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r \ <br /> � � 5�, �� ��a �� <br /> �� - <br /> Total Fee: • / Date Received: �P`� ��v/'('W Pll�� G/���- <br /> Entered By: Permit#: A �/913� <br /> '0�0 O �-—T 00�3/ <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 ADDRESS: 1 i99 EtmWooa��e ZIP: 55364 <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 Ciry Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> su�cient on-site parking is available. Non-permitted events wil!not be allowed. <br /> NAME OF OWNER: Scot&Lissa}[avey PHONE: (home)_ <br /> (work) <br /> MAILING ADDRESS: 1199 Elmwood Ave CITY: Mound Zip: 55364 <br /> CQN'j'�C'TQR: Friedell Architects&Builders P�j�j��i: (952)548-7000 <br /> CONTACT PERSON: Ro�er Friedell MOBILE/PAGER: <br /> ME�II,IN�`i E���R�+SS: 2238 Gdgewood Avc Cj'j'Y: St Louis Park Zjj�; 55426 <br /> STATE LICENSE: # 177z EXPIRATION DATE: o3i3 tro9 <br /> ARCHITECT/ENGINEER: Mark Gunstad PHONE: 612.963.9408 <br /> MAILING ADDRESS: 2566 Ellis Avc#408 CI'j'Y: St Paul ZjP; 55114 <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�PD.SE�w�RK(I�BSCYibe ii2 delQl�: kitchen addition into garage,roof overlay <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: 2 GARAGE STALLS: ATTACHED ✓ DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �LS �� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accLirate; <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 to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br /> 31 <br /> _ I <br />