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Total Fee: $ O7/3�,� ? Date Received: /� O ��J <br /> Entered By: Permit#: �� — ;� <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 O ONTRACTOR <br /> JOB siTE avn�ss: 4 o S' �Q �n C�Cr �C. �Cl � zir: 5 5 3 4 / <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Z'eS ❑ IVO lfyes, 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 /> sufficient on-site parking is available. Non permilted events will not be allowed. <br /> NAME OF OWNER: J O h f� ��`� U [C S PHONE: (home) L��I 3 3 3 • L 3 4� <br /> / (work) <br /> MAILING ADDRESS: C(�`� �< < fl ('�('i(� �� CITY: O�OII(� ZIP:'S S 3 f/ <br /> Pella Windows and Doors <br /> CONTRACTOR: 15300-25th Ave. North, Ste. #100 'HONE: Q S� �(s-(.04 7 <br /> CONTACTPERSON: GER: od� � �( r �o�1i S <br /> — Plymouth, MN 55447 <br /> MAILING ADDRESS: _ License # 20165884 ZIP: <br /> STATE LICENSE: # iATE: <br /> 763-745-1400 <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 detadn: � �r n cld�.� r�p I�t c� �Q n-�.s <br /> (n Qxls�l��l' l`�n.P/�l/1L�is <br /> --r <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��r 7 �{ � <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 perinit 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 SIGNATURE: � DATE: �� aZ � O � <br /> 31 <br />