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Rug 30 06 10: 40a Harry J Jensen 612824z896 p. 2 <br /> G L' �' � L�� �� <br /> Total Fee: $ � Date Received: �'� �0� <br /> Entered By: �) �; ,,,,���- �j�,��� Permit#: �D�/ <br /> �' <br /> CITY OF ORONO -BUILDING PERMIT APPLICATION <br /> All information must be snbmitted in full before plan review will be started. <br /> (please prrnt all information) <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS• 905 Femdale Road West Z�_ 55391 <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes Q NO /f yes,a special event permit is required wilh Police Department and City Council approva! <br /> 60 days prior to the everrt. Shuttle bus service wi11 be required unless applicant a'emorrstrates <br /> su�cient on-site parking is available. Non-permitted events will not be a!lowed. <br /> NAME OF OWNER: Jot�sToo�s PHONE: (home) (952)473-1165 <br /> 905 Femdale Rd W �WOI�c� (612)333-6399 <br /> M�1�ING.�D�SS: CTTY: Orono Z�• 55391 <br /> CONTRACTOR: Harry Jensen Constcucdon,Ine pgp�• (612)824-2895 <br /> CONTACT PERSON: tfatry Jensen MOBILE/PAGER: (612)267-0928 <br /> MAILING ADDRESS: 4401 Pleasant Ave S CI"I'Y: MPIS Z�: 55419 <br /> STATE LICEN5E: # BG�20394180 EXPIItATION DATE' 03/31/07 <br /> ARCHITECT/ENGINEER: AlbeRsson Hansen Architecture PH��, 612-823-0233 <br /> MAILING ADDRESS: 1005 Franklin Ave S C�'Y: Mpls Z�p; ssaos <br /> N�; Christine A�bertsson REGISTRATION: # 26012 <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: Cosmetic rcmodel of euterior and intcrior finishcs.Ncw wiodows,sidii <br /> roofing.AddiGoa of powder rm and kitchenctte,cabincts and interior finishes. <br /> STORIES: 1 SQ.FEET OF EACH FLOOR: 3]5 <br /> NO. OF BEDROOMS: ° GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 200,000.00 <br /> I hereby apply for a building penmit and I acknowtedge 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'5 5IGNATURE: DATE: $- ,3 0 • �� <br /> 31 <br />