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, ' � � <br /> . � <br /> �un 15 �6 06:99a Scott Morriaon 952-449-8883 P• 1 <br /> Total�+ce: S DatcRooa�od• <br /> Entered Sy: Permitt�: <br /> Cr'X'Y OF ORON4-BU'YX��1VC PEXtMI'T.A.PpL1GA,�'YON <br /> All in[orraat:oo w�ust be submiKed in faU bcto�p�n�+��11 be�tartod. <br /> (pltdse prT�t ett lnjornrollan) <br /> THE APPY.iCAN'r TS: (drete o�e) OWNER O COhPY'1ltACTO <br /> r"� 6 <br /> .ros smr��►nn�ss: f'�2� ��/9v� - up: 5 5 3 <br /> W:ll thu be a P of Somes,Reensodelers S�owcasc�oQ►e or otl�er Display Ho�e? <br /> �y� No Ifyr�,a spec,al er.,rr perr�r►;r is r�qwred w;en Pdtca DWpor4.nu owd cl�y�araeN oppravcl <br /> 4Q doyv prior lo dre ewwt, Sl�etde b�s service w!l/be reqvi�+ed wrAess�plleon�r afemo�ru+�tes <br /> �����v��a�ava�raaie, Naryarriwel[rd evcro�s wi/!ieot be dlrn►e+rL <br /> xw�o�owt�r�xt S�a�T�S�r��y� ��o4Qisa�rort�: �►o�� `':Z-y�i-�;c/' <br /> �„��� �„�� � �_s� _���c <br /> MAII.D�1G A,DARF.SS• �=' a- � ��C�Y: s �L 4 G ZIP: 3 5" � <br /> corr�rw►cron:' - � s�ox�-`1 b�- 5°1 e_� po113 <br /> Colv�rwcr r�soN: osn.Ernwc�xx: .. _ 3���. <br /> sr�iic�i�rrs�� t� � �y� _ ��racorr nw s,�ts�._I�`t� � <br /> ACtCH11 EC17�:NGNr1EER PHOIYE• <br /> MAII.ING ADDRESS: C�'Y: ZdP: <br /> NAIV�: �GXSTRA'C�ON: # <br /> J <br /> 'Y"XPE OF WORK: New Honu Addition q�s�y�� , . <br /> Move Home RemodeUAhe�stion(icc Siding.Windows) <br /> Any eazth movemenC �aay r�quixe MCWD review ds�d permit�� <br /> �xoros�e,n wo�zx�a��a«d�r�n: <br /> S'rORIkS: �Q.�ET OF�►CS FIAOR: <br /> NO.OF BEDROOMS: GARAG�STALLS: AT'rACHED DF,TACH.FD_ <br /> ESTIMATF.DCOPISTRUC'�'tON'NAX.UA�'1'xON(cxcluding la�d� S � � <br /> 11u�by spply fOr a building pettnit and 1 acknowlcd�e th3t thr in[Ormetion above is ta�pletr�nd�curste; <br /> that the wark will be in conforrnance witl�thc ordit►ances ond oodes of t6c Gry snd wi�h the Statc Duilding <br /> Code:[hae 1 uadcis�ad this is�wt a parmit au►d work is noc to styct without a permit;and ttfffi the wo[k will be <br /> in accotdancc with thc approved plan. <br /> ��jC MPL[CA,N'I"S SIGNATL7tE: DATE: <br /> ;i <br /> j •d OTOi-92E-�T� stood uFn3uad di� � i0 90 St �nC <br />