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_. 10i1Bi94 16:25 THE CITY OF pRph�p 612-4?3-735? <br /> . � . 802 <br /> r � <br /> . '''� CITY OF �ti0N0 -� BUILDING PERHIT aPPLICI�TION <br /> To�al FGe: S J�, 1 ��� ,� Date Received s • <br /> Date Approvedz <br /> EnterQd By s -��1 Permit B= '�"�.�j <br /> u,L ZppOgrtATIOP NDST BB SIIBi�'IITTED IN FQLL BE�ORE PI.AN REVIL'K {P�LL Ag STARTID) <br /> (Se� Check-off List �neloeecl) <br /> TgE^APPLICANT i$a^ (circie one)---OWNER CONTRACTOR ^w Y ^-----~--^--' - -' <br /> Jo�a szTs AnDxass: <br /> d27/S Cou�r s�� .�r �rr: .SS^3S(� <br /> (work) .� <br /> Ti7NY Elf�("N Cf)M�'APtY� PHONB s (hOme) _ <br /> NAI� OF Oiillaffits <br /> PLYMOt1TH. MN 564=t3 CZTy; ZZPs <br /> �LING ADDRESSs . <br /> paorr�: .55 9•0.•2 S/ <br /> GONTRACTOR: :� ., � , . <br /> 41CJ Ct:lll:311t�ZF LAt.F_ CI'!'Y: SIPt <br /> 1rtAIylNp P►DDRSSS: <br /> ST�� Lz�sg: : 32 z o <br /> ARCgI T$CT/SI�1t3ZHEER= PHONE: <br /> M�jZLZtiG ADDR$SS: CIZ'Y: ZZP• <br /> p�= REGZST�tATjoI1 R <br /> ��� oP ��= N�N � Aadition Accesaory Structuze Movt � <br /> p��o Remoce /Alteratiotl RenoVnte_,�_ Land Alteration <br /> �'ROPO$SD W0� �a�+scribe in d�tail) z <br /> �,�:, z��9 2,x.�(. :. /o�s /�p <br /> 8TORIEB: � SQ• PL+'8T OF �ACH PLODR: <br /> I�O. OP 88DRQOMSi� ��$ STA�.x+S: ATT. � DET. <br /> Z 9D D oD <br /> BSTirsx�a copa�ucr=oN v�vAT=op (eza�.�ainq iana) : S i — <br /> I 2t�reby apply �or a bul3.dinq pQrm3t and I ack o�+ledgQ thnt the in�ermation <br /> �� 1 be in confoxmance w+ith the <br /> above ir c�mplet� and Rccura�e; the nt�h� t r � Sgate Suildinq Codet thrat Z <br /> ordine�nces and cvdes of the C Y <br /> understand thia i� no� a pormit d work i ot to start without a per�teit� end <br /> tihat Che work �vill bQ in aeeez'd Ce wi e approved pl.an. <br /> . � <br /> , -: �-. _ c-�� � <br /> � � - DATE:� <br /> 1�YLIC?#NT'S SIt;NA'I'UItB z <br /> �% <br /> -,�� <br />