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04!20/2005 15:15 952-935-9544 4,tJ.,0<MINNESgTA RUSCO PAGE 02/03 <br /> Total Fee: $ S <br /> . D t�ceived: <br /> Entered By' Pe : <br /> CITY OF ORONO - BUILDING PERMtr APPLICATION <br /> All information must be submitted in full before pan review will be started. <br /> lease print all irk formatl0) <br /> TRE APPLICANT IS: (circle one) OWNER OR C NTRACTO <br /> JOB SITE <br /> ADDRESS: J?/Jr- ' ZIP:• C7r���0 <br /> q53 <br /> NAME OF OWNER-. r PHONE. (home <br /> (work) <br /> MAILING ADDRESS: C 21P:� <br /> `75�• 9c$5 <br /> CONTRACTOR: PE[ONE:- _ <br /> 1PAGER: lalZ- Zoo' boas <br /> CONTACT PERSON: <br /> M-- 5�5 �1.3 <br /> MAILING ADDRESS: 55sS8 c� I� Ci7'Y:_ iUl� d P <br /> STATE LICENSE: # din <br /> A,RCHI=CT/ENGINEER: PRONE: _ ZII': <br /> : <br /> MAILING ADDRESS: TY: _ <br /> NAME: UGISTRAMON# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/AlterationLand Alteration <br /> PROPOSED WORK(describe in detall): <br /> axisD <br /> STORIES: SQ.FEET OF EACH IOOR: <br /> F BEDltO(�1vIS: GARAGE STAL�S: ATT. DET. <br /> NO O , o <br /> ESTIMATED CONSTRUCTION VALUATION(ex�luding land): <br /> I herebya 1 for a building permit and I acknowledge that the information above is complete and <br /> PP Y <br /> accurate;that the work will be in conformance with th ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not permit and work is not to start without a <br /> permit; and that the work will be in accordance with approved plan• <br /> APPLICANT'S SIGNATURE: <br /> DATE: <br /> NOTE! Parude_l �42� events require separate ermit approval by Police Deparbne�st and <br /> City Council 60 days prior to the event. Non p ed events will not be allowed. <br /> 5 <br />