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� � ♦ <br /> I <br /> ��y� <br /> Q�o� n�•�ro�� � � � �,r� <br /> r.o.eax eo I�x kccctvc� � <br /> z�50 Kdkx PmknmY <br /> ������;6' (g52j��,,l(,pp Sl3t� Amawu: S 5AC�1od11: <br /> 1 {f� <br /> I IomcoweerW)Sl�ek es <br /> he�ehalens W'c�l Signcd: a le�qrinvl <br /> �1 b�tOblW'CS Qd C Y� <br /> crr�r o�o�ono-nE�ioLrrlorr r��vnr <br /> c�u pe�M�s nws�I�C■pp�o.�oa w d,�r�u��l�ry otrrcim aaMorxoAaw,ne�nmeie) � . <br /> •Jbb�5itc� •Owne,r:Infoiriidbon,•• • � • � - ,: � <br /> Typ�� �Rcaidcu�ial ❑Cnmmercwl • <br /> 3ite Address: $ .S <br /> O�vner. c-��o a�:�`� Coun�:l MailingAddr�ss: 39� Rcbv� s�. N' <br /> City: S�-. ��a�� Zip� SS/ol - 1 �o S <br /> Homc Phone• 6 5�- (�0, - J o o S _ Alternate rhone: 6 S�- 6�� y s b � <br /> co�.�rv��:���.• I�lcsy be� 6s�- 6oL-tis33 <br /> '•�ari'ractor;��A�plt��nt;Ip�riisrition:' :.;�; ;`,�•. <br /> Coi�trnctor/App.: Ve�� �.�,,c • • =nt. CvtuaotPerso�L �ai 4n �'tue��� <br /> Address• l�{ o0o vt:� P��cG StateLice��se#: N� <br /> City: J 2ip: S S 37`� �7cpirntion Date: r <br /> Pl�one: b loi- 6�S- S9�o Altornatc Phone: 6 3' a � ' �'�f a <br /> �b3 • a _ ���r �{t�� <br /> '' • . �'.�.`•A'4� ,�V�L'��l�Llll�l\3'CG':Fi`� � �17M '!'� �1�1�1111'�:'i��:;,'r <br /> Gcnernl Instructions: <br /> I. You may l��+cquired to oblain oll'�r perntits�i.e,:wcll abaedonment,se+vor,etc. <br /> 2. Work must not begin unless the ponnit card is avallahle on the jol�site. <br /> 3. A 24-48 hour natice is requfred for olf inspectiuns. Call(952)1A9-4600. <br /> 4. Sewer must be di�ontinued At the City sen►Ice by qualitiod contracbor before derno psnuit is <br /> issued. <br /> De��wlition by m�t�s of:a Manunl Disassembly �Heavy 6quipmenl ❑Otlter <br /> Perntit(s)Issued:�3eN�or Disconnection ❑wetl Abflndonmcnc# <br /> [n rcturn for issusnce ofsaid Demolilion Pern�1t,the u�uler�i��cd o�v��er hereby agcccs es follo���s: <br /> 1. The stn�ctu��e(s)�I�all ba kept enclased a�xllor secured until auch tirne as demolilia�is <br /> con�plete. <br /> 86B-d B00/Z00'd 081-1 + seiuedwo� }ien�ry0ad YYVlti�80 80-BO-OI <br />