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�--= .���Y OF OR�NO � b12473�5�0 09/��/96 �4:00 �1 :��/03 �G;S�� <br /> . <br /> .. , '��tal F�: � Y)ate Itec�ived: <br /> Entered HY� Permit�: �`�-� (�L <br /> C�T'�' O� OR�NO - �IJd�.D�TG PERMYT A�P�.ICA1'ION <br /> A� �t�foc�aa�on anust be�abmitted ln full befor� plan review dvill be startesl. <br /> . (please print ald ir format�on) <br /> ' erw�������������.. _��..��..���..��w..�.��..���^����«..��.�����e� � ������������.���.�.��........�����_�_��_��.._�_—..__��_� <br /> T� ��'LICAlV'I' IS: (circte one) O�VTYER, OR CONTi2ACTOR <br /> , <br /> d�8 SI'I'� ADD�S3: ����j �����..C�(l`�`'�l �����-�: ZIP: �j�J3� � ,:.,,. <br /> �. NA11� OF OWNE�L: �C�hY� � �Y>��G-�' C`� PI�OME: (home) �j o�'r���� I <br /> (work) <br /> ` ��.�C� _.�.2�.1 <br /> �.�a:n���nREss: �a��� �,c,�. �����.`��,c�: a.�: �� <br /> � REAlEWAL 8Y ANDERSEN ' <br /> CONTRACT4R: 350�73RD AVE. NE <br /> . CONTAGTPERSON: FRIDLEY, Mt� 55432 <br /> � � NLA�.ING ADl}�SS: (6I2� 5Q2�4777 Zjp: <br /> ���'AT� I.ICENSE: a LICENSE #20I3Q983 <br /> . A�tCHYTECT/ENGINEER: �'I�pNE: <br /> 11�AII.ING AUD1tESS: C�TY: ZIP: <br /> NAME: R�GYS'Y'�tATI4N# <br /> TY� OF WORI{: New Addition Accessory Sm�ctnre <br /> Move Remodel/Alterat9an�_ I.ar�d Alteration <br /> Pd�OPOSED�VVORK(deseribe in detai�:�;0�� �.� Q ,,.�� ��.����1�1C`� �� ��1`�1-� `:� <br /> �`� � � ��� ��� C �� � Q <br /> STOYtIES: SQe FEET OF EACH FI.00�t: <br /> NO. OF BEDAOOMS: GARAG� STALLS: ATT. DET. <br /> �— C�'' <br /> ESTIMATED CONSTRUCTI4N VALU'A'�YON (eaccludfn=6an�: $ j �—" <br /> I h�reby apply for a building petmit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in confor�nance with the ordinances and �odes of the City and wich <br /> . ' the Swte �uild[ng Code; that I understand this is not a permit and work is not ta start without a <br /> pernut; and tl�at the work will be in accordance w�t� the approved plan. <br /> APPLICANT'S SIGNATiJRE: � C�,� ����� DA�: �� `(.��j �) � <br /> �1���3��- ��'� <br /> NOTE! .P�de oi�To� �vents requfre separate p�rnait ap,�roval by Pnlice .�eparhtter�t and <br /> City Cor�r�cll BU days prtor to the ebent. Nnn�rernt�itted�beRts wdll not be �llowed. <br /> Rer.aivari '�'imn Con �� 1 �A7Ah�f Arin4 Tim� C�r 7A t � A�D�( <br />