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w � <br /> . � ��A� S � <br /> . a�� `�� � � <br /> � � <br /> Total Fee: $ � �g�• �P �,C ate Received: v�-�-�� <br /> Entered By: ``�' Permit#: _���3 g�, <br /> CITY OF O ONO — BUILDING ERMIT 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: i�so sraoketts Po�ntxoad ZjP: ss39� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑✓ NO If yes, a specdal event permit is reguired�vith Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER• Robbin and Kris Johnson PHONE• (home) (952)475-3526 <br /> (work) (612)812-6354 <br /> MAILING ADDRESS: �2g0 Bracketts Point Road CITY: Orono ZIp: 55391 <br /> CONTRACTOR: Bottema Construction Inc. PHONE: (952)448-2182 <br /> CONTACT PERSON: Robert Bottema MOBILE/PAGER: (612)418-6711 <br /> MAILING ADDRESS: 5075 County Road 140 CITY: cnaska ZIP: ss3is <br /> STATE LICENSE: # 2os2�o�3 EXPIRATION DATE: 03/31/07 <br /> ARCHITEC NGINEE MBJ PHONE: 612 338 0713 <br /> MAILING ADDRESS: 12 South Sixth street Suite 810 CITY: Minneapolis ZIP: 55402 <br /> NAME: .iack Meyer REGISTRATION: # 13373 <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 /> PR�P�SE�w�RK�IiCSCPIbe ll2 l�e1Ql�; Frame and finish 342 sw ft pool house on top of existing pool equipme <br /> foundation"equipment room" <br /> STORIES: I SQ.FEET OF EACH FLOOR: 3a2 <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ✓ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �oo,000.00 <br /> I hereby apply for a building permit and 1 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 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: osi2oio� <br /> 31 <br />