HomeMy WebLinkAbout1994-006002 - vinyl siding PERMIT
�j1�Y OF ORONO PERMIT TYPE:
"�.?750 Kelley Parkway • P.O. Box 815 ��t_j I f i?�i�l�_
' Orono, Minnesota 55356-0815 Permit Number:
Date Issued: �:C;r�,Cxi�'y
(612) 473-?357 t::� ;'€�:;:���?:1
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
�� CITY OF ORONO — BIIILDING PERMIT APPLICATION
j Date Received:
Total Fee: $ �'`��� -
Date A��roved: �
Entered By: �-� Permit p:��n a.� � ___- .
. ,.
AI�L INFORM�iTION MIIST BS SIIBMC TTED IN FIIL.L BEFORESeI�AN REVIEW WILL B$ SZ�BRTED --
(See ------------------------
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�g� p�,pyICANT Ig: (circle vne) O�dNER vr ONTRACTOR
JOB SITE ADDRSSS: ���� �h��1��'� ��� IVQ.1fA(Y� _ ZIP: ��3�
� (work)
I 1 Ia,�C PHONE: (honte) ���"0 v���
NAME OF OWNER: Ti 1 .
CITY: ZIP:
1KATZ�ING ADDRESS: M�
�' �f ro Y� PaorrE: f o l 2-4-1�1'3 83� —
CONTRAC'rOR: a
I •,,�� ��: �a�P�.U�� rn� zzp:
MASI+ING ADDRESS: Z I� 1-�/r�G�.� v� —
STATE LICENSE: �
PHONE:
ARCHZTECT/ENGINEER:
��: ZIP:
7KATI.ING ADDRESS:
REGISTRATION A
N�s
Accessory Structure Move �
TYPE OF WORR: New Addition Land Alteration__
D�o Re.*nodel/Alteration Renovate
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PROPOSED WORK (describe in detai.l) :
�ISCG
STORIES: I �IZ- SQ. FEST OF EBCH FLOOR:
NO. OF BEDRaOMS:
Gp,gAGE STAI�S: ATT. DET.
g,STIMATED CONSTRIICTIoN VALIIATION (eaclndi.ag
i�a� : s ����0�
I hereby appl.y for a building p
ermit and I acknowledge that the iaformation
above is complete and accurate; that the work will be in conform Code W hat I
ordinances and codes of the City and with the State Building e�it; and
uaderstand this is not a permit and work is aotr oved pl�ithout a p
that the work will be in acco danc with the app _ .
DATE: " I'O � f
APPLICANT'S SIGNATQRE: �
. . �. . . . . . . . .
_ . . . . �
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� ��'�`.�' o� ����TO
Post Office Box 66•Crystal Bay,Minnesota 55323•Muaicipai Offices
•
• - • •
On the North Shore of Lake Minreeto a _
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd.Qur re1uest for a permit or
data", we would like to inform you thQ f its departments may require
license from the City of Orono or any
you to furnish certain private or confidential information.
You are notified that:
l. The inf ormatiohey�erm t or li ensebrequested. determine your
qualification for t p
2. You may refuse to supply data, but refusal may require that
the City deny the permit or license.
3. The information may be shared with other local, s�ate or
federal agencies to the extent necessary to process the permit or
license.
4, If your requested permit or licease requ�res Councii ac�ior.
to aporove, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6, Your full name is required to procsss this application or
pe*znit. -
, � � `Tp�J'�c?�h ���►"��r�
!- - - �� Middle Last
Firs
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Address
� �� �J-�Cf
City
State Zip
�I Z- ���-3�3 8
Phone
I understand rights as sta above.
Sign ure � ' �
� • PUBLIC WORKS—473 7359
BUILDING&ZONING—473-7357 � ADMINISTRATION&FINANCE—473-7358
pSSESSING