Laserfiche WebLink
"- � ."Oct•� 2 � 2001" 3 � 21PM ELDER-JONES BU I LD I NG PERM I T SERV �i�4���No � 2919� LP � 2.�w rvv:a�� <br /> ,,` �C-� . <br /> � � �' To'�hal Pe�: � �C'J � Date Recelved; /`�"'' -�'� <br /> Ente�ed HY: ,,, _ _ Permit�Y: �,� �,��"C' <br /> �;ti.�-r�� f�".3 Z''l ' , <br /> �TTY OF 4RON�0 - BUILDIIYG P�RMYT A►PPLICA7'YON <br /> Ap�1t�4orcnadon mu�t be eu�mitted in t1u11 before plan review wfU b� �t�rted. . <br /> � �, . �p�ease pr7nt al�l�ormurlvn) � . <br /> ' �s�r-�����.��J.--r..«..w-��...r...r��w�wrr.�...i������w�w���.var���ww..�rr�arurr���� ����M� ^��������....�. � . <br /> T�iE APl'I:ICANT IS: , (c�rcle one) �OI�VN�R O ONTRACTO <br /> � . . , <br /> JQB SYTE ADD��3: �I�.QO -Q.i i�O� , Zl'�': S�� � '' <br /> q � ,� y <br /> �, NAdVIE OF OWNER��..F�a `�� L�o � ��C�, P�'ONE: (home)_`�5a•��-1•�"'o�1r� <br /> (work) . <br /> MA.ILING ADD�RESS: � C1TY: 3.�: <br /> Rez�e�val B ,A,zadexsen ' ( ' � C� "/ /l <br /> CQIVTAACTaR: ,�_____ y E: �' � � <br /> �-.COIVTACTP?�RSON: . 350-73rd Ave_� �; t � � <br /> k�Xidley,MN 55432 <br /> � MAi�.1NG AU�?R�� 763-502-4777 Zi�: <br /> �8'rAT� LICEN3E: �Y � #MIVZo130983 �,� � <br /> . �,���, . <br /> . � <br /> • A,BCH�TI�CTI$N'GINE�R: PHONE: , <br /> �ViA�I.ING ADDRFSB: G9TY: ZIP: ' , <br /> NAME: - BFGISTRATION� � � <br /> TXP� OF 'VVORK: NBw Addition Aoce�e�ory St►uct�ue <br /> Mave � Romode1/A1tetQtian I.and Alteration . <br /> P`ROP�SE.D�I�VORK(desc�be in detai�:��o,�� 1�,�,J� �,�;���_ <br /> � , , d��� - <br /> s�r�a�s: sQ.��T o��Cx�t.00� <br /> I�O. OF B�DROOMS: GARAG� STAt,LS: ATT. DET. <br /> FSTIMA7'ED CQNSTRUCTION VALUA'I'�ON (txcluding 1en�: $ ~ d�� <br /> I hesrreby epp�y toc a building permit and I acknnwledge tt�at tt►e informe�ion above I�coa�ptete a�l <br /> accuratc; tbat the wock will be In conf��maacs'v�ith thc orc�lnartc�s°e�nd �ades of the Cicy and with <br /> , ' the 3tste Bulld�ng Codo; that I understand thi: is not a permit�nd w,ork i� not to start a+�Lhaut a � <br /> � pern�it; and that the work wil!be �in accordance w�th the approvod plan. ' � <br /> kPP'LiCANT'S SIGNATUAE: Dt�TL; .�C� �O � <br /> 11�OTE1 ,p',c�d�.��eve�ts r�qt�re�e,parnts permit approvol by Pol�ce Deparb�te►�'ond <br /> G3fty Couacil 60 Qapa p�1nr to the event. Non�pe►�,t�te+d eveRts wilr no!be allawea� <br /> � , . _. _ � _ . . . ---- <br />