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* � � T <br /> I � <br /> � <br /> � <br /> k <br /> ti <br /> k <br /> a C�ty t�f C�CQr�t� <br /> B �Iding P , it Apptication fc�r tl�a��#�ance! RenQvat�on <br /> windows, doors, sidin� s r�-r�f, etc.} <br /> ��o Y ,�,,�A�: ��� eZoi3- 85 <br /> '' Po eoX ss <br /> �Q g ,p � cc��sav.na�ssa2�-ooss n8e�r��a: <br /> �:l a �� a.��� � sr►e�,address: ���7r- �� <br /> `:� ` '� '' ��'/ '� 27�KeNey PaHcway Plart rev3ew iee: � <br /> \�� Orona,MN 5535fi <br /> " Total Fee: � / (,�3 � <br /> � in: 952-2 � Fa� 9�2-249-4696 ��.c:.�ron�.mr,xs I � <br /> is ap�ication must be�mpl�2�d Fn fult�xxi a1f reguireci information must t� . <br /> f cotrtpteRa appticmtfons wiq be�turrted. (Please prirrf) <br /> GENERAt IMiFOR�IAT{Ohl: <br /> Jo6 Site Address: "'"� .��.aRg iCt�`!' _ ��" <br /> Wiii this be a parade of Ham Rem�►delers Sho�vvcase Home or other Dispiay Home? Yes o <br /> rr y�es,e specist event perrMr fs ww,� arMr clry ca�a�apruva/Bo days wia ro ans eve,�t st,rrl�naa se,vice r ere <br /> rop�drtsd uMess demonstretes�o�te peAdng is nreii�6Ae. Nvn-pemdtard everNa w�1 rr�6e etiaw�d. <br /> CONTRAGTO�t/APPUCAN � FORMAT#DN: <br /> IVame: ' �?�1,e Gp►J $"�YLc?G��OW <br /> SEate License� j Expiration Date: <br /> Lsad Cerifica Numi�er: Expiratic�s Date: <br /> �for work an �thet tractsd p�rior to 197s <br /> Phcrne: �. � {office) �,. � � (c�e!}) <br /> �riing Addres : 2.-Su�Ii. �-�o � �- P: <br /> Gontac2 P� : �. - #is: s�oi' Ha�r�eowner �.� <br /> Ema;t andt�F , ..-3 E'5. � t ,S <br /> PRC3PERi"Y�R tNF� �i: <br /> Marne: I � '" = t4?7l# a <br /> Phone{day}: ' cjS2_�) <br /> Address: ' S�j�y City: .L�c2g5 r}�ct�tZtP: ---- <br /> Email and/or F�x ,�,r'�j " <br /> PRCIJECT FN QRMATION: 3 <br /> ry�,ot w�ojecr:, �, � e►�y�tn��,�+�u <br /> ❑DooKs) ❑ ef []Fre Qamage MCWD revtew t�peem�s: <br /> Minnehaha Greek WatgrsFtmi E)ishscE{M C?) <br /> ❑Re-roaf,aspl�alt ❑ ir [j Stam Qam�e 18202 RAfnnetbntce 8Nd <br /> ❑r2e-roof,cedap' � tion Q�4tater oamaye ��'�M �� <br /> Pttare: 952-47'l-C15�i <br /> ❑Re�roof.othet 4�Pe�KN? ❑ n9 L�OtheT:{speafy? Fax: 852-47i-1�EF63 <br /> Q ��� �v^�nu.rrtinnePt�hfscc9�k.arq <br /> Overaft Pro' Descri art: ' � : �D� <br /> Estimafed Cs sW�ion Val an af Pm;ject exrNxNe�g ta�d} �,'��k7�- � <br /> APPi.IGAMT l+fUWLE BIIENT• _ <br /> . agraes proviae�i� ' req�d or��ested by me s�it� <br /> . C�rtifi�th�t-the i supplied is�u6 8nd t�[rect Co the t�c� ` ' know4edge. 3he apptic�t�soogr+izes tl�t tl�eY <br /> are s� e€rn' a campla�e being awsre t�t�rn isi�re to ao so,tl,e a�f��w <br /> htst to ft untu it is . <br /> • Sam6 aH c7f the�f ' thet ycw are aslced tD P+�de�tl�is . is ' by SNdte 18Yt SS eit[t� � W <br /> , Private inromra�on wh�ch�n�r cart�ot be�'+�'�e��can 6e�v�to the � a me <br /> �_ � ' data infamatkxt which generally cannot be ger�en ta e�kt�t!�pc�Wiic tx�e sub�d of the d ta. Our � <br /> purpose snd irrtended af this ir�cumation is tn anrulally uPcf�te tnx'reccxd5 at�tee�'ds t�f�govsrame►�8g6rNaes <br /> re 'red laua_ !f ta ` tfte � n�be ts5ued. <br /> ,4ppticanYs S tu►e: �� ��� ��Z3`�� <br /> . i_na[upde�m: oa-o�-zm, <br /> I <br /> 3 <br /> i <br />