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. _� <br /> ]���� <br /> Total �ee: � -- f �� D�teRec.cave : � (1 oZ�JU� <br /> Entcred 133r; ��� I'erniit#: ;� � C� 5 <br /> �'I'I'�' O� ORQPr�O - �3U��T3��NG PEI21l�IIT APPLICATIOI� <br /> All infol-niation tniist be sub��iittcd iii fiill before j�lan review will be started. <br /> (please pri�it ccll i�ifof��aicitio�z) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> �'EI,I+, �PYLICANT IS: (cir�cle oiac) �'VVN��I;IZ O C'ONTRAC�'OI2 � � <br /> JOI3 STTI+�AllD12��S: Z� R-c C�S v��LL �•��_ ZIiP: �S_�_ <br /> � �Vill this be � a'arade of IIoaa�es, I�ex��odelers Shorvcase Iiome or other Dis�►lay I3onie? <br /> ❑ �es �I�ro lf��es, a,s�ecrnl e��uzl pernril is�•eqrrrred��i�itl�Poli�e l�epar•U���e��l ar�d Cilv Cor�i�cil ap�r ni�al <br /> 6�cic�vs prror to ihe ei�ent. Shirtt/e bus ser��ice�i�il/be requrred�u�less crp��/ieant de�uorr.�ir�,te.r <br /> szr�ficreni ofz-siie pai ki��g rs ai��iiicrbi�. P�a�-perv�iiiled�i�eriis iril/iro�!�e��rlloi����:1 <br />� �v�e��,or ow�v�;�z: ,�fi�� -Aw��-r- rxoN�: <<,��»e��s�-_�o�-�v�t�(3 <br /> ��vork�(�tZ�Z t -��cPo <br /> 1V�AILING AllDI2r,sS: ���-�5- ��� vtir L�..b �'�TY� C�L�l�U� Z���': S�3�p <br /> CO1�,'7['ItACTOIa:��vZ�� V�/i�:Tz iJ I+-�C. PHON�: S'�l Z.�'�Z��1 t{�(`-�' <br /> C()N'I'�C'1'P�RS()1�`: c�v�c��q 1!�[Ol�ti��/I'AG�R � Sl�wti� �S c^�.��.., <br /> Ii�lAIL1Nl��i�liilii;SS: i'7Cv'�, S�-��c_.�ol--�W���r' tt�t i.ii Y: l�f��.E/� %ii': ��� <br /> ���eTrlr��c��s�;: #� ,. �.���i� ���i�iz���rlo�v�����,:��� ,�o�__ <br /> �RCI�I'TEC�I'/CNGIllr�LR: IPFION�: <br /> IVIAII�:l�1i�G Al)1)I2�'.SS: '��'�'�': �I��': <br /> Ii��lt'��: �G��'�'l�A'�'IOI�: # <br /> '�'��� ��' ��V��d��; 1�Iew Honie �dditioi� �\ecessocy Structure <br /> � Move Home P�emociel/�lter�tio�� (ie: Siding, Windows) �— <br /> Any earth movement may require NICWD review and permi�s ! <br /> �'flZ��'����',� �/O��i�(�lebca•ibL isi c�'�t�ei�: �_Oc-vz2 L� 1�_�'�N�� f-r- <br /> �_1f1�._ F�t-e�-� ���J---- <br /> �T'��2I��S: ��.����'�`O��'l�.�I��+�.0�1�: _ <br /> � I�1�. O�� �F�)I��(3I�S: ���2�G�': �'T��,�,�: rS�'��C��h�:�➢ �����'�C�-IE��_ <br /> � <br /> �;��'�N�:�r�'k�;��C'�I�1�,'�'��.�T�;�'���I�I ����,�1.�r6'��i�T{����i�c�n��U 8�.�c�c�): :3 ��_ <br /> 1 hereby apply for a buildin�}aermit and I acl:nowledge th�it the information above is complete and��ccuratc; <br /> thzt tl�e�vorl: ���ill l�e in conl-orman�e ��vitl�� tl�e ordinaiic�s and codes oft'hc City ancf wiih the Si�te Buiicling <br /> Code;th��t [ understai�d tl�is is not a}�ermit and worl:is i���t to start�vithout a permit;and th�it tl�c�-vorl:�vil I be <br /> in accorciance �vit�h th� approvcd plan. <br /> --_.. <br /> �-1�'�'����`�'d''�����1��'��U�2���: _ -- u����:: z �� ���-- <br /> ;� <br />