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} � <br /> ,� 7. � <br /> l � <br /> Gity +�f C#rQna � <br /> , Building Permit Ap�li�atir�n for in�rnallAlork <br /> (�rindows, dav�s�s�di�g, re-r+�#, etc.� <br /> fl��.-. �O �add��: �ae„� D� /O <br /> / � PO Box fi6 <br /> � Crystai Bay,11+�155323-0066 E)aEa reoeived: � '7— <br /> r� <br /> � " a� Sheet Ada�ss: Recehied t�t: <br /> ,{� 4 �E�'� 2T5A Ke�y ParkwaY Plart re�V�ew�eee: <br /> ��y�. �y�� ()rono,[U�!55356 <br /> `'-- -- Toffii Fes: <br /> Main: 952-249�StW Far. 952-249-4&16 www.ci.orona.mnu� <br /> This appliGBtitm fiarm must be comQteted in full and ati reqtii�l inforrnatian mt�s#be submitted. <br /> lncomRte�aRFlie�tions wili ba r+etumoti. (Pleass printj <br /> GENERAL lNF4RM�lTFt3N; j <br /> JO4 Site Alddf@SS: � Y► 7 %��' _ <br /> Ntiil this lt�a e Parade�Hatites,Rer�llf�d�1�� o ' e' r Elisplay ?' es N+rs _ <br /> N y�s,a;pscisf event perm3t ls-mqubed wtth Pottce�►trr�ettt and C�y Gout�c+�appiovat 8Q d9ya¢flor ta tbe eve[N. SttttittE bus s �be <br /> reqUlred u�raas appBcaof sr�r�'an-s$e�kk�is, . Narp�heve»�s ss�not�aBowed <br /> CONTR,1 70i2 i APPi.lCANT IN-F�O^Rt1A'FI�1:/� <br /> PJamc: LF."'lcti'c�0�^..�im�5 WY�,4��Y"�• <br /> _. ___ .. <br /> State Lic # E��it►n[7�tte: �L <br /> Lead Ce tu►n Number. � E�cpr��atian Date: <br /> (for worh ott ftames�f were constrsaclstf pr�or to?9T8 <br /> Phone: 3. (otf�? i - 4�8'�{— Z. i��? _- <br /> Maifing Ad�dre&s: ^,� t�it5 t ;� ZiP: <br /> Co���p��_ Applicae�t is; f�lome�nvner tcu�e.a�) <br /> Emai!a Fax: ` _ �vti, <br /> RR�PE!�t}lt{tN�ER iNFQRN�TtClN: � � <br /> Narne: ' �` � ae �� <br /> Phone(day): . <br /> Adckess: ��y� W. `�;" Gity. ZIF: ��,�x <br /> Emav andlor Fax v� <br /> PFEBJEG tNF�RNlATtOt�l: <br /> Type vf Pr jzCt: ___�-- --- _ q�y earth mDuerrun!may etir8 <br /> ❑Door(s)' ❑Rernodel ❑Water Damage #GI(V[}I�evi@w&pe <br /> Minnehaha Cresfs{Nster�hetf Oi (hAGWDj <br /> ❑W�dow�s) Q i2epair []Sborm Damage t$2tl2 l�trnetonka BI <br /> p s�a�ng i ❑Rearor�tio� �otf►ar:tspecHy) aeephaver+,Mht 5 " <br /> F�wrre� 952-471-059� <br /> ❑Re-roof ❑Fre Damage Fax: 952-471-Ufi82 <br /> ywrw. hacreek_ <br /> OhrsraH ct Description: , ' ' <br /> . Consbve�tton Valuation of P►o euciuding tantf} . �r�,'3�C)�„-�_. _ <br /> Estimate <br /> APPLtC T ACKt�WLEDGE�IlE1�1T: <br /> rees ica;xavide t�11 iniotEnallon �r raquested by�Bc+i�'ing Dep�Unee� <br /> � CArti�es that the in#amat�suppliett is trtle end cot't�ect��te best of h�lher ktto�dge. 11�e a�t � thsi tt�Y � <br /> ar�sv�tY resPortsible f�submittin8 a camPtete apPl�sr t�ng awara�at ep�on faihue to da so.tlte sta� na atfemati�e � <br /> buq[to reject R un1N�is compieta; <br /> . tX afi Of tl�e�1fOrtn8rtion tttat you are�ked� on tf� � is ci�si�d by State law� er pmrate a' <br /> ti2l. Privete dab�i�fomtstion which�eher��r c�'mot 66 givett tct it�pUbfie but can he gi�ten� su6jad�the <br /> . Gotrtfufential �ta is its�(tt�an aAtich�rreral�r c�fttnt 6e EpYen t�s�her iEee pubBc nr the suhject the data. 13�x <br /> es a� intended use�st�rts[nF�nnatiExf is ta etuKl9Ny upd8te our rB�Ar�f��nd tEl�dS of tltttBl`gOY8r11 agencias <br /> ui�i law. ii s ths' the a ' tiort m not be issu8d. <br /> Api�licanf'fi Signature: , oste: ��'� °� <br /> tast Update�: a3-Oi-ZOf i <br /> _ _ _ _ . _. <br />