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CITY OF ORONO - BUILDING PERMIT APPLICATION �� <br /> Date Received:- - 1 <br /> Total Fee: $ <br /> � <br /> ,� ,) Date Approved: <br /> Entered By: * / Permit y y <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check off List Enclosed) <br /> ---- - ---------- <br /> ---- <br /> --------- --- <br /> --------- <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: 4695 North Shore Drive <br /> ZIP: 55364 <br /> (work) 471-0723 <br /> pHONE: (home) 472-1879 <br /> NAME OF OWNER: Stephen C. Ward <br /> MAILING ADDRESS: 4695 North Shore Drive CITY: Mound <br /> ZIP; 55364 <br /> PHONE; 471-0723 <br /> CONTRACTOR: Owner <br /> MAILING ADDRESS: <br /> Same as above . CITY: ZIP: <br /> STATE LICENSE: # <br /> Mattson/MacDonald Inc . - Structurp]IONE: 827 -7825 <br /> c+�QZl?$NGINEER <br /> MAILING ADDRESS: 1516 W . Lake Street CITY: Mpls . ZIP: <br /> 55408 <br /> NAME: Wes Mattson <br /> REGISTRATION # 16901 - Engineer <br /> TYPE OF WORK: New Addition X Accessory Structure Move — <br /> Demo Remodel/Alteration <br /> Renovate Land Alteration_ <br /> PROPOSED WORK (describe in detail) : Addition 23 ' x 35 ' attached to existing <br /> home . Four Floors - Unfinished Bsmt . , Family room/Bedroon , Garage , Master BR . <br /> STORIES: <br /> SQ. FEET OF EACH FLOOR: 805 SF <br /> NO. OF BEDROOMS: (2) GARAGE STALLS: ATT. (2) DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ $ 85 , 000 -00 <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance withathI <br /> ordinances and codes of the City and with the State Building Co de; <br /> and <br /> understand this is not a permit and work is not to start without a p <br /> that the work will be in accordance with the approved plan. <br /> DATES � I <br /> APPLICANT'S SIGNATURE. <br /> J <br />