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� <br /> 1�,� <br /> 1ti- <br /> TotalFee: $ a7�• � � DateReceived: �2 � �Z- /��;5� <br /> Entered By: Permit#: ��>p u - ��y_fl. � <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 in,formation) <br /> --------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SI•I•E A�D�SS: 35 Crystal Creek Rd,Orono Z�: 55356 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑✓ NO If yes, a special event permii 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 /> su�cient on-site parking is avaelable. Non-permitted events will not be allowed. <br /> NAME OF OWNER: steve Koehler PHONE: (home) (9sz>a�b-gss� <br /> �WOrk� (612)330-0483 <br /> MAILING ADDRESS: 35 Crystal Creek Rd CITY: Orono Zjp: 55356 <br /> CONTRACTOR: Steve Koehler(Homeowner) P$Q�' <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <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 /> PROPOSED WORK(describe in detain: Add 3/4 bath and 1/2 bath in basement, <br /> Finish off additiona1270 square feet in basement. <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> - �n <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 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 SIGNATiTRF• -' DATE: ! `i l�� <br /> �� , <br /> 31 <br />