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T � � I <br /> � <br /> City of Orono � <br /> „ Building Permit Application for Internal Work <br /> windows, doors, sidi , n-r�of, �c.) <br /> �0� ��� r�� _ <br /> O O �en►,�s��oea o.�s�.+wd: .5 <br /> � � s�cAa�ar��s' �0°�°�br <br /> 2750 KrMy Parkw�Y PI�nvi�w iN: <br /> Orono.IYNd 56366 <br /> Tobl Fee: �� �. p�� <br /> M�n: g62.�4¢�lepp Fs�c �62•24P�816 www.c�.orono.mn.us <br /> � This appNcatlon 1bm�must b�oomplN�d in fu�and aN�sqt�irod i�ormation must bs submit�sd. <br /> �PM�iPP����wIM b�e+sW�n�d. (PNrss R�►t) <br /> ���,►„�: �, s�o �►,ds�- � <br /> .,��.�: <br /> Nlul tl�s b�s Para�ot NonMs.l�nod�Nes�HonN or ol1�Dhpl�y Floe»� Y�s No <br /> Nrs,���af�l�rrw PNn�lt Aquhal�Ao�MO�O�pnl�nt and CM►�Cwrid�opro�l�0 d�t P�to th��nt SMipN bus snww w�ll be <br /> �p�N�d urMres�piDrx d1�n�on��Ms auAlahnt on�p�Adrp h arM�bb. Mon�pNniMd rwnts w�not b�aNbwrd. <br /> CONTRAiCTOR I N�ATION: <br /> Name: /l'1� (�/LS�"- ob � S�� l�►3�OFQ Ln� <br /> State�bense�t 0 Fal p al 7 7 ExPtitbn Dste: p3/3� S 0�a <br /> Lead C�N�unber. Expir�tion�ate: <br /> rybr w�or�t on honNs IMr ao�� a�sst <br /> �e: 76 �a 7- 6 ca�� 76 a�v— 13 � c��� <br /> M�urp qdd�: �y�' qcY v� ZIP: 3 6 Y <br /> Co�cx Person: n� 4+� APpNcant ls: cbor / Homeowns� t�o�.o�.� <br /> Emaa ana�a Fax: 763 — ti��� Q�o <br /> PROPERTY OwNER W�AI►710N• <br /> trame: _ � �n n f�u�/9� , <br /> �(day�: , <br /> �� _ 'dS�- . s_�s�� � �: ��9��� z�P: <br /> - <br /> EmaN sndlor Fax <br /> PROJECT INFORMATION: ������Wn <br /> T�°�P�� MC1ND nwNw i p�rn�lb: ! <br /> ❑�s� p R.nad.i O wa�� �,.�,.r,.c�wawsr�.d o�a cMcwo> i <br /> �yy�s� p� p�om,oam�p, t820�2 Mk�nsaNa eMd ( <br /> ��i� ❑Re�lora�ion ❑Otl�:(spsdN) ��^.MN 55391 <br /> Phons: 962�T1-0590 � <br /> � Fs�c 952�71-0682 � <br /> �Rs�roof ❑ � www.minnehahacreek.orn � <br /> OvKall ProHat D�c�iptlo�� <br /> E.n�c�vaw.uo�ot�l.�od�akw a� s f �o� _ <br /> a�uc�� � : <br /> „�..���.���a���►�•�� � <br /> ���,.�.��d,�.��,.�������. ���,�t�y I <br /> ars soMy n�porabN tor subn�tl�w s oompl�e�appNa�io�b.ina a�rs t�t�'aihms m do so,a�s stsfr nss no almmauve I <br /> but m rojsct ft untll R ts aanplNs; I <br /> Sort�or d d th��tlat you an a�d b provid�on this appW�ion is d�slMd bY StaL� Irw as Nther private or j <br /> cpnt{d�r�l. P�d�b kllOnmtlon wNch p�r�s�NY�����D ths pudNC but Csn bs qivsn bo ths subject of the <br /> dad. coMw.nur cw a iMom�tlo�wrra� �nw�N c�rnoc a �.n b .itl�.r u�s pubNc «n�. sub�.cc of ine dam. our I <br /> P��pot..nd inw+d.d u..a ws i�am�tlon is b.nn�Ny updMs o�x�sooed� n,a r�or�d. d oa��o�xr�ntal spen� <br /> hw. M b 1h�infDniribn th� not b�hN�sd. <br /> qpP�ar►t's Si�ra�re: �: ����o� � � <br /> taa uvd.aa: oa-o�,20�� <br />