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GiTY OF QRONO �a� ;�` Z <br /> � 494b'16 U6t�3/40 'i 6.�2 � ;()1/Q� NO:3b4 <br /> � r � <br /> , Tcital ��c: � Date �.eceiv�d: <br /> Ez�t�red �3y: — - - permit#: � <br /> C� (��' O�tt�l'�I'� �- �TT,377 LT��i i'G�'��.IV�'�t' A��'�'�..��C�'�'Jt��' <br /> ,�,�1 fn!'t�r�nation mt�#be subml� �d °uX i�iti beiore ptan review will be started. <br /> {ptetrse, r�nt cz11 i�ftt�rcation) <br /> � <br /> .._.�._..�....,...� �... <br /> � � <br /> '�'.� ��°�..Y��3�' ��: (eircl� vne} C��R t��QNT�.A�GTf�R� <br /> ,)Ol� STI'E .ADI�RESS: �����..�r.,y1_Q_. , O�c c,r� �'e �'a�� <br /> c� <br /> :�tAi41� 4F CD'VVN�R: ��,Q�o�t ����..�_.-�,,�„__���_�___ �°$f3t'dE: (hcame}��..r <br /> (w�rl�� <br /> T�.CA.YLIi�i(�.�iD��S: `�.����c>�-�-�.�a�.Q '��'I'�;��r��,^r�►�1 Z�.P:_,`�.,,`.'�-� <br /> �t3;�1']CR.4G'1CtAlt: ' , �'Ht�i�: ���,.,......�...� <br /> �QI�7CAC7C P��S�N: � 1-1 p� _ lvid�Bi�/PAGER: . <br /> I�.,�NG AJ3DR�SS:��..�i�.�-t` ----p-�-_��TY'.�.1.����..�':.`�"�� . <br /> �'��'� ����tS�� � ��iq� M�`� <br /> ,F1R�HIT�CTlENGIlYEER: -- PI��►iY�: <br /> 14I�LTi�FC AI?I3RES5: C�'X'Y: ZIP• <br /> � R�t�IS'1`�i.ATION# �..,�,,. <br /> � <br /> T"�'PE QF �YQRK: New Addttion Accessory St�vctur� _r_�___ <br /> �VI!?VC RCIn( S�I/AItCLAt10A "�C � Laud Alterat�4n � <br /> �'Rf����l�'vV`t�RK(c�escribe in detai : ���.� �P..��2.� _.�.---_- <br /> S'X"U�iES: 1 � i �� SQ.F� 'OF EA.C3E��L.CDUR: ��\o0 <br /> �IE�. OF BEF?12.QC?i�iS: � t� ►RA.GE STAL�S; ATT. �_ DET, <br /> ���'�1,.�'�"�� C��tS'T'��tJCTIfl�!VA .UA"�'Ia�l'(eaccludang��nc�: �.�.°l�._.� <br /> T hcecby apply fvr a'bui2ding ptrmit anc i acknowl�dgc t�aat the informatian ab�ve i�complcte aa�d <br /> a�cur�te; chac rhe work will be in canfo ma�ce with the ord.inances and codes of the City aad with <br /> thc Stat� �u�.di�g ��dc; t3aa� I unders� �d t�.is is not a pezr.�xit and v�o�� a� rzaC to �t�.rrt 1wit�zouk � <br /> permit; and �hat the work will t� in a{ a4rdan��wit�t�sc approv�d glan. <br /> .rl�'�°I.ICANx''S SLGi�iA�TU�tE: � �- - DAT�: ,�„1_�,��.�.- <br /> .�'�7'Ef a�'t�t��d�1�¢� ev�nts re5 aire �se�rat�,�erm�t a�praval 6y k'glic�I�epamn�nt�nd <br /> C�ty �auM�tl 61�days�ric�r Bta �he �ve t. �Yon p�rna�tt�d events wzll nat be a1l�wtd. <br />