23� �irr,L ,�ir�nu�, �rc�o, /`�i�/ ZIP: 5 r39/ <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �No If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: �1.�"/?�rt- k�ireLeSs PHONE: (home) 9�•g�G•`�T� <br /> (work) <br /> MAILING ADDRESS: ��� ����� CITY: ���/a' � ZIP: ✓�r 38 <br /> MN <br /> CONTRACTOR: To E� d��"�=1�� PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: ��CS�iZ 1 of ��/L PiztJriG PHONE: 9�G✓Z. 9oa.y�99 <br /> MAILING ADDRESS: 5`�T3 �/22L(ey �/icw /� CITY: +�it �ai�i� ZIP: �3 � <br /> NAME: �of�t v/S REGISTRATION: # /a��7 <br /> TYPE OF WORK: New Home N� Addition N�a Accessory Structure "ya <br /> Move Home N s4 Remodel/Alteration (ie: Siding, Windows) N�[ <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detai�: /�a��sa�t o�pJf'Lei-9�JLc.°ty 9�R?.nt.f�i' cy2. <br /> �o,�j�GtG �zd sui'rou�ed w�-h �lai�c 4nlr f'enee. <br /> STORIES: N�A SQ.FEET OF EACH FLOOR: �� <br /> NO. OF BEDROOMS: N�A GARAGE STALLS: ATTACHED A/�!, DETACHED N�F <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��� <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 ardinances 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 /> APPLICANT'S SIGNATURE: DATE: 03. d�, � <br /> 1��Si�li1. �tt�/lf"�far' j/�Qi-��cn, �ir�eleSs <br /> 31 <br />