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� <br /> // r <br /> .Total Fee: $ ��/� S 7 Date Received: � �'7 � � <br /> Entered By: �.,� Permit#: ��, . ' <br /> ' �`�y <br /> y�:�����;IC,C- <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 OR CONTRACTOR <br /> JOB SITE ADD�SS: 1280 Bracketts Point Road ZIP, 55391 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ YCS ❑✓ NO If yes, 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 app/ican!demonstrates <br /> sufficienl on-site parkirtg is available. Non permitted events ivill not be alloived. <br /> NAME OF OWNER: Rob&Kris Johnson PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: �2g0 Bracketts Point Road CITY: Orono ZIp. 55391 <br /> CONTRACTOR: Bottema Construction Inc PHONE: (952)442-2182 <br /> CONTACT PERSON: Bob Bottema MOBILE/PAGER: (612)41 R-6711 jl�' <br /> MAILING ADDRESS: 5075 County Road 140 Cj'j'Y: Chaska ZjP; 55318 <br /> STATE LICENSE: # 20521013 EXPIRATION DATE: 03/31/07 <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 /> ,� n <br /> PROPOSED WORK(describe in detai�: RE-�( o � k3� C R E��'c w,o a s c�o s�`�-s <br /> mouE �h c4�on wo ( s A c� r��w wpwt Adovc aA��n.c �n. rztich�� F� QA`�ofZ <br /> � �r�l sv �. <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� C�� 0 0 0 . 0 C� <br /> 1 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 i s not a permit and work is not to start without a permit;and that the work wi II be <br /> in accordance with the approved pla ,. <br /> APPLICANT'S SIGNATURE: � DATE: �'J�a l `-b � <br /> 31 <br />