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May, 30.. 2006 6; 50AM Elder Jo�es Permitting �No,522? P,�3t�, <br /> ' ►'►�l.e�.-�=-� c�,— .<{��. <br /> V�`��^ � <br /> c;' <br /> r .• : <br /> Total Fe�: $ ��(� � �4 � DateReceived: �-�4 ti(�> <br /> Entered By: ;��� Permit#:;/���'�1; J Sr <br /> C�T'Y OF ORONO —BUIIrDING PERMIT APPLYCA'TYOl� <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE A.PPL�CANT XS: (carcle one) OWNER OR ONTRACTOR <br /> JOB SITE ADDRESS: 3 T�'z— YV, �Tl���'i ��Y�� ,ZIP: <br /> . . <br /> Will fihis be ar�de of Homes,Remodelers Showcase Home or other D�Splay Home? _ <br /> ❑Yes No ,�'yes a specfal event permlt is required wleh Pollce Departmem and Ctry Council approval <br /> 6�days,prior�o the event. Shuttle bus service will be required unlese ap,plicanl demonst►'ates <br /> su�'icienr on-sile parking is available. Non pe�mitted events will not be allowed <br /> NAME OF�OWNER: I�S S �C G�I/ ��ONE: (hiorme) 5� 7 — �$'/'� <br /> ��) <br /> MAII.ING ADDRESS:,.��,� ��ITY: O D ZIP: ��I <br /> CONTRACTOR: RENEWAY.BY ANDERSEN PHOIVE: ti <br /> CONTACTPERSON: 1920 COUNTY RD. "C" WEST pAGER: <br /> AZAII,ING ADDRESS:- ROSEVII.,LE,MN 55113 �: ' , <br /> STATE LICEI�TSE: # ' 651-264-4777 v p�,�: <br /> — LICENSE#20130983 <br /> ARCHITECT/ENGINEER: PHONE: <br /> A�E�1NG ADDRE5S: C"�TY: ZIP: <br /> NAME: � �2EG�S'�LA,'Z'�ON: # <br /> TYPE OF WORK: New Homc Addition Elcccssary 5 e <br /> Move Home RemodeUAlteration(ie:Siding, indows �_ <br /> Any earth movement may require MCWD review and permsts! <br /> PROPOS�D ORK(descr' e in detai�:�5,_ �w _ <br /> � <br /> STORIES: SQ.k'EET OFEA,CSFLOOR: <br /> NO. OF B�AROOM4: GARAGE STALLS: ATTACHED DETACHED <br /> EST3MATED CONSTRUCTION VALUA'�'�ON(eucluding land): $ �� / �� i <br /> X hereby apply for a building permit and I aclmowledge that the information above is complete aud accurate; <br /> that the work wi�l be ua coz�onmance with the ordinances and codes ofthe City aad with tb„a Sta.te Building <br /> Code;that I understand this is nat a permit and work is not to wit]aout a permit;and that the work will be <br /> in accordance with the approved pl . <br /> 0 / <br /> AYPLICANT'S SIGNATURE: "'� J DATE: �7 <br /> 31 <br />