HomeMy WebLinkAbout1992-004151 - rebuild handrail, etc PER: IT
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CITY OF ORONO PERMIT TYPE. r,:irl} �����
1335 Brown Rd. South • P.O. Box 66 Permit Number: ;_�:.��.��t
Crystal Bay, Minnesota 55323 Date Issued: =•i f�.-� �- `
(612) 473-7357 ,^F�.j `'j !'�'"
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FEE SUMMARY:
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AN FRMITEE SIGNATURE ISSUED BY:SIGNATURE �Q,(_,v...
CITY OF ORONO - BUIL:�INGtiPER�iIT APPLICATION
Total Fee: $ �� � � U Date Received: � �-'% � / Z--
V/,^ Date Approved:
Entered By: x�,,�c.`"
Permit#: `f/ .�J�
AT•T• INFORMATION MUST BE SIIBMITTED IN FULL BEFORE PI�AN REVIEW WILL BS STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLIGANT IS: (circle one) 't+1NER , r CONTRACTOR
JOB SITE ADDR$SS: lZ� � � ��Qi�l (,�' C�1(.� �'� ZIP: :'��� I
(work)
C PHONE: (home)
N� OF OWNER: ,e� ��/{V �
MAILING ADDRESS: Z�� � C6�'/�'l.7(�1(.c: o� ��CITY: �7ClL'�-S�c�'� ZIP:�S .�'�I
CONTRACTOR: P$��'
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: �v����,� PHONE:
MAILING ADDRESS: CITY: ZIP:
pp�g: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORR (describe in detail) : '�� �c�f) �-Y/=t/�l�'�/c_ �y l�1-,��'�
(�L '" L < <' - � ;
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STI�I�LS: ATT. DET.
ESTIMATED CONSTRUCTION VALIIATION (egcluding land) : $ /�Z C�U i
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the
ordinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit; and
that the work wiI 1 be in accordance with the approved plan.
APPLICANT'S SIGNA -i � E� C' L> DATE: �Z��J
r
� 4,
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C ITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal OfSces
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� - � � On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would like to inform you that your request for a permit or
license from the City of Orono or any of its departments may require
you to furnish certain private or confidential information.
You are notified that:
l. The information you furnish will be used to determine your
qualification for the permit or Iicense requested.
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
Iicense.
4. If your requested permit or Iicense requires Council. act�on
to approve, 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 process this application or
permit.
First Middle Last
Address
City State Zip
Phone
I understand my rights as stated above.
Signature .
BUILDING&ZONING-473-7357 • ADMINISTRATION�&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING