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03112/2602 20: 58 952-894-0960 K-DESIGNERS MN PAGE 01192 <br /> 5ep-P5-2000 D9;5�am Fram-CITY OF ORONO �952249d616 T-660 P.002/OD3 F-509 <br /> Toral Fee: $ / �'%� . � �' Dat�Received: <br /> E�tered BY: _ /1-o Pct�miit#: �-�-( � `j .___. <br /> ;- <br /> CZTY O� O�tONO - BUII,DING PERMIT APPLYCATION <br /> All xn�,formation must be submitted in fuU before�lan re�view will b� started, <br /> (pler�se print al! in,fbmrQtion) <br /> 1'�3fi APP�.YC�►�,V2 IS: (circle anc} 4WNER CONTRACTOR. � � �� <br /> JOB SI'TE ADDRE.SS: f�S� �R�b� 5 l ��p; <br /> w�°l ���CA rn� 5�3�� � <br /> NAME O� UWNER: G2EG � �'UL7-E ��'t�(2sD� , P'HONE: (homc�RSZ ,4�S .32 6 / <br /> (wor1� ...._._ - <br /> .MAILING ADDRF'.SS: ' CYTY: ZIP: <br /> co�c�ror�: 1� �s��a£2 s �xorr�: qs� s�9�r 3 s�o� <br /> CONTAC'�'1''ERSON: �A�IV 5 C I{A F�(� MOi�U.,�tYAG�1L: <br /> �[.nvG,�vnxEss:, io w wY !3 cYr�:�vnsNv�c�� Z10�:_ss33� <br /> STATE LICENSE: � a o i 3$6 � <br /> ARCI'.�[1'ECTlENG�TEER: PHONE: <br /> MAII.IlVG Ani.IRF.SS� CiTv: 7�P: <br /> N�: REGISTRAI'ION# <br /> �YPE OF WORK: New Add�tio� �/ Accessaxy Strueture <br /> Move � RexnodellAliexat�on. Land Altcration <br /> PROPaSED WU�iK,(describe in detarl�:��[���}_� (���/�O � S _ <br /> sxox�s: sQ.�Ear or�Acx�oa�: <br /> rro. ar n�D�ao�xs: G�Ga� s�r�w�,s: ��r. n�cx. <br /> c <br /> FSTIIVIAI'Tt�D CONS�UCTION VALU'ATYON (excltidi�g lan�: $ q(� �� ' <br /> r here'by app�Y for a buildin�pecmi�t a�acl I aclo�wwledge[hat Lhe i�o1'ormation above is complece and <br /> accur�tc; that the work will be in conformance witb the ordinances aad codes o£th,� City and wit1� <br /> the Srate Building Code; that Y understand this as no�a permit and work is not to srart without a <br /> pem�it; and that thc work will be ' ozda.�ce wiih the approved plan. <br /> A�1'PY.�CANT'S S�GNA7.'UIZE: "�� DATE: �' <br /> IYdT�? �`arad,e of�o►1�es events Ter]uire separate perniit appruyal by Pu ur�DepdTtrnent wid <br /> ' C�ity Councd[ SO days prior co the even�. Non permitted events will not be allowed. <br />