Laserfiche WebLink
i � <br /> Total Fee: $ Date Received: <br /> Entered By: Permit#: <br /> CITY 4F ORONO - BLTII.�DING PERNIIT A,PPLICATION <br /> All information must be submitted in full before plan review will be started. . <br /> ' (please print all information) � <br /> -------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR � <br /> JOB SITE ADDRESS: ���� U.UIr�C��� �-V�E; z�: �Ss�'1 l <br /> NAME OF OWNER: �/Yl�,s���E�I�G PHOi�TE: (home) - - <br /> (work) <br /> ��,�a.livG annxEss: �S � Uc YtG,,�i _-_crrY: z�: -�G ! <br /> � ��e S <br /> CONTRACTOR: � � �� � PH��: c� Z� ��- <br /> CON'TACT PERSON: �( 1�IOBILE/PAGER: <br /> MASLING ADDRESS: � � � CTTY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGI`i'EER: PHO�IE: <br /> 1VIAIL�G ADDRESS: CITY: ZIP: <br /> N�y�: REGIST'RATION# ' <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: '�7�7��v�v � <br /> STORIES: ______ SQ.FEET OF EACH FLOOR: <br /> NO. OF B]EDROOMS:� . GARAGE STALLS: ATT�. � DET. ._ :-x � •,-�.., ; .�-.- <br /> _ <br /> o c� <br /> EST .M.ATED CONSTRUCTION VALUATIO\ (excluding land): S �a�' <br /> I hereby apply for a building permit and I acknowled;e that the information above is complete and <br /> accurate; that the work will be in conformance wich the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a perm.it and work is not to start without a <br /> permit; and that the work will be in da � ' approved plan. <br /> APPLICANT'S SIGNA DATE: 61 <br /> 1�'OTE! �Parade of Flomes events require separate permit approval by �olice Deparlment and <br /> City Counci160 days prior to the event. Non permitted events will not be altowed. <br />