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, � <br /> Total Fee: $ ,3(0�l . ��C Date Received: (�,�7/97 <br /> Entered By: .,::�,Q,�� Pernut#: �/,_3�-/ <br /> CITY �F ORONO - BUILDING PERNIIT APPLICATION <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 CONTRACTO�t1 <br /> �..�.- - _._�. <br /> JOB SITE ADDRESS: �(�() /rG�'�v LI��'� ZIP� <br /> NAME OF OWNER: ��� t��1`�`�� �/V�: PHONE: (home) '���r�.,��t��' <br /> � (work) �f �9'���?�) <br /> MAILNG ADDRESS: �f��� ��1, ��o�(� CITY: a '� � �,iZIP: � <br /> CONTRACTOR: �1 PHONE: <br /> CONTACT PERSON: PvIOBILE/PAGER: <br /> MAILING ADDRESS: CITY: Z�: <br /> STATE LICENSE: # C;�,l.y.(� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> rJ��; REGISTRATION# <br /> TYPE OF WORK: New � Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: <br /> STORIES: I SQ.FEET OF EACH FLOOR: ���G <br /> NO. OF BEDROOMS: 4 GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 2,�U��d v <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> r <br /> APPLICANT'S SIGNATURE: DATE: � ! <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 9 <br />