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c-= T��TY OF ORONO � 6124730510 09/24/96 14:00 [� :02/03 N0:522 <br /> '�� F�� a Dato Received: <br /> Entered HY� Permit A�: <br /> EITY OF ORONO - BUILDING PERMYT APPLICATION <br /> Alt informatlon must be submitted in full before plan review will be started. <br /> . �please print al! irtforn�arion) <br /> • -�------------=----------------------------------------_-----------.._....- --------__----_----- <br /> TH� APPI:ICANT IS: (circle one) 0�1ER QR TRACTOR <br /> _,_ JOB SITE ADDRESS: �2�0 � • '�m �t;1:�2 ZI�': �S�Ca� ;�� <br /> •. NAME OF OWNER: �;nn�, � �..-�.-cc�--,, �xorrE: (home)9Sa•�3a• C��11 <br /> (work) <br /> MAILING ADDRESS: �,�� CI1'Y: r�cr�.�2 ZtP: '� <br /> . . . . , <br /> COI�TRACT4R: R�N�WAL BY ANDcRScN �' - <br /> . CONTACTPERSON: 3�c-73RD AVE. Nt !.R: i <br /> ' ' MAlI.1NG ADDRE$S: �RiDL�I'> MN ��432 ZIP: <br /> (6'_2) �02-4777 <br /> ��'Y'A1'� LICENSE: N i:��hs� #20130983 <br /> . ARCHTTECT/ENGINEER: PHONE: <br /> MAILING ALbRFSS: C3'1'Y: ZIP: <br /> NAME: RF,GISTRATIUN#� <br /> TYP� OF WORK: New Add'uion Accessory Strucbue <br /> Move Remodel/Alteratian�_ Land Altcration <br /> P'ROPOSF.,D�1�VORK(deser�be in detai�. Q.e.,Q _ �{„.�u�,lLSL .-Qc�e c�� L�v�r��n�S <br /> � � <br /> sTo�s: sQ.FLET OF EACH F'LOO�t: <br /> NU. OF BED�Op1VIS: GARAGE STALLS: ATT. DET. <br /> c� <br /> FSTIMATED CONSTRUCTION VALUATION(excluding lan�: $ ��t9OO � <br /> I h�reby apgly for a building petmit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and �odes of the City and with <br /> . ' the Stat�Bullding Code; that I understand this is not a permit and work is not ta start without a <br /> permit; and that the work will b� in accordan,ce w�th the approved plan <br /> APPIICANT'S SIGNATURE: DATT: �-I • I�.N ►���,� <br /> 11�OTE! .P��d�nf� events regr�frt aepamte permit approval by Polriee DeparhRent and <br /> Cily Councll 80 days prfor to the everat. Nvn pern��tted eveRts will not be allowed. <br /> Rer.aivad Timn Con �A 1 �A�A1�( A.�„+ Ttm� C„� �� t . ��Dlf <br />