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��kTY OF ORONO � 6124730510 09/24/96 14:00 �I :02/03 N0:522 <br /> a <br /> � <br /> Toral Fe�: S,_,_, 3 � Date Received: <br /> �r�na ay: �t�v: ► ��� I . <br /> �ITY OF OROlr10 - BUILDING PERMIT APPLICATION <br /> At�fnfoe�nadon must be submitted in full before plan review wfll be started. <br /> •, (p�tease prfnt all�r4formarion) <br /> • .�..�_-----=-----_.�_�w_._..._......__...._.._.�...._..�.........__..._ --��_��_____-- <br /> TH� KPPI:ICAN'I' IS: (clrcle one) OR�I�TER 0 ONTRACTOR <br /> • . , , <br /> JO$ SITE ADD�SS: I��� �o,� ��•md �d . znP: s��`�1 " <br /> M <br /> •. NAME OF OWNER: , '�.R�1 PHONEi \r"�"�,�jj f�• / �/� �[JLV"f <br /> (W01'�C) — r <br /> MAILING ADBRESS: ,�(e�-�,� f�.'�QO�CITY: ZIP:_S�z.�J <br /> . . . . , <br /> COl'�ITRACT4R: RENEWAL BY ANDERSEN ' <br /> . COIVTACTPERSON: 350-73RD AVE. NE y <br /> . , ��G����------ fRIDLEY, MN 55432 Z�� <br /> (612) 502-4777 <br /> �b"rA1'� LICENSE: A! LICENSE #20130983 <br /> . ARCHTI'ECT/F1�TGIIY�ER: MiONE: <br /> M�LING ADDRFSS: C�7'Y: ZIP: . . <br /> NAME: REGYSTRATt4N� <br /> TYP'� OF WORK: New Addition Aoc�sory Stcu�caue <br /> Mov� Remodel/Alteration,� Land Altsration <br /> PRO � WORK(descHbe in detai�: 1 c�,�r� � ^^, <br /> , <br /> � <br /> ST��: SQ.P'B�T OF EACH FI.00�: <br /> 1�T0. OF BED$OOMS: GARAGE STALIS: ATT. DET. <br /> � <br /> FSTIlViATED CONSTRUCTION VALUATION(excludfng lan�: $ �}, 3�� <br /> I hdreby apply for a building petmit and I acknuwkdge that the informetion above is comptete and <br /> acc�uate; that d�e work wlll be in confor�nance with the ordinencxs and �od� of the City and with <br /> , ' the State Building Code; that I u�deretand thjs Is not a permit and work is not ta starc wlthout a <br /> petmit; and that the work will be in accocdan�e with the spproved plan. � <br /> APPI.ICANT'S SIGNAI`IJRL: DATSs � g•�� <br /> 11�OTE! p��.q�H�ev��ts r�egvfne ae�rota parmtt opproval by Police Deparb�tent asd <br /> [.Y�y Coanci160 d4ya prlor b the avent. Non perm�tted�ve►Ws w�U not be allowed. <br /> RPCPIVP�I Timn Cnn 9A 1 �A9Aluf Ari�� Timn C�� 7A 1 . 17A1( <br />