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Nov, 17, 2010 2; 13PM No, 6451 P, 1
<br /> . .
<br /> City of Orono
<br /> Building Permit Application for Internal Wvrk
<br /> (windows,doors,slding,re-roef,etc.
<br /> 4fis�OZit. IW?IIin7AtldrpS& �/ / � d
<br /> ��� '�' �.,, ro nnY ue Pcrmu n�or,ur�: ' D�_/�
<br /> //0 Q �ry?lel DaY�MN 66323{itl��; � [/
<br /> II ���reuiivdd; /�
<br /> `�� ., �' S6uuf AOtlrr.c�• NrwiveG by.
<br /> ��� �o{� 3766 Kglley Nail,way
<br /> �it,��sss Orono,Mru S575G Plan revirwl _
<br /> _ Ma���. 9�2�za��suu i�: BG2 2a��ete ,�, Torsi F�x;; � .
<br /> Th(a applicalion Mren must be i+�rn le�ed in `��u3 ��� ��
<br /> P NII and ail reqwred inform�tion must L'E submitted.
<br /> GENERAL INFORMATION:111wmP'�e applicetlona wlll be rpWmed. (/�/eage piinl)
<br /> Job 9iheAddnse; ' �c,c. �dQ
<br /> WII O�ia be�Paradd of Homes,kemn 1• � �� � ���
<br /> �➢�.�+�ecialpvyn(pp�/pqi��.,��• �L1ero`�n�GJsc Hnme of ulliHr n p�� ay��pmG9 I Yes
<br /> r nev!wIA PGbr.i 7ap�rfn�nl�nd 4ry r.ouncu wwu W!fi0 sey�p,iw Yu M6 eVCn� �t�� NO
<br /> IBquxix!i�nlr��a appllmn�tlmronsuulwr e'+fieYCfit en,�ih���mkMP IC�vrolnA,L..Na1-NwmA'h.rr�venls wiH�iuf OC B(aw.M��aC WV��nr.
<br /> C6NTR�ICTORlAPPUGpNTINFO��AT10N:
<br /> Nfiml; �..�.�vLX`�A/ ;�l;"_- , -
<br /> 3tale�I.icense# ���� • �
<br /> ���3�—'9 �.� �.
<br /> Phons: �'--�,_�- �� FltpiraUon Dalc.
<br /> Mallln�Adtlrcaa: ��- 7�LL o O_ offic6 _
<br /> _1c�7 E' ���1.��►�. �I � ����>
<br /> Coniad Perr:nn' �{; `. LIP:,l.5,.',y�-.`
<br /> Em�ll clhd/o�f�ax: ' •— llNplicAnt Ia: `Z,unha. � I loine��wner rcua.un.
<br /> _ ' -��$�. )
<br /> PROPERrr owweR�FORnvrnON: '—
<br /> Neme: � � �_ �� _ ^
<br /> Phonr�(dflVl: T� �-'�
<br /> --�--- „ W,�-•—����— �--.�
<br /> AOdreee. �3,-, �� �
<br /> Fmeil end/w F;ix �'�"—�-�"�[t Ci �,�Is„�� 71a� S_1s,�
<br /> � �
<br /> PROJECT INFQRMqTION; —
<br /> 7Yw„r pro1eee .
<br /> �Y�'+rth irwvemnntmay�yulfc
<br /> �J�Ouo�(G) fl Remnnai roCwD►avlew g eemiio
<br /> ❑Wnq�l'DanIdQB �
<br /> ❑win�uw(s} rl Rep:,ir I J E�nrm Uan�aoe Minnehoha�:K�k Walenehr.n DistriGt(MCWD)
<br /> 7 NI,v1 Mirnigtanka kiva
<br /> u����nA ❑Kuefuradon n?ephavp�t,MN 55391
<br /> I I OMcr(apecily) Phnne: 9��)1 06!1n
<br /> LJ Rr.-roa� ❑r�re D.mape Fex� 4n«�1-066:
<br /> Overall Pra�ct pr,�cripvor�: ��� — .m;nnehahaaa�,q�
<br /> 1 a n_� �.:� c' �,' (t
<br /> [st7malcd G�nstrucclon valu�tion ot ro'ccLt(e�m,1Ud q land) s • � �
<br /> �—= S� / �� o `�
<br /> APPUCANT ACKNOW�EDGEMEN7: �
<br /> • Ayieee tn prmitle all in�uunml��rtq�i�;J vr r�qi���ie BuIINi
<br /> • Cenifies U��I lhe Infinn�pon supylu:d la p1,e anil uurroct In M. ��P;�in�e�d:
<br /> �re eokly respunolble!fnr wGmilrynp o r.nmpka appli�nflnq bri�rel of MrJbr.r�,qydyo, The�ppl�cen�id�Bnl�r.e�Q{�hyy
<br /> but lo reiecf it unlll iria�mplele, Q �ti+ro t�nt����li��lure to dn ao,Ih�slaff has no�Ippm�livd
<br /> � Some nr all ur Ihe Inhfrmnpon U�at yvu nr¢esknr,�lu pruvlae nn���qPplic:wlion i.y classiLuJ�y Ste►r.uw aY rithar privp�or
<br /> uan8d.r.ndel. Nriva�c dela I��niom�.lion whlnh�ner�lly c;�nnot Ae pivE„lu the pnhlw bu��;,,!n�N�n W lhe�u eef ni tltr
<br /> �dte. CnnMtlenliil d�L-�ia l�(p�qp��i yyhlCll Dennl'ally�q�p�hra fliven lo eithcr the puUln;�r Ne�up�ee�o{U�e date. Our
<br /> Gu�yosc and�n1enJ�d uee af Ih�e iqfonu�Gon Is In annu�IlY updiir.our ry��oiJe nnn rcmrds uf othn�grnrcmutitrlsl�ganr..ies
<br /> re ����:d b iew. n u�rofuae in�u 'I lhe Infem,Auon,llw�uollratlnn ma nut be Ir.w�.
<br /> ,/� �
<br /> APPlicain'�SignatUre: �y�JC�.�� � /�
<br /> .�.� l +-c rQ—Q� DeOe: � �I'— V I �
<br /> �Nsl UVtlafed: f76-M.�D9
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