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a� <br /> Ch, of \44�j PERICT# �l 9v7 <br /> Elk RECEIVED BY <br /> 1 y e CITY OF ELK RIVER <br /> DATE: <br /> BUILDLNG DEPARTMENT <br /> 13055 ORONO 49RA�NAY" <br /> PO BOX 490 <br /> ELK RIVER,bfN 55330 <br /> INSPECTION SCHEDULING (763) 441-4900 <br /> MECHANICAL. PERMIT APPLICATION //h/O <br /> Site Address: �� (-7 ( i ci +1 i 5+ Suite/Unit <br /> The Applicant is: Owner ❑ Contractor ❑ Other ❑ <br /> Property NAME <br /> Owner ADDRESS <br /> Y il4kiT CITY STATE ZIP <br /> TELEPHONE <br /> • <br /> NAME 1 a;e117'11 //L'/-G/ S <br /> Contractor ADDRESS ! 917 / L' � <br /> 4`nier ' 47 <br /> CITY ����i�lr STATE in'/ ZIP 5'57 33/7 <br /> TELEPHONE 76 3 Ly7-8 3 7 LICENSE# <br /> NAME <br /> Engineer ADDRESS <br /> CITY STATE - ZIP <br /> TELEPHONE RE G# <br /> USE TYPE <br /> Single Family❑ Townhouse ❑ Commercial/Industrial <br /> Multi-Family ❑ Institutional ❑ Other (0) ❑ <br /> New ❑ Addition (ADD Alter (_4LT)❑ Repair (REP)E1 Other (0)0 <br /> PLEASE COMPLETE OTHER SIDE OF APPLICATION <br /> ^° SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRIC, GAS, OR PLUMBING <br />