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CITY OF ORONO � 61Z4730510 01/21/98 15:20 � :03/03 N0:727
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<br /> Y�1..��_S'�.Q�1����
<br /> Wu�d stcrv� �xrith 1Iu�
<br /> � Waod c.ot�'►bir�ati�n �r �dd�c�n
<br /> ��C„, Fact�ary fir�place with �yue
<br /> _ �actr�z�+ Fixepl�c� (s) � �'r�esta�ding lViasnnry
<br /> V1�o�d Sftive (s) T �'r�nk.lin, other �,.�,; „______
<br /> Brand N�me ,� ,S'UP�2 ,�A.l�?TN _.. _. Mc�clsl Nc�. „ y'Z T
<br /> .� -w...
<br /> Mfgr's �in.,WC�."l��f�nc:es, si�e `�._.�., r�ax T_,� min. flu� dia. � _
<br /> .�._.,_.�
<br /> �' . ; , ��Y
<br /> Nc'r. _ I�itchen Exha�tst duct�d _ recircul�tin,� �� cfrn
<br /> l�c,. �.�.�. ;�ath Lxhaust (mu'st b� drY�teci �utsid�j.
<br /> � �frn
<br /> N�. t7th.cr T'ans: L,�1c:aCiurls cfm
<br /> ,��,�t�►,�,,�� (MUST H� �p�'TtOVEi� F3Y �TRE MAR3fIAL)
<br /> I�x�t�lta�ion Remvval
<br /> , . .�W� �, ��u�l i�i1;W..�.W..�.�_ ��llons under�round T insid� c�uc�ide
<br /> .. � L�' �as: � �,�ll�ns
<br /> _ Utt�er � ..�.�..�..�....�,_.,;�,.:.._._.._.._._ _. Gas openirtg
<br /> �`��.����+���C".��?�
<br /> 1. 3.�Si6 vf�Lntzac:t r'c * c�r i �
<br /> �, _��'`�x .U12� $ ....�...�. ...�:...,_�
<br /> � (c�ntr�t price)
<br /> �. �t�1��.P�g�.,. ** Acld th� St�te �3uildin� Coc�e 1'�ivisian
<br /> ,�;uYc�Ar�e to each pei�rnit. x .UOOS $
<br /> � ��..�......._.�.._..,...�
<br /> ��r ,$.5d, whichever is gr�ater� (GontrQct pric�)�
<br /> �; .��,-�►���in� (�nly tt�ail-in s�p�li�ati�7ns) � �._
<br /> �. TOTAL �'ERMIT ��� (�dc� lii�es 1-� Hbove) $
<br /> _._...�.�.,��
<br /> * C'C)N'I"RAC;7'�'�tlC!'�aK JOB C�ST means thc�ctual or estimated�laUar t�rrr�wnt char�e�! for tt�e �crmitt�:d
<br /> work inciuding mat�rial�, lnbor> prafit, AI1Y� 0[I187 �X�1� G�19tR. IL is the amount tn be Cliaf�ed ro the
<br /> r•uetan�er far thc wo►�k dr�nc. IF any m�t�ria], e�uipnaet�t, lp�nr, or i�istallution Are furui9hed hy the qwner,
<br /> tcnartf or su3y c�thcr �fartY the rentinnable mprkee vnlue of suc:h itcros rnuMc he actcled t� �he e��imasecl co�t
<br /> vr cantract Nriae for pemiit fcG purpases. 7rf ih4 cv�nC tt�at thcre is a dispute on the amoUt�t c�f the j�l� 4ost,
<br /> �hc City pYay rcqua�t �t�r subs�isaicm df a �ignecl c�py of chc actual c:crntract.
<br /> '"* ThC S"('AT� Si1Rr.,HARr� is ,qa05 of �he eonrracc price under �t,0i�,(1()0 ar g.50 • w6ichever i.a
<br /> �re�ter, For val�a�liutxs ovt�r �1,00(�,UOU call che Depsrctnenr of Inspectiprl,n] 5ervice� faC thG price.
<br /> Th� und�rsi,�nec1 �ereby F�ppli�s to the �City far issu8�r�e of � MeclinnicKl P�xmic, A�rees to dc�
<br /> all w�rk in strict ucc��•daru:� with thc c�rdinanc�s of the City �nd the r�gtilatians of tlie Mina���c►ta
<br /> Sfat� auilciin� C'cKis, Hn�1 certities tZaat ttll stat�sm�nts naade oa this appliCation Rre eot�}�lek�, true
<br /> an� �;c�rre�t.
<br /> ��pti���nt°s �i��t�tur�: , - ,.� _..��....�..w.. , , I>ate: ���
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<br /> APP�•�,vc;�l F3y: �ake.
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