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HomeMy WebLinkAbout1994-006198 - add/remodel PERIliIIT . � C�TY OF ORONO PERMIT TYPE: r 2750 Kelley Parkway • P.O. Box 815 �.:�t I�C};��i� Orono, Minnesota 55356-0815 Permit Number: ;_,��;_,: =a;_; (612) 473-7357 Date Issued: � : :,i _:,... �. ;%' SITE ADDRESS: _. _ ��ti$T� s—'ts��� _r�; = . !. . . . , . ..__ -s 1?--L :—��i —i�i�F=�:w; DESCRIPTION: i�:��i ?.���.�'i:� �'�F'€i�3.#. :;:•���• :�;F—±�C$C1:`�E:t�it..�C�E.I_ �_�3 i I t��y�� �:��_�"�` i YF'� �°�—�t��f��#= ..r=� :-�t ���_f�,vr: Lrl 1! V! 1.!l11Jl1L' �1 t�l1t�l4L V�i 14L j,� 1�i Jl Y�'�.�1 t� !'1 V� t`LJ� �JT�VY ±j';'; �e!i Fttt�f� Li REMARKS: . y:.� ���' i.� �� UlTJlt �L t�u!aLJ ��'��''�.t�.t f�_+�Lf:�'�k' Y!!1f J1L4Lj! 1 t l t!'!!�l\ /L'iJ nwvf�i%v ��vi.%� eivi ii-'�`r%,',: FEE SUMMARY. !}i�;?:tL�.A VL�. yrV! T .-._e__. . . _`.'_:!`y �t;'j �;ii 3t? �+=i 5� ��_� �•`_,'-!. .�tt? �'• .� ' —_ i y .-�L�� Ct"tc!'t`°�s� ___------�'�_,i.� ���i'�.cc i eL==k` �a%�� . i� � CONTRACTOR: �— �� - ' � " -�� � �-� OWNER: :;;=��- ._ ... _ _... _ :::.,�.,..... : ;.: : � - - � : --,' �;-�.';- i .rs,. : =i 1 �. . ;.7L�•Etr'�f"e... �J�� �_;C', ' " - '•`tE_1�_f _..�iC� k�� i..nt..�� . _ __ �`_������_! ����E1�� '•��i��_�i�;�._ �';�; �=�!.'* `•�+�''1���! f�'H�:. t ! � � j �..L,'«. . 4�3�.�..h . h' �.�' . ._. _. ._ f=;`:u .s.-;i�,., ;�# �,Ji�1 f�4iy ;'-!1 ��.;�.L� �.. � . �. .' . �...L..y^. �ai. p.... ���e��'� �3 [ ' -':Si c_ �.� :( �).... �� f � �_ �. .. : I .� t R"�i ' F x 'i hh.,.:.. : S � E"t � : .i"'{: E�f :` . I 1�<t :.�y-:�!^.r#... . _ . ._ _. ._. ..... . _ . ...»_. _. . ._� . .�.. .. ... _ _, . _. ,i,: , -:r•.,w �t�_ ti��... t�t�,. # r.-- ,•-,- . , _. :���::r'� t r- T.- � { ( F , s , i r .�F t _ .� '• ' .t I !"',r C � � ,. + :_,_. 1 ! � F i� i'{�j;*j�' (y �� i + i ;e �:i ..._•.r s: .L i._�_. f"'�. .i.r �.�.�. . . _: .. .: i'':!.._-..� .s ... .:': ... . .� f ..L.✓� � .. _. . _._3.: . �._ .F . . . . .._i.._ i , .- . ... . .. �_c'"'.i..�{�f..� .,...�., i fvt., i 2-,�t r.!t.}. _ �_�- .� �, . .!. � ... .i ! i.;u«. �_ _ _.. .f•.3 _ .�+�:'. � +'���t" _.i`.�;.4� f = ` � ` . i � � .. .. L - .� � � J APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE � � ' y CITY OF ORONO - BIIILDING PERMIT APPZIC�T��N � Date Received: Total Fee: $ - Date A�nroved: ' Bntered Bv: Fer.nit�: � - __ . TION MIIST BS SUBMIT�ED IP7 FL7LZ B��� P�N �vl� �I'I' BE S�`�RTFJ� AT.T• INFORMA (Se� Check-off List Enclosed) ----------------.------ ------ ---------- _ ------------(circle one) Oi�T�IER CONTQACTOR�� THE APPI,ICA21T I5: ---- .'- � y �:- ZIP s JOB SITE ADDRSSS: _ � `� ' (work) � � l P30NE: (home) NAME OF OWN�= � � ! F `'" /<< iti��%� CITY: ZIP: 2�AII.ING ADDRESS- , � � �' , � PHONE s �l �/ _. `��.L� ' � c; ; c,c'" ' r-- CON�RACTOR: -n �-j ' � C- CSTY: /��-,�.1`= �I ZIP: �: '� �:��' �� MAT_T ING ADDRESS_ `��/�� ,�.� � r,`: ' { STAZ�E I,IC.�NSE: T `7 �/J� PHONE= ARCHI'I'�'CT/ENGINEER: C=�: ZIP: MATZING ADDRESS: REGISTFtATZON � NAME: Accessory Structure Move � TYPE OF WORKs New Addition Land Alteration Demo Re.*nodel/Alteration Renovate �1 PROPOS� WORK (describe in detail) : ��� �;���. � STORSESs S4• FEET OF EACH FLDOR. ��� gTAT,T•g: ATT. DET. NO. OF BEDROOMS: _ c��-. � I.and) : $ _-���C��'' — � ESTI�SA�F.D CDNSTRUCTION VALt7ATSON (eaclndinq hereb apply for a building permit and I ac�cnowiedge that the info�ation I Y that the wor!c wi11 be in conform Code �'''ithathS above is complete and accurate; and with the State Building e�it; and ordinances and codes of the City understand this is not a permit and work is not to start without a p that the wor}c will be in accordarice witiz the apprvved pl.au. • % � / j�/ ; �� / �_--� DATE s l< ` � � APPIrICANT'S SIG2IATORE s /` . , �� �- � � � ���'� o� ��.��.�aT� `I 11 Post Office Box 66•Cr5'stal Bay,Minaesota 5�323•Municipal Offices � _ � - � � � On the IVorth Shore of Lake Minneton a DATA PRS�ACY ��SORY "Ri hts of subjects of 9 Y 2n accordance with M.S. 13• ou'thatdyour request for a P=quire data" , we wou3.d like to inform y of its depar��ents may ;�.cense from the City o= Orono or anY � � n=o�ation. you to furnish certain private or confident_al �ou are notified tnat: T w�IZ be used to dete'-"mine your 1. m�e inTormation you fu_nisn cuali�icat'on for the perni� or license requested- 2. You may reruse to supply data, but re=usa1 may require that the City deny the pe�i� ar license. be snared witn otZer Iocal , s�a�e er 3 . The information may o roc�ss the pe'-"mi� ci f ederal agencies to the extent nec�ssary to P y license. , yo pe�ait or IiC8RS2 reauyTes Counc�I. a��=or a. �f your recues`..d � become public. to approve, some in=ormat.�on �ay 5 . You have certain rights under M.S. 13.Oa to review griva�e data on yourself. 6 . Your fulZ name is recuired to procsss this application or pe�it. %� �� f-E�v r/v �� i c �_ �� Las� � Middle r^irs� ` �-��. �- � � ��� _, � � t- i �� � � Address / / l �1. J� j Cc�� �( ) , I� /`lC'�� i4 � �� Z1.D ' State Ci�y C/ �,'/ - %/ -�-� — Phone I understand my rights as stated above. : �/ / �` _ - - -- j� -�"` � . Signature 3UILDtNC&ZONING-473-7357 • ADMINiSTRATION&FIN.�NCE-;73-7358 • PUBLIC WORKS-473-7359 �SSESSING