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Cl l lr ur UKUNU �" 6124r�U5'10 U4/�4/�1t3 UtS:59 [� :U1/U� N0:368 <br /> . ,, . � <br /> Total Fet: $ ���p-� � Date Rcceived: � � b�o� <br />�y�' tcrcd By: Pecinit�: `��J 3.So �— <br /> ___._ <br /> CITY O�' �RONO - BUILD�IG PERMIT APPLICATION <br /> All iuformation musi be snbmitted In full before plAn review wiil be siarted. <br /> (plcast prtnt all Ir{formaiion) <br /> ___._--_. ��------------------ -- ----------------- <br /> 'T��: APPLICANT IS: (circlt one) OWNER CONTRACTOR <br /> JUB SITE ADDRESS: �� � �l� ZIP: ���� <br /> NA11�1� OF QWNER: C f�gf5� �,��-t��(��fl��4PHONE: (homc)�-�7J-�`�/a <br /> (work) �–� <br /> �it9,I.LING A.DDRFSS: __� CTTY: ZiP: <br /> „ <br /> CONTRACTOR: TIJIN CITY EXTERIO 0. , INC. pHp�; � 763) 425-4737 <br /> COP+TTACTPERSpN: JOHN JORU CLAUDIA IViOBILE/PAGER: N/A � <br /> MA.'LINGADDRESS: 9060 ZACHAR ANE N. /�108CITy; MAPLE GROVE ZTP:55369 <br /> STAT&LICENSE: # 2535 <br /> �,� 7�� -�a��ys� <br /> AR�C�CT/ENGll�ER: PHONE: � <br /> MAILTNG AI?D�SS: �TT'Y: ZIP: <br /> NAr��: REGISTRATIOi�# <br /> TYI'E OF WORK: New Addidon Acccssory Stiucturc <br /> Move RcmodeUAlteration I.and Alteration <br /> PRQ�'OSED WORK(describe!n drtai�:__7�j�f��� <br /> ST'���: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEAROOlYiS: GARAG�STALI.�: ATT. DET. <br /> 6Q' <br /> F.S'�"I3�IATED CONSZ'�UCTTON VALUATION(cxcludln$land): $_/�� <br /> I hcrtby apply for a buildisig permit and I acknowledge that the informatfon above is complete and ' <br /> accuraec; that the work will be un conformance wiih the ordinances and codes of the City and with <br /> thc Statc Building Cade; that I und�rstancl thJs is not a pemut and work is not to start without a <br /> permit; and that thc work wiIl bc in accordancc c approv d plan. <br /> � <br /> APPI.ICANT'S SIGNA DATE: ���–� � <br /> lVOTL! Pamd� offlome� tvanls requirs separotr permit approvai by Pollce Depurtmenl arrd <br /> L'ily Councll 60 days pr�or to the cvact. Nort penrslttad evtnts will�tvt bc allowed. <br /> a 7�� ,� G� . <br /> Ni�v,�y 1a� - � j���� <br /> � <br />