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w <br /> ..^ <br /> Total Fee: $ =�,�.�.����'.� Date Received: � � �%��f � <br /> Entered By: •��'t�--- Permit#: I G �r�I�'(p <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> n <br /> � All information must be submitted in full before plan review will be started. <br /> " ' lease rint al/in or�nation <br /> v � �_,�����'� (P P ' .f ) <br /> , , ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: �280 Bracketts Point Road ZIP: 55391 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ YCS � NO /fyes, a special event permit is required with Police Department and Ciry 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: Robbin& B.Kristinc Johnson PHONE: (home)q��-y TS-3Sa� <br /> 1280 Bracketts Point Road �WOI'IC� (612)812-6354 <br /> MAILING ADDRESS: CITY: Orono ZIp: 55391 <br /> CONTRACTOR: Bottema Construction Inc PHONE: (952)448-2182 <br /> CONTACT PERSON: xoeert� Bottema MOBILE/PAGER (6�z�4�s-6��i <br /> MAILING ADDRESS: 5075 County Road 140 CITY: chaska ZIp; 55318 <br /> STATE LICENSE: # 20521013 EXPIRATION DATE: o3i3iio� <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 /> Any earth movement may require MCWD review and permits ! <br /> PR�P�S�'�w�RK�I�CSCPIbC 111 ltBlQ[�; Change flat ceiling to trayed via new trusses. <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��'� o 0 0 , o0 <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 th is is not a perm it and work is not to start without a permit;and that the work wil I be <br /> in accordance with the approved plan. <br /> i <br /> APPLICANT'S SIGNATURE: � DATE: /0 -a 3 -� � <br /> 31 <br />