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Total Fee:� $ Date Received: '��Cv/C �" <br /> Entered By: ���jj Permit#: / '��� -- %- <br /> ,t. <br /> CITY �F ORONO - BUII,DING PERIVIIT APPLICATION <br /> All information must be submitted in full before plan review �vill be started. <br /> ' (please print all information) <br /> ------------------------------------------------------------ ---- -----�_____�-_------------------------ <br /> T'HE A.PPLICANT IS: (circle one) OWNER O CONTRACTOR�j <br /> �-. <br /> JOB SITE ADDRESS: I��?% ����V l L-C� '�i�c, - ZIP: �S � `i/ <br /> NAME OF OWNER: t I �` � �� � c c, � � c1 PH0�1E: (home) (�1� -y�/ - 7G 7� <br /> (work) <br /> l�IAILI1i 1G ADDRESS: l Q,�i S� ec��-�c�,�<<` S 7, CIT`Y: c�r��v c' ZIP: ��3`J/ <br /> CONTRACTOR: " ��'�� .l�;��-.k�.�.5 PHONE: (�S l " 7 7l� ., `�5`/S <br /> CONTACT PERSON: r r�„��� .�; e�lc;�u.� ,`�ZIIOBILE/PAGER: (os'l- :�� � -l��S-`1 <br /> 1VIAII.,INGADDRESS: i7a/ o�d ��ds�,�, R � CTTY: S!,��k( ZIP: 5�s�o� <br /> STATE LICENSE: # '�"��� ? �c� 7 <br /> AgCHITECT/ENGNEER: PHO\7E: <br /> MA,IL�TG ADDRESS: CITY: Z�: <br /> N��,�: REGISTRATION# � <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED`VORK(describe in detai�: T�� c�(-�� \� ��c��\ % ��-�'� � �`��--• `� <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF B�DROOMS: GARAGE STA.LLS: ATT�. � DET. � - � <br /> EST 1MATED COti'STRUCTIO�' VALUATIOti (excluding land): S �� � `»� - <br /> I hereby apply for a buildinJ permit and I acknowled�e that the information above is complete and <br /> accurate; that the work will be in conformance wich the ordinances and codes of the Ciry and with <br /> the State Buildin� Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> `--� �� . <br /> A.PPLICANT'S SIGNATURE: �tia,.�C . < � ' - DATE: �- (. _ �,. f — <br /> 1�'OTE! Parade of Homes events require separate permit approval by Police Deparlment and <br /> City Council 60 days prior to the event. Non permitted events wi11 not be allowed. <br />