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v�G:'1�:'y� 11:�y THE C I T4' OF OROhJO 612-4�3-7357 ��'7 <br /> CITY OF ORdNO - BUrLDING PF�2tMr'� APp7,ICATIaN <br /> To�al Fe�: $ �?. `�-��:�G- - � Date Recei.v�d: ��� - /_5�� _ ��% �� <br /> / Date Appzoved: <br /> �ntez�td �y: 4(°J l- . <br /> ' Perm��#: '�'Y�S�.,�S <br /> ALL xNl�'4ItMATION MII5T BS SIIBMx'!.'TED IN FULL a�'�� PLAN REVIL�VP WIx,L $8 STA�T�D <br /> (See Gheck-o�£ Li.�� Enclased) � <br /> -------------__�..�------------------_�-_-----------��____�_�-------------��----------� <br /> T�8 APPY,ICANT ISt (cir�I.e or�e) pWNER os CONTRACTOR <br /> JO� SYTE ADDRBSS: Z��t � Sv SS �.�1. ��. ZYP: ��' 3 '2 <br /> (work? "� <br /> NAM� OF OWNSR Y 'N \�y� w \ ��1M�P4 _ PSONE a (hOrite) ��S` O Z�� <br /> I�AI'LING ADnR8s5:��{.S �PC2 �►�Cz 1+�4L RD CxTY: �►.r I��r ZA--r�4 ztP: S53�f ` <br /> CQN2�.ACT�R: -��HS E ra �ka��S �y PHONB: L1`l� , BS�11`S <br /> , <br /> MATLING 1�17R�SS- �D 1 �-.I�Kt;s 1+uQE PA.�1�c- CZTYS 1M 1 N NE'TOtrKA-ZI�s SS 3 '� <br /> W�l�`t <br /> ST,ATE LICSNSE= �_ �1�- Obb" � ls� <br /> �xcgYmECT/�v�ir�sR: iZo$Er�-t- � ET �-2 ��K p�r�rr$: y 1 �-- 1��9 <br /> MAILING AbbRBSS: ��S 2S P�w��$�vGI�1.'Y: �}k-�.N 1t�S E.H �I P t SS 3\7 <br /> biAMB s �O 8��-r- �ET �tZS E.� I2BGISTRATION # '-" <br /> TYF� pF WORR: New� Additior��� Acce�sory Stiruc�ure_. __ Move <br /> bemo R�mo�el/Alteration R�ndvate Land AZtera�iot� <br /> PR4FdSBD w��K (8escribe in detail) : ►yEw 5 � N Z-�.L� �f�v���-`r <br /> �a�E 2 - S'�'b cZ� �TT I�;�.�� ��-+�CZ I���-- <br /> � �-- <br /> STORIES: Z Sf,�. FFET t�lr EACB F7,OQR s <br /> IQd. OF aSDRt�pMS s � GARAG$ STALLS: ATT.3 DET.�� <br /> $STIMATED CdNBTRDCTI�N trALt�AT�dN {�:�ludiag 1�X1d) : $ ��S, Qd� <br /> I he�'Eby app�.y for s buf Iding permit anc� I acknowledge tiha� th� infaxm��i�+a <br /> above is c�mplet�e and accurate; that �he wvzk wi7.�. b� in cor�farmaace with the <br /> ordinanaes and codes o� the City an8 with the $ta�e Bui,�ding �od�; tha� a <br /> undeXstand this is not a permit �rid work is not ta �tart wit�hout a pe�mi�; and <br /> that the wark w�.11 b� �.n accordance with the approved p1an. � <br /> ��tr S EtJ 1'tc9 vtiE.S� ��K�-_ <br /> �PLY�I�'� SIGNATQ�tI�:__�4-0�.._ DATE: �o" \S" �Z. <br /> . - - - <br />