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�•`,- <br /> � Total Fee: $ Date Re�eived: <br /> Entered By: Permit#• <br /> CTTY OF ORONO - BUII.DING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print ald i�aformation) <br /> THE APPLICANT IS: (c�rcle one) OWNER O CONTRACTO <br /> JOB SITE ADDRESS' 4140 North Shore Drive �, ss36a <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑Yes Q✓ No If yes,a special event permit is required with Police Department and City Council approval <br /> 60 days pr-ior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> sufficient on-site par/ring is available. Non permitted events will not be allowec� <br /> NAME OF OWNER: �e Woychick pgONE: �IlOTrie� (952)472-4296 <br /> (work) . <br /> MAILING ADDRESS• 4140 North Shore Dr C�, orono �p. ss36a <br /> CONTRACTOR: s�n�aer R�«��ng�.�.c pgp�• (651)503-7385 <br /> CONTACT PERSON: Mike Schroeder MOBILE/PAGER (651)503-7385 <br /> MAILING ADDRESS: 19773 Everhill Ave Cj�'j�; Farmington �; 55024 <br /> STATE LICENSE: # �-20626545 EXPIItATION DATE• o3r�iros <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS• CITY• 7IP• <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home RemodeUAlteration(ie: Siding,Windows) ✓ <br /> Any earth movement may require MCWD review and permits! <br /> PRQPOSED WORK(describe in detail�: Teat-offand replace siding w/James hardi siding <br /> STORIES: Z SQ.FEET OF EACH FLOOR <br /> NO. OF BEDROOMS: GARAGE STALL5: ATTACHED ✓ DETACHED <br /> ESTIlVIATED CON5TRUCTION VALUATION(ezcluding land): $ 17�°�•� <br /> I hereby apply for a building pemut 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 'thout a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: ��2�+d� <br /> 31 <br /> �52 Z�q�6� � <br />