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Total Fee: $ DateReceived: <br /> Entered By: Permit#: <br /> CITY OF ORONO- BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all inforuwtion) <br /> THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR <br /> JOB SITE ADDRESS: 2455 Old Beach Road ZD,: 55391 <br /> Will this be a Parade of glomes,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 dans prior to the event. S7nrttle bus service will be required unless applicantdenrorrstrates <br /> sufficient on-site parking is available. Nan permitted events will not be allowed. <br /> NAMEOF OWNER: Larry Lundquist PHONE: (home) (952)471-9235 <br /> (work) <br /> MAILINGADDRESS: 2455 Old Beach Road CITY: wayzta ZIP: 55391 <br /> CONTRACTOR: DSM Custom COnstmction,Inc. PHONE: (612)719-2724 <br /> CONTACT PERSON: Derek Montague MOBILE/PAGER: <br /> MAILING ADDRESS: 11110196th Ave.NW CITY: Ells Rive' ZIP: 55330 <br /> STATE LICENSE: # 20448379 EXPIRATION DATE: 03/31/08 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: 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 review and permitsl <br /> PROPOSED WORK(describe in detail): Remove and replace shingles <br /> STORIES: 2 SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 14,300.00 <br /> I 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 SIGNATURE: DATE: 10i09/07 <br /> 31 <br />