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T"otal Fee: $ Date Received: y a�0 <br /> Entered By: Permit#: D 3 <br /> CITY �F ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before pla.n review will be started. <br /> ' (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER O CONTR.ACTOR <br /> �--- ____.� <br /> JOB SITE A.DDRESS: ��l�C� 1,� d t� i4f� ' r�_ ZIP: � S � �y <br /> NAME OF OWNER:��6\'1 ' �- �' ��L� t?� _ PHOiVE: (home) � S Z"`t��z"l l S z. <br /> (work) (c`�I - �3�!- %Sb2 _ <br /> �IA_II�Pt 1G.A.DDRESS: `���oC� �2�f-H-�{�(Co.� -D('CITY: �,('C7/�L�- ZIP: 55��1 , <br /> CONTRA.CTOR: ' PH0�1E: <br /> CON'TACT PERSON: IIOBILE/PAGER: <br /> MAII_,ING ADDRESS• CTTY: Z�' <br /> STATE LICENSE: # <br /> ARCHITECT/ENGI�EER: PHONE: <br /> MA,IL�'G A.DDRESS: CITY: ZIP: <br /> N��: REGISTRATION# � <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED`VORK(describe in detai�: ����r'a-2(' tc,��� ,`o � <br /> STORIES: SQ. FEET OF EACH FLOOR I��v <br /> NO. aF B�DROOMS:�� GARAGE STALLS: ATT�. Z- � DET. : . � = :..:-. -.< ._ <br /> ESTII�i IA.TED COtiTSTRUCTION VALUATIO\ (exclud.ing land): � "�,�,�,c, _F, <br /> I hereby apply for a buildin�perm.it and I acknowled;e that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with <br /> the State BuildinJ Code; that I undeF�and this is not a perm.it and work is not to start without a <br /> permit; and that the work will be in ord nce with the approved plan. <br /> , � ��. �- <br /> APPLICANT'S SIGNATURE: ` �> , _ _`\�. ` DATE:�" 2 � <br /> 1VOTE! Parade of Homes events require separate ermi approval by Police Department and <br /> City Council 60 days prior to the ev�e�nj. Non permitted events will not be allowed. <br /> �j,c C '� c s s� �JGc�.-- r�c�✓a�/ � N s,� o� �� <br /> � <br />