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Total Fee: � Date Received: �� � i � I ��l <br /> � Entered By: ��,�� ,�' -� �,�� ,� �.= � i'� Perniit#: �� C ��(c (S f- <br /> , � . <br /> � �,=�—y , � �� <br /> . �' v� _CJC, {'�� <br /> CITY �F ORONO - BUILDING PERMIT APPLICATION ��, �, �� <br /> All inform�.tion must be submitted in full before plan review will be started. <br /> (please print all i�formativn) <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: Ol0 S �Gt,���,� �, ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ r10 lfyes, n special event permrt is required with Police Department ar�d Ctry Council approva! <br /> 60 days prior to the event, Shultle bus service will be required r�nless applicant demonstrares <br /> su�cient on-site parking is available. IVon permitted events wi!!not be allowed. <br /> NAME OF OWNER: ��>�- �j�(�-�1(1-�. PHONE: (home)�a'����4� <br /> .� (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: Renewal By Andersen pHONE• <br /> 1920 Coexnty Road "C" West ' <br /> CONTACT PERSON: Roseville MN 55113 'AGER: <br /> MAILING ADDRESS: _ License #20130983 ZIP' <br /> STATE LICEN5E: # 651-264-4777 DATE: <br /> __ <br /> ARCHITECT/ENGINEER: PHOIVE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration(ie: 5iding, Windows) <br /> Any earth rnovement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detai�: <br /> � . , <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> OU/ <br /> ESTIMATED CO1�fSTRUCTION VALUATION(excluding land): �� �� ! <br /> [hereby apply for a building permit and I acknowled�e that the information above is cornplete 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 t underst�nd 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 SIGNATUR.E: DATE: V 1 <br /> 31 <br /> Z 'd 06T9�L9IS9 3�IA�13S 1IW213d Q B S �I 9T =bT 600z BT U�C <br />