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' ��I <br /> ��� p(� <br /> a - �� <br /> �/„� Total Fee: $ Date Received: <br /> � Entered B <br /> 1 - y: Permit#: <br /> CITY �F 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 APPLICAN7' IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: L�I O � �� J�O'��..�� I �=Q ZIP: � <br /> Will this be a Paracle of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ NO Ifyes, a special event permit 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 /> suffrcient on-site parking is available. Non-permitted events will not be allowed. <br /> �- ` <br /> NAME OF OWNEIft: � C�I�Y1 �C�-�'1YY1 PHONE: (home)��o�-y��—�(���p <br /> (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: Renewal By Andersen <br /> 1920 County Road "C" West _PHONE: <br /> CONTACT PERSON: Roseville, MN 55113 AGER: <br /> MAILING ADDRF:SS: _ License #20130983 ZIP: <br /> STATE LICENSE: # 651-264-4777 DATE: <br /> ARCHITECT/ENC.INEER: PHONE: <br /> MAILING ADDRF:SS: 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 revi w and permits! <br /> PROPOSED WORK(describ in detai�: �p�(J�Q`� � ,� ���(' C��r � <br /> STORIES: SQ.FEET OF EACH FL R: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED COI�STRUCTION VALUATION(excluding land): $ �� U lU(U � <br /> 1 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 SIC:NATURE: '''`)��SC�ATE• <br /> 31 <br />