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Total Fee: $ , 7 � Date Received: //�3��� <br /> Entered By: � Permit#: ��9 R� <br /> CITY F ORONO - BUII,DING PERMIT APPLICATION <br /> All information must 6e submitted in full before plan review will be started. <br /> (please print all information <br /> TI� APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: ��C� �Q'/le, �`�ZIP: ���J 5 � <br /> NAME OF OWNER: �U���Q����Q7� PHONE: (home) 7 ���t�� <br /> � (work) -- D . <br /> MAILI�TG ADDRESS: (� ; crrY: ���-�2�- z�:�s <br /> - S"��-�26�� <br /> CONTRACTOR: Q(� C�/1,� S��i PHONE: C�—��D—��,� <br /> CONTACT PERSON: �e �a2er, MOBILE/PAGER: << » <br /> MAILING ADDRFSS: aL � CITY: ��I ZIP:�j� <br /> STATE LICENSE: # 3��`� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> N,�1VIE; REGISTRATION# <br /> TYPE OF WORK: New Addition x Accessory Structure <br /> Move Remodel/Alteration�_ Land Alteration <br /> i � - / <br /> OPOSED WORK(_describe in detai�: 6 � � �e C-�C� � � <br /> � <br /> STORIES: �_ SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� 0� � <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 proved plan. <br /> APPLICANT'S SIGNATURE: \ ATE= ` �^�'� <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 />