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� , . . � <br /> RECEIVEC� <br /> Total Fee: $O`Z7 , <br /> 0 V 1 3 2009 Date Received• �� /O o � <br /> —�. <br /> Entered By: � f`�T� ^F ORONO Permit#: • o70G 9�D�1b <br /> ' CI�'Y'OF ORONO -BUILDING PERMIT APPLICATION <br /> All infdrmation must be submitted in full before plan review will be started. i <br /> (please print all information) <br /> --------------------------------------------------------------------------------------------------------------�- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR i <br /> JOB SITE AD�RESS: � l 5 �' �o �e �-�0(,.s !1 Rd Z�: s�' 3�� <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 City Council appro l al <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstra�ies <br /> suff cient on-site parking is available. Non permitted events will not be allowed. i <br /> NAME OF O�'NER: K t /1 �@ C� h e ll� S PHONE: (home) 8 0 7 • S�,ti i <br /> / work) <br /> MAILING AI�DRESS: 3 � S S J� fr?C S�OW� CITY: L.o� Ca� ZIP: 5� 3 S� <br /> �– <br /> Pella Windows and Doors i <br /> CONTRACTOR: 15300-25th Ave.North, Ste. #100 'HONE: �(S� ��5 •G o47 <br /> CONTACT P'ERSON: _ plymouth, MN 55447 GER c�b d� D E,T P� ,�'>>� <br /> MAILING ADDRESS: _ License# 20165884 Z�' —� <br /> STATE LIC�NSE: # �63-745-1400 �`��' i <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING DRESS: CITY: ZIP: <br /> AU � <br /> NAME; REGISTRATION: # <br /> TYPE OF V�ORK: New Home Addition Accessory Structure � <br /> Move Home Remodel/Alteration(ie: Siding,Windows) � <br /> Any earth movement may require MCWD review and permits�— <br /> PROPOS WORK(describe in detain: � W/ �1l�o W S ~ � S �S fl r! �l lQ�(�C - <br /> /'�t � S v L �!' <br /> STORIES: � SQ.FEET OF EACH FLOOR: <br /> NO.OF BE ROOMS: GARAGE STALLS: ATTACHED DETACHED� <br /> ESTIMATE;D CONSTRUCTION VALUATION(excluding land): $ ��. � � 7 � <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and acculrate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Bui�ding <br /> Code;that I u�derstand this is not a permit and work is not to start without a permit;and that the work w 11 be <br /> in accordance with the approved plan. <br /> APPLIC�IT'S SIGNATCTRE: � DATE: �� ( � a � <br /> I <br /> 31 I <br />