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� <br /> � Tbtal Fee: $ ��/`-� �� z� Date Received: ��3'D� <br /> Entered By: lZ%� Permit#: Ab7S7� <br /> L �y�5�� <br /> CITY �F ORONO - BUILDING PERIVIIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> � (please print all information) <br /> --------------------------------------------------------------- -------- --- ------------= <br /> -�_- --------------- <br /> THE APPLICANT IS: (circle one) OR CONTRACTO <br /> ----__ <br /> JOB SITE ADDRESS: Z�{ o Z S¢��7�,.;_�,t�;� C� ZIP: 5 � `3�� <br /> � <br /> NAME OF OWNER: -�.1uhn ��f���r�c r � �t;�nE-� L�C_PHONE: (home) <br /> (work)CiS�� - '-f7��- l�-1 1 <br /> 11-IAIIIING ADDRESS::�� ; �-��� CITY: �''r c ���C� ZIP:�J��i� <br /> CONTRACTOR: ; I���i n 1 ��rc�n c� ��-�rY�eS t�L'_ PHONE: C{5��-y 73-(�-7 / <br /> CO�1'TACT PERSON:. r.� , ',,-�� MOBILE/PAGER: (r/,� -3�� � ����, <br /> MAILING ADDRESS:.���'G � � c� � r ����c�� CTTY: �;r .n�� _ZIP: . �� � � <br /> STATE LICENSE: # !3C r��",3c� :.�'.� <br /> ARCHITECT/ENGINEER: f,�t;��-�--� s ��re h ,-�'�c'f:S PHO\rE: C�.l� -3�� -d ic'i O <br /> MAILING ADDRESS:33 i S�rt,,-,d,�-t,�.�'V�c 'F*=-��o CITY: ,��(y�s . .'�i�,'' ZIP: ��C�r <br /> NA11�: �`���.c�,� �r. �°�� t��:H�n }-�U�r-�t s REGISTRATION# ,��� lL�G`_� ' <br /> TYPE OF WORK: New �(_ Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> r' ---_' <br /> PROPOSED WORK(describe in detai�: �� ('; ;-,-, b ��r' � �"e�='r�r� ����'- _ <br /> STORIES: , SQ. FEET OF EACH FLOOR: rY�C��,, !�C"/ — LC�u,'r_r 1��c'c <br /> NO. OF BEDROOMS: ` �-�cL�r, GAR.AGE STALLS: ATT. � DET. <br /> :� Lo�v�.>- <br /> ESTLti1ATED CONSTRUCTION VALUATION (excludi.ng land): � �`f�4r����--%l_ <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Buildin� Code; that I understand this is not a perm.it and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNA . / DATE:��� � "�/ _ <br /> ✓ ` <br /> NOTE! Parade of Homes events require separate p�t approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events wi11 not be allowed. <br />