Laserfiche WebLink
. <br /> . --. , <br /> . <br /> � <br /> � <br /> � <br /> � <br /> , <br /> Ci1�y of Orona► <br /> Buitding rmi#App�li�cat�on for Ma1n#ena�ce t ReRo �ion <br /> Mfl[tdQWS}E�+OR1i'St sitfe�t ;f'�-TOCt�� E'd�C.} <br /> Ad�6iu�Adtkss&: �rf� <br /> ��^0�+. � {�C?Bmc 66 Perm�numbar_ / —vv <br /> Q ' a 1't � Crystsi Bay,MN 55323-F3f�6 �ie received: �!� � <br /> r� �,,�- <br /> � <<'� -,, ir�� u�"treC�/�fidlBSS: R�Gei4ed!sy' �L�' <br /> et <br /> ��,��`'� 2750 Keqdy Parkuray Plan review fee: - <br /> � Qrono,MN 55358 <br /> �' Totat Fe� `�� 3 �IG� <br /> A�ieius: 952-24 �a�c: 952-245-4&46 .a.�u.=:.:,Jre.t,. - / ��✓J <br /> �_ <br /> �'i1S ►►tl�b@ GCITi{���Ed iC1 fil�8t1t�8H F$('�lUEd-ffl�CNfllHtiix't t111l5�.be , <br /> GEMERAL EI+IFORp�A�t�t ��Plete ap�icatiais vai(!ba�ta�ed. (Pt�a�P��3 <br /> ,�ob sm���a�$: �t'�._�'�'��.�ir�R��,a:�'� t,.JN.z7 31 ' <br /> tA�A tE�is he a Paraefe o# ' ,'Remodeiers shawreesa�kx�nr olher�splay Nom�g Y ' Mo <br /> �f yes,a spoaal evqrrr pwrnit w�tr Paaoa De�er9nevt arrd CAr�ap�xvrd BQd�sartw�8,e eve.n. mrs xn�e ww ce <br /> r ne arr <br /> feqWt6ld(w#B�t demor�trWac ttAl�CieMo�cks pi►king�ev�a6�.Alon�pemtd�Bd�ents Nd$rtot 48� Od <br /> GflNTRACTOR l APPt.NC IfiiFQRMAT1011: <br /> N9me: .� 3.t ` � Y�,T�xl <br /> State t�cense# G ?-t"'i�,� Expirst3on�3ate: —' <br /> Lead Cer6ficatum Number: Exphat�n t'}ate: <br /> (far work on han�tAat ca prbrto 9978 <br /> tmona — /! l��l �- t - {�) <br /> Maiiing Addr+�ss: -Svi Z�� �Y <br /> Contact Person: .f. � Appficarrtt is: , ..�--•--' H �a� <br /> EmaiE and/ar Fa�c: ' ..�..a �5_t".�u�t - � - c 5 <br /> PRUi�EEtTY OWt�tER fN , TIt3�i: <br /> Nacrte_ . _ w- .-- : 'r��Ttt� -a <br /> I €�iwne(dayj: �tS - ,, <br /> ' adctress: �p Git}"- '4'.i.��,xr �yZt <br /> Email snd/or Fax G�! r ' <br /> PRQJE�T tt�tF+DRI�lA ° <br /> Tya��. �►ny��ra �s <br /> '�ooartsl e! fl F'ire�e ��� . �.�l <br /> p Re-roof,aaphalt ❑starm Damase 'Is282 k� <br /> e o0 <br /> []tae-roof,cad� �on ❑Watier Datiiage fl���� <br /> oof Pha�e: 952-+�79 <br /> IO Re-raor.enner taaerari�t t�n$ L7�{sr�? � F�c saz-s7� <br /> mdo�u(s) j �:vv1._rai.�a ' s�eed;c. <br /> f <br /> �ve�ait Proj,�t t)e�scxtp. —,��� — _T <br /> stimated Gonstruction V ation af (excludln�iand <br /> dPPLiGt�NT ACKNQWiI. t3EMEMTt <br /> � . Ag�rees m p.ovAde��. requhed or.equsseed t�y aie Siui�ns Depa�trnenf: <br /> . CeNfies that the i 'an suppFiqd is hU8 and wrtac�to fhe best af li�sfhar krwvMedge. The appRcart ttmF they� <br /> are sdel�r roePonsible r�brmu'tfi+�a�amP�ete�O�b�a awere that upon faih�e to do so.iFte�f Ft0�R186Y9; <br /> but W reJBCt il u�i[is �; � <br /> s Some or a(I a€!he i tl'aat you�+e asked to prvvide on 4�s appt'�ors is tiassi5ed 11y 51�e taw Hs ' pr»tate or t <br /> C[�tlal. €'tiv�a ' is inhxmauvn whict+genera4y�L be�ven to n+e pubtie bcrt caz+�e�ur subj�cc oi Nte;; <br /> data. ca��at �s�tc�rrmmano�,�n ye►,e�t�r����+��+���*�'�'��t �aa�a. cuu <br /> prxpa�e and te�We� aF tE�is#�roRr�etion��o erttwauy aada�wn�Ms�nd re��� �G� <br /> taw. tf the [�be lssaed. , <br /> Aplplicattt's Stgnatiure: Dabe: ' �� <br /> r�}upaa�cs: os�os-2ot� � �� <br />