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CITY OF ORONO.= P.LILDING PERMIT APPLICATION <br /> Total Fee: $ , a Date Received: <br /> Date Approved: <br /> Entered By: <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: 1000 Old Crystal Bay Road, Orono ZIP: <br /> (work) 473-2588 <br /> NAME OF OWNER: Robert L . Melamed PHONE: (home) 471-7772 <br /> MAILING ADDRESS:1212 East Wayzata Blvd . CITY: Wayzata , ZIP: 55391 <br /> CONTRACTOR: Lakewood Development , Inc . PHONE: 473-2588 <br /> MAILING ADDRESS: 1212 East Wayzata Blvd . CITY: Wayzata ZIP: 55391 <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER- Bruce Schmidt and Associates PHONE: 476-6222 <br /> MAILING ADDRESS:320 Manitoba Ave. So . CITY: Wayzata ZIP: 55391 <br /> NAME: Bruce Schmidt REGISTRATION # 14549 <br /> TYPE OF WORK: New X Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : Construction of Single Family Residence <br /> STORIES: 1 SQ. FEET OF EACH FLOOR: 3 , 090 <br /> NO. OF BEDROOMS: 4 GARAGE STALLS: ATT. X DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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 accordance with the approved plan. <br /> ` ' I.0/ <br /> APPLICANT'S SIGNATURE: i ' I / � • DATE: <br />