|
� - PEIZMIT ,
<br /> �
<br /> CITY OF ORONO PE�RMIT TYPE:
<br /> 2750 Kelley Parkway • P.O. Box 815 Permit Number: ��L`�����u� - -`'
<br /> Orono, Minnesota 55356-0815 i:�i=,��.7'�
<br /> (612) 473-7357 Date Issued: _ _. _ _
<br /> _;°_!.'__'.�`- -
<br /> ----- -----------------------___._.____.__._.._.__.________.__.--
<br /> SITE ADDRESS:
<br /> �_�;�._
<br /> �� : ; , .
<br /> DESCRIPTION:
<br /> ��1�i��!! 4-4�:I�F[.:',;. .
<br /> 1 i-!Er"�T i 1�lG '=,Y'=�TEF1'=i FL�+F '��i�E —�;: __. , _: .:-. . _. .. �,__ _.-. .
<br /> h`r�l#��:E LEfi�3i'.it�t�; !�it:i[���I i;;�`1 i,�.�c,_...; �_;::,
<br /> 1 H.iF� C:�tt��DlTi+�iri�t�i�;� t�t�F�::� LE���t���s1s; `�-'�:-��.�`����'_ :._ -.- - _. ; _
<br /> �'=�t��i'=.; _.
<br /> � {,�:�r.;3��__^�'a f,En� !'.1��::E 1 �::I�?:_: i��i�;� �,:..�;_
<br /> REMARKS: � � ���
<br /> FEE SUMMARY: - . - ' -
<br /> V=�L!3�;?"I��:� �;,t_�i;i�
<br /> E�.�t�� ��:_�_ �i;.�? . �t;
<br /> L�!.�il'?�"�c!t'`�� ------- �=' �,i7
<br /> �,:.�:��.
<br /> ��,{.al ��� ���1 . ':zt;
<br /> CONTRACTOR: __ �,�,F,} ; ��,,i.�. _ OWNER:
<br /> `-;4��F� ��'ti = �i��.7 �F�I�• ?i"' .-���y �,..
<br /> :��._. _ _,�-f 1���-. _ �aC-it:�t�E�EFi�� t�R�.•.
<br /> �1��4 =;t;�V'=;t i �iF: 11�f L��� '=�T
<br /> �����n���i!i f���F�{'r••. hrit�j r-�"':��.�':' t_�€-i�_��`�I_I ;'n� =C�;�if-�
<br /> . _ �..._.' . .��. __... .�
<br /> ii.:�. j 3`i-.• . "" _ ' ( .t :s-- �: E",..' F_''.1 �C�=�i'�_ n,:. _5 i%� ':`t:;r. _.,y s_. . --
<br /> i � #_ .1�!'�:.�+`.'•:.<�.�Y+�'4�,_� ���:�';�',=�{ �4r i:.___. . _ . _._. .. :��_. _. �.!t;',� �I_I �'.t-g}:;� 1�-:= i-�:��=�4�_ _�}"`�f'il..:-`�f':x.:.f:i� -
<br /> 7 �� � =•L:r-�-;*-"L�i !���ii '�'":L:{:-:"y si :-�- � ,.-���:` tj t'+ i tt i- � �� �i f �� ,
<br /> _. ..-- : �;.._ = t ._ ;�_.�;�,_. _ . _ ,�'+ ��v =.;��_j.,: . �i••� =��: �I._ � .���{=7:='L.:i;���.:::w ,�a �-! ��(_i_ _�I , Y �ii=
<br /> - -. ...{�}�.. a. r,,a�} -+i: - - - �,.�- - - - � r. ,� i } ..� _,4 i_ ..�,
<br /> !i+..;s�'' ' ) J- • ._.,_> :t'v: ��i�� '�t- i t �= -:i. l��=; ;[1� �) �'.�t� £'i , }ih,_' .) 7 �' � `_
<br /> L _P'{.__,,f�.'• ^:=- �f'.-:i`�_•+'�• `-.. ,` .. ..� . .:.�`.{':__.. . �: - �--- _. _ . _:L.'--. `•a;_ a i`t C.�.�'..� .. . �
<br /> APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
<br />
|