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� M <br /> . � i <br /> t <br /> �� <br /> I ¢ <br /> � <br /> 8y <br /> 0 <br /> ' ° �ity o►f C�rQno <br /> Buiiding F it Appl�catian far Mai�ter��nce I Ren�ration <br /> WlndOWS,C�o4FS, slt'�It1 , fe-rOOf! P�G. <br /> ; n�a�n�r,ac�ress: ��um�er: v�o/3 �68'S <br /> ��� <br /> �� ' �p c��ar s$y,nnrr�a-ooss t���a: -. 3-�C3 <br /> ( � � <br /> � ��� "'. �.�, � sn�sr�d�ess� �ve��sy: <br /> 1t,_.� ,�,�' 2750 iCeAey Parkway Plan reviewr fee; <br /> � � � Ot+orro.MPt b5356 � . � <br /> � � � � <br /> � Tatat Fee: <br /> Maia, 952-2 s, Fa�c 952-248-4816 s.�s��.c�.n�rcr:c.mri:.rs <br /> ThiS Bp�plEca#� must be ix�[nptet8d in iuti and a8 reqtraac!information mus#be submitted. <br /> t a�tptete a�laat[a►�s wili be returned. (Please print} <br /> CsE1dERA1_ MFOttMATlQN: <br /> Job Site A ��'tss: �?. �l� <br /> Wdl thi�be a Parade a#Hvrrf Remadelers 5howcase F1ano or other Dlsg[ey Home? Yes �Io - <br /> �rr�s a ev�x�mt is +�'�ce end c�y��so�sB wr'c��u�e�. a� � w�r ea <br /> +�v.r�a u�s�s �a�:es o�-srrc�;��. nr�.�-�erm�rm,d��,��e,B arr�ma. <br /> CONYRA R/AP?LlG1lN �OF�AATIC7P1: <br /> Name: �'�41M� +,t T YLc9G� <br /> State Licens�# � ( � F�cpiratiorr Date: � <br /> Lead Gertfir.�tian Mumber. Expiration Ba6e: <br /> (fo�wtrrtc c�er h�rr»es that tt priw to�878 <br /> Phane: � �°�� S'�.•`Lt � f� <br /> i4�ailing Ar1d . 2_-Svi h. �u o �Y- �" P: <br /> Cantact P n: AppNc�n#is_ / Homeowner � ` ane> <br /> Email a�dlor ax. --;�" iE.�.C,D� t ,5 <br /> PROl�'ERTY Ei21ldF � Etfi�E: <br /> Narrre: � 'n� '" _'�'�d.�1_ . �'G�4?tj �s <br /> Pno�,�{a�yt: �s s�.-�;ti f1�- <br /> Address: "F�?li GitY�r'f,1.��', ��ZiP: _�.. <br /> Emait andlor t�ax �q - <br /> PROJECT 1 al2MATIUN: <br /> -iypg pf AnY eatih morema�#may <br /> ❑Docx(s) C{ ei ❑F`ue Oamage �1CNtD revieMr ffi penpf� <br /> lNFnnehaha Cnf3Hk Watersh+ad D1sFrict D) <br /> �Re-roof.asp a!t ❑ ir ❑Stocrn Dam�e t82t12 Mlr�netanlsa 8lvd <br /> ❑Re-roof,ce�r Q tion Q Watet Damage Deepfiev�.tWN 553$1 <br /> Pho�e: 952-d71-0590 <br /> ❑f2e-raof.oth�r{sPecif�+? ❑ 'r� �Otr►er:tsP��Y? Fa�c s51-•�7�-�2 <br /> � s) ivuw•minnePsahacr�ek.tx� <br /> C7ve�all Proj Descrip�tion: ,Z _�.�. 2J� <br /> Esfimated C �an Yat cm af Pra�ct(exclucqng t�c�} $�f/y�i��,—"� __.._ <br /> #__. <br /> APPUCANT � GKNGIWLE EMENT: <br /> . Rgrees provide ax� - n required or fequestea by the e�hi+r�s De�Fmen� <br /> . Certifies that tlie ififdme 5up�l2d i5 tttlE 2Rd COtfeCt to th8 be�of hislher knowledge. The appficaM recog�izes that they <br /> are sWe�y resp�slbte for mitYtlng a complete application beEn�awaee thac upon fanure to do so,u,s s�r,a$� earnative <br /> but to re,�ect ft ur�fi�it is e: <br /> • Sort� sU of tlroa' . n thet�u�askad M P��g��s is�hy 8tr�e lew e�s e�tt6�r riYste ctr <br /> . Pitvate inia�r�rt which 9en�ly�ce�'rtot bs�en hs#Ise pt�ic b�t#can be�v8tt�D`the su ` of the <br /> t�ffi. ' dafa ktfortnation vr►►�ch ca[�not Ise�rerr�o�itt+iar#he �r� af ihae . aur <br /> p«xpersa and i�sterEded afi this irdo►r�tion is ta ar�ua�y u�s a,�rec�ds at�d records c�€at�r gc�nmsM'ei" 'es <br /> r ired iaw. If to ' Ute r�ot tl@ is�eci. <br /> e�icant's Ssgn wre: -� a$r,�_ �"2a-Ztar <br /> ��up�«d: Zo„ <br />