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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ 326 , 0 Date Received: L2 -/0 q'J <br /> Date Approved: ) ZX <br /> Entered By: c ,-(/ <br /> Permit#: <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: ZIP: <br /> GEORGE FUNIC <br /> 540 OLD CRYSTAL BAY RD. (work) `7-23 -r/i( <br /> LONG LAKE, MN 55356 <br /> NAME OF OWNER: PHONE: (home) l c� <br /> ?S -3 Slr <br /> MAILING ADDRESS: v( CITY: ZIP: <br /> CONTRACTOR: PHONE: <br /> TAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> // <br /> �GZ/(�C�,PJ��( PHONE: <br /> ARCHITECT/ENGINEER: ��yy ��� // �� �} � /f�� <br /> MAILING ADDRESS: 2 ? S ?at& 4 fL/O ( CITY: /(G J, �L ZIP: S 5 9C <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition ()< Accessory Structure Move <br /> Demo Remodel/Alteration pc Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : P-24444-elbe /1-0-64r04. o4—t-eget <br /> STORIES: 1 SQ. FEET OF EACH FLOOR: 216 <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $, / n LICO <br /> i <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 with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in ac/• dance 'th the approved plan. <br /> APPLICANT'S SIGNATIIRE: DATE: (-7-X-3 <br />