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MAR-09-2006 15�44 JUSTUS LUMBER C0. 952 277 1690 P.01i02 <br /> � <br /> Totai Fcc: � j)( `f . `-'` DateReceived: <br /> Entered By: �t� ,f L.-1�� } �> l 1'crmit#: <br /> � <br /> CiTY OF UI20N0 -BUILDING PERM�T APPLICATION <br /> Alt informatiou must he submitted in full bcfore pl�in review will bc started. <br /> (pleas�print all informatron) <br /> T�� APPLICANT IS: (cercle one) OWNER O CONTRACTOR <br /> JOSSITEADDRESS: ?��� �Y'DUI�I(1 � S_ _7TP: ,�_S.3S(� <br /> Will this be a '�rade of Homes,Remodeters Showcase Home or otucr Uispl.iy Home? <br /> ❑ YCS �l�o !f yes, n specitil e.vent�>ermit is req:rrred wilh Pv�ice De!pur�ment a»d(;iry Council uppruv�i! <br /> � � 6U c�cl,vs p�'i��•t�the eve�at. S/zullle bt�s�service wr�l he reguired unlc�s upplicunt dem�nctrdtes <br /> srt�ciert[on-.cite parkrng is avuilable, Non-neririiUed event.s wi(!»u/bc ulluweil, <br /> NAIVIE OF OWNER: �1 L� �('1 �� � 1 I'H4NE: (home)�IPj a► �`�!'1 to � ���� <br /> (work) - <br /> MA1LiN(;�ADDYt�55: 5� 1 r O Wr� S • CY TY: or01�1� Z�P: �;�3�a(o <br /> CUNTItACT012: �CJnB,r+e,r �jY O�Y�,rs PHONE:q°Jo�l •a�l�l • �bS� <br /> CONTACT 1��,YtSON: p NIOBILE/PAGER: • �0$ • � <br /> MAII�JNG ADURESS: �1 Ni►r1 1�V�� CYT'Y: ZIP: S�SQ <br /> STATE LICENSE: # . EXPIRATIUN l)A'1'T�;: ?� • ��- c�.00�D <br /> ARCI-11TCCT/ENGINEER: PHONE: <br /> M.AILING ADDRESS: CYTY: ZIP: <br /> NAMF,: RCG[S'I'1tA'Y'YON: # <br /> TYPE OF V'VORK: Ncw Home Addition Accessory Structure <br /> Move I•lome _ Remodel/Alteration (ie: Siding, Windows) � <br /> PRQPOSEll'VVORK(describe�nde�tai�: � � V1t`I�p�,OI�VS � � dp0� _�J�cs�h2°�rl <br /> �Q 0�,�'0��C.h�GI �e. ,�.4� � -- <br /> STU12YE5: SQ.FEET UF EACH FY.,OOR: <br /> NO. OF BEDROOMS: GARACC STALLS: ATTACHED nrTacH��_ <br /> ESTIMATEA CONSTRUCTION�ALUATION(excludin�land): � � W i S�O .o� <br /> J he�chy apply Tur a building permit and I acknowledbe that thc information above is complete and accurate; <br /> that che work wifl be in conformance with thc ordina�ices�uid codes ofthe City snd with the StAte Building <br /> Gode;that l understand this is not a permit and work is not to start witliout a permit;and that che work will be <br /> in�ccordance with the apprnvcd plan. <br /> APPLICANT'S SI(Y1�A'TURE: � � DATF.: O <br /> 3l <br />