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-t..- <br /> City of Orono <br /> i <br /> Bum Per Application icor Maintenance I Repbcament/Remodel—RaalaloadiattNA,y <br /> (Le.windows,doors,sig,mot,Om—NO STRUCTURAL EXPANSION) <br /> . ._... _ .. . <br /> Adasswilikring . Penult*law_ --czsp/7,... fqi:3.- <br /> ' .‘- -0---- ' G1,,(1 <br /> 0 ,., PO Omen . .. , , <br /> Crystal Bey.MN 55323-0005 1 8 liala'socket -- -41--g-;-/ . <br /> , <br /> NI Seethe. <br /> Maw <br /> 4/ <br /> Phu rarbaribec , - -- . <br /> 6* .- Onino.WI 55358 <br /> - - - - . - 7/ 7.6-78. <br /> ._ . oo - ...9..-- . <br /> TPeer <br /> Nehx 952,24#4000 Roc 952-2494616 3MMISIAINSUINAN ' , - - - '•s - . - . • •_ ' - <br /> This amilionlion farm aunt becanyieled la*Amid all required Infomiellon muit be submxt <br /> kemapkie applkelloes will be seleneed. rleaseptatt) <br /> GENERAL 111FORMIA11011k . ,„,, <br /> Job Site Aides= - 1 MO lisej -,-.,ql <br /> IAMBS*be acionade el • er Ohm* es a.. <br /> lire.aspeaisieveatpaasitislaspintd ivia fillteDeparbsentaidelbrOxmaTapporstandosprioriellsetamt MEM bus Arne*%vibe <br /> swiskediikessapplresedemonsbalessibii ohlaalepidingiseralkilik. Noaftwakdammodsallnatbeabwad <br /> CONTRACTOR/ TIM <br /> Name' çjfli <br /> Sisk License# Expkaion Dale - <br /> Lead Ceihicalion Number: - Expiration Ode <br /> (for aMen Imes detwereemeioneftdprierfo <br /> 19* • . <br /> Phone: <br /> Nng Addrese _., 0 I,tr-4 404, attlyor c___ZZ...)5534 I <br /> Contact Penton: . - Appiceetic 1 Homeeemer fames owe <br /> Erns/andkr Far (IA to tgaxi <br /> PROPERTY' • :---- , - ' -. • • . <br /> Name: %le 'W (IS . .- . <br /> Phone(day) <br /> Address: A ,-i %, - Or ii I I ZIP: ‘ ' <br /> &nal ander Far <br /> ti <br /> PROJECT WIFORNIATIONt Omni projectdascdpeon: <br /> Type anynt - Ammo&marmisitiseg alio aloft <br /> C4.1 Daggs) dRemociel • 0 Fire Damage MICRO MAW a penults: <br /> O Regoot awls* - 0 kap* 0 Slam Damage Illinnabdis CreakiNalarehad Diabict MIND) <br /> 15320 neionia NW <br /> 0 Re.mot came 0 Reeboolion 0 Water Damege Illinneinake.IMO 55345 <br /> 0 Re-ext other lepedly) El Siding 0 Other:(weft Phone: S52-471-0590 <br /> • Ric 952-ert-asa2 <br /> 0 WiedowN lemeilienabahessekjel <br /> Estimated Conebudime IMMO=(*Psalm*fasdhalhig hate $ 'W.0 <br /> APPUCANT ACKNOINLEDGENIBIT: <br /> • Agoras-to provide ail intonnallee required ar rammulad by es Balding Depediseat _ <br /> - <br /> • OarWies tbat live imilismalion sopped is Imo and cavect Is Ike beat of hider leinehmlya The applicant recognizes that they me <br /> solely empondble for Moats a complete applIcelion being aim that loon kikre bib so.the shades no alma*e but to <br /> reject Sunlit Aka:mike <br /> • • Some or al et be hioneellon tisk you are ailed ID provide on Ok modionlai is dmilied by Skte km as either private or <br /> conlidardial. Pdvabs dale b ialaneelionsbicit generally aimed ba given let*public bat am.be Oen lo ea subject of the data. <br /> Conadanlial dais is imfornamilon Midh genet*moot be ghee le either**MSc ale_p4 of the dela (kr impose and <br /> intended me of Ws'damsel=isle ennuellymplelle our snoods and receek gleam gavemanentall agencies tequited by les. W <br /> , you refuse lo SUPPir VW ' ' 10r, . al,applicellan me oct be immi. <br /> Appowes -., ..: : - .4., 1.• mr/is . i 1 4 , Milt <br /> A . ini <br /> IS • <br /> • Domesas Ognettara isoragiliVirketliff. Debr LI a 1 i • <br /> Loa Upbeat Awn= <br />