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. ,,..�,,; <br /> � <br /> � Total Fee: � $_5 3l�_�g Date Received: �' ��'� � �'o <br /> Entered.By: � Pernut#: ��j �3 c�c/ ;��! Y • <br /> � ^ <br /> G'a,c-Q-aal /D-/�-��. l2<,s( ,, �; - <br /> CITY 4F 4RUN0 - BUILDING PERNIIT APPLICATION <br /> All information must be submitted in full �iefore plan revsew will be started. <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE A.PPLIC.ANT IS: (Gircle one} OWNER OR CONTRACTOR <br /> JUB SITE ADDRESS: 212 5 C ar r i ag e L an e ZIP, 5 5 3 91, <br /> Jon Rohs Construction and <br /> NAME OF OWNER: Re a 1 E s t a t e , In c. pH4NE: (home) 9 5 2-5 91-0 8 6 4 <br /> 600 So . Hwy 169 (work) 952-591-0864 <br /> MAILING ADDRESS: Sui t e 15 5 CITY:Mp 1 s . �,g�; 5 5 42 6 <br /> � <br /> Jon Rohs Construction and <br /> ' CONTRACTOR: Real Estate , Inc. Z,HO�; 952-591-0864 <br /> CONTACT PERSON: J on Ro s MOBILE/PAGER: 810-4311 <br /> MAILING ADDRESS: 6 G 0 S o Hwy 16 9 , ��15 5 C�'y; Mp 1 s ZIp. <br /> STATE LICENSE: # 3 5 9 4 <br /> ARCHITECT/ENGINEER: J ame s C ar 1 s on pHp�; 6 51-5 7 8-3 9 7 4 <br /> MAILING ADDRESS: 10 5 G en E ag e P CITY: Wo o db ury ZIp: 5 512 5 <br /> N�; .7 ame s C a r 1 s on REGISTRATION# <br /> TYPE OF WORK: New x Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WURK (describe in detai�: New walkout ramb ler <br /> , <br /> ST4RIES: 1 SQ. FEET OF EACH FLOOR: z� 73/�a-�,., /z2�*�, �.���Q <br /> NO. OF BEDROOMS: 5 GAR.AGE STALLS: ATT. �� DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 4 7 5 , ��d <br /> I hereby apply for a building pe;rmit and I acknowledge that the information above is complete and <br /> accurate; that the work will be �n conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand t ' s ot a permit and work is not to start without a <br /> permzt; and that the work will �e in accor nce ith the approved plan. <br /> � <br /> APPLICANT'S SIGNA ,f�,o DATE:I b-�-2d7�� <br /> NOTE! ,��ade of Homes e �quire separate permit approval by Police Department and <br /> City Counci160 days prior to the event. Non permitted events will not be allowed. <br /> 9 <br />