Laserfiche WebLink
i <br /> G�.�d �-y-o,7 <br /> � Tota1 Fee• $ l O2� `Sd Date Received: � � <br /> ]Entered By: Pr3'xnit#: '���7�� <br /> CITY Q�F ORONO - BUILDING PERMI'T APPLIC�+i.rI�ION <br /> All information must be submitted in full before p�a€e� review will be starCed. <br /> (please print all inf'ormati�Et� <br /> ---------------------------------------------------------------,-------------------------------------- I i <br /> THE APPLICANT IS: (circle one) OWNER O C�i�iTRACTOR I <br /> JOB SITE ADDRES5: �p� CrN 5�-���el� _ 7Z�. z�: 5 5 35Co �� <br /> Will this be a Parade of Homes, Remodelers Showcase Hon�e or other Display Hor�te? � <br /> ❑ Yes ��To If yes, a speciaJ et�ent permil is req:tired w�i1h Polic�e Deparlment and City Cor�ncil approi�al <br /> 60 d�ys prror ro�he event. Shuttle hus sen�ice ti��ill be required unless uppl icant demonstrates <br /> st�ffrcien!on-site parking is avai/able. ,Van per�rtitled evenls�a�i!/not be nllowed. <br /> � <br /> NAME OF OWNER: ov�n. --�—✓��C-S PHONE: (home) 9 S Z-83 - J' J`���{9 I' <br /> (�vork) <br /> iV1A.ILING ADDRESS: �� Cr 5�1 C{� ��CITX: �,("�v1 v ZIP: �,���(o <br /> CONTRACTOR: ��rd�,nce � v-'o � nt��n��Ftd PHONE: <br /> CONTACT PERSON: �Ar ev-�e MOBT.LE/PAGER: (D t 2- �{l9- Ia 9 5 <br /> MAILING ADDRESS: OS W� Z �=' "t' CTI'Y: �Is 1�/95 ZIP: SSa 33 <br /> STATE LICENSE: # T�C 5 EXPdRRA.TION DATE: O 3 n� <br /> ARCHITECT/EN PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: GISTRATION: # I <br /> TYPE OF WORK: New Home Ad ion Accessory Structure <br /> Move Home Re del/Alteration(ie: Siding, Windows) _� <br /> Any earth movement m requ�re MCWD review and permits! <br /> �'ROPOSED WORK(describe in detai�: Rer�o �}I( cco /�e �;� A,n �rn�4q� <br /> e- �2 � i � wi�n t,.15 =n�5 .�e � ' +4c�, '=w+5"tW II ffArdt� F.(A►�►� . <br /> STORIES: SrQ.FEET OF EAC FLOOR: � <br /> NO. OF BEDROOMS: GARAGE ST LS: ATT'ACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATIO excluding land): $ �7 ���•x+' __ <br /> � <br /> I hereby apply for a building permit and I acknowledge at the information above is complete and accurate; � <br /> that the work will be in conformance with the ordinan and codes of the City and with the State Building <br /> Code;that I understand this is not a permit an work is to start w�ithout a permit;and that the work will be <br /> in accordance with the approved p`an. <br /> � • �+ v � DATE: 2-7-07 <br /> APPLICANT S SIGNATURE. _ <br /> 3 ' <br /> i 'd ` dSi =ZO 10 80 Qa� <br />