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'' Date Received: <br /> Total Fee: $ <br /> Entered By: /,, Pemut#: <br /> ---- - - -- - ����� ��C <br /> F ORONO - B G PERNIIT A.PPLICATIOl� ��:�ti�� <br /> CITY O �� <br /> ���-►'c�um <br /> All information must be submitted in full before plan review �vill be started. <br /> (please print all information) <br /> ----------------------------------------------------------------- -- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTR.ACTOR <br /> � � ' 1 �-�%z�/���"X�� ��/ � <br /> JOE SITE AD�RESS: ?��T <br /> ,� � ��3 � _[-� <br /> NAME OF OWNER:_ PH NE: (home) SOZ 1 7� <br /> (work) ` /��v <br /> MA�Q�ING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAII,ING ADDRESS: CITY: Z�: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: Z�: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(descri e in detai�:� C,�G,� <br /> C .� <br /> �`� �' �� � �' � �� '��Gc�.� <br /> STORrES: _ <br /> � SQ.FE��T OF EAC OOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. > <br /> G_G':-" _ <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> per�nit; and that the work will be in cc rdance with the approved plan. <br /> APPLICANT'S SIGNAT . DATE: <br /> �� <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />