HomeMy WebLinkAbout1994-006167 - stucco exterior P��. �liIIT �'
CITY OF ORONO � PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: ='``'�` `��•�'y`-'
Orono, Minnesota 55356-0815 Date Issued: �3t}�,���,.�
(612) 473-7357 t iF.t�.�.;'_=��.
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FEE SUMMARY:
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CONTRACTOR: OWNER: - �;�:=�:.1 i r�!�t. -
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APPLICANT/PERMITEE SIGNATURE ISSUED BY SIGNATURE
CITY OF ORONO - BiJI�ING PER�IIT APPI,IC�TION
� Dat� Rece?ved: �' �� `� � �L
Total. Fe=: $ �
' Date A�nroved: �
Entered Bv: Per.nit� (D/ �' / - __
A7•T. INgpgMATION MIIST B$ SUBMITTED IN FIILL BEFORE PI�AN RE�7IEW WZI,I+ BE S�`�RTED
(Se� Chec�C-aff List Encl.osed)
� �pPZIC�NT Ig- (circle one) Ot1►`1ER or CONTq.ACTOR
; � �.� �� .� /�G�JG� ZIP: S�S��
JOB SI�E ADDRBSS: G �d �/ �
(work) ��S'�Z�.S
�� �.�-er/C:lv PHONE: (hcrae) �7/-GSz a
NAME OF OWNER= �.4 v'/1� � �
� ✓y,� C 5 ��d i/L-1
CST`_'- ZIP:
2�AILING ADDRESS: --�/� �
PHONE- �-�'�� "-cl"O/a -
CONTRACTOR: /JG/�s Tt�-GI��i-
MATT,ING ADDR.ESS: / '3/% 9 z'N'lrE,�ir�csS R-D
CSTY: /�/���c"7"�'�,La ZIP: �S._.�oS
ST��'E I.IC�SE: z
PHONE:
ARCHZTECT/ENGIN�R:
CI�,�,: Z IP:
MAIZ�ING ADDRESS:
REGIS�RATION �
NAME:
Move �
Nea Addition�_ Accessory St�uLandeAlteration
TYPE OP WORR: ` Renovate
D�o R�*nodel/Alteration�_
PROPoSED WORK (describe in deta:i.1) : !
GGo �'X�c,���i�- G' �,� O�/c.l.���
�' %C Y-�- G ✓✓i i �r/� r�
STORSES: SQ. FF•ET OF EBCH FLOOR:
NQ_ pg BEDROOMSs
�gp,� gTALLS: ATT. D ET.
� I.a.nd 1 � $ �s�'10
ESTZMATED CDNSTRUCTIoN VALI7AT20N (eac�uding
hereb apply for a building permit and I acknaw3.edge that the information
I y - that the work will be in conform Code `n71thathl
above is comolete and accurate, and with the State Building e�it; and
ordinances and codes of the City
understand this is ne i� acc rdaz�ce ith the a�proved pZ� ithout a P
that the work wiZl b . _
�/f � /,I DA�: � ��; y.
APPI,ICANT'S SIGNATORE: /�G� , / ,
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� � � ��'��' o� 0�.��TO
Post Office Box 66�Crystal Bay,Minaesota 5532:3•Municipal Offices
M .
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On the North Shore of Lake Minneto a
• ' • •
DATA PRSVACY A��SORY
n accordance with M.S. 13.04 , Sa�d-our request for a permit or
I uire
data", we would like to inform you t of its departments may req
license from the City of Orono or any
you to furnish certain private or coniidential inrormation.
You are notified that:
1. The information you fui nor ZiCensebrequested, aetermine yaur
erni�
aualification for the p req�ire that
refuse to supoly data, but refusal may
2, You may e�it or license.
the City deny the p
be snared with other Iocal , s�a�e or
3. The inf ormation may to process the pesmit oi
f ederal agencies to the extent necessary
Iicense.
our requested permit or Iicense requyres Cou�cii ac�ior_
a. l� y become public.
to approve, some information maY
5. You have certain rights under M.S. 13.04 to review griva�e
data on yourself.
6, Your full name is required to proc�ss this appl.ication or
pennit.
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Address ���G �
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City
State
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Phone
I understand my rights as stated above.
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Signature
� • PUBLIC WORiCS-473 7359
BUILD[NG&ZONiNG-473-7357 • ADMINISTRATION&FiNANCE-;73-7358
ASSESSING