HomeMy WebLinkAbout1992-004660 - re-roof/overlay I'EFi�Ii�IT�
� ,
CITY OF ORONO , PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 E��J I LG I�lC;
Permit Number: ���y��,�,t f
Crystal Bay, Minnesota 55323 , Date Issued: t�`��i��=�:�
(612) 473-7357
SITE ADDRESS:
F,� '=:TUE�E='= �AY RG N
L':V
�'. I . �I. = i r:�'—�11—;�—:�.—e yt����q.
DESCRIPTION:
C;�:—��rf�_�F:E��t�l�F;LA�'
E:uil��i�4� �'��t,rr�it. Tv�=�� =_�—;�L,�i�;E���;��c�
Bu?1��a�-�� �:j���r•€:: T y�_� F E—h����:iF
� � � �����
ti �: ������ik �� �� ��,��w �`i
� :- �a �+rwx���� � ,� � -� � '
,�: �,��iF�� '` ,`� � � K�
�o-
4 `� ��a�� - MJ�FN'��� ., `��°�M1.��r� �l
1
� ,P 4 #� �w d g 1���,i,� F�. r m�"�l� .A,'
��` P'"��'� '��v�� qs �,�r�f� ;r� �t& "��' i
r f�„���i�����'�' �" �4,y"�'������° �� ��aVk �t
rl�' G '� � ��
� a �' �' �_ � ��'��.
g�i� � �y,�„,'" x � � w
�� �r � � ,��� „��,�������� � �;�r � ����
����
�� �
'�"" ' ������ t�:��v���fiE �t=��Cf
_ ����
,, � �������i,����� � ���` � � �.'s'�,s�Cft��'4� #�
�,, � ��. ,� .
. _ ;:t G�M �7.�
f'%'}:�'%ttt s(}� �]
. .. 1 i.tLi V V Y W 7r
REMARKS: ' '
�,�1Ft��4': TL I T.5�
t;��t�'F:�T—;��A�A� }`[!U
#�'�;s`��� C;1;;1 ��G�.� T�t 1:5�
.��:na iar
FEE SUMMARY:
�1(��.t l�j�'T i i}�J �S5()
E�=tS� F�� �17 .i.ii i
'��c.�i�cFrar��� ----------���i�
T+��#•�1 �ee �1? . �,i)
CONTRACTOR: ����� AF fi�,��:HARD
F.� ���T��E�E�'r� E�AY FiCy t�!
�iki��(�i� �� ��:�?S°�
(;f.j,.•:�.l d i F�-F.�,;:_F�
r______ _---_.._ _ _._ _ _ _ . _ _ _ -- ._ _ __ ..._._—_--- - -- _ ----
_- - - -.__ _.____ ____ _ . _--- _�--
E�� ;?:`a�}��=�!.��•��� 1���:���1' ����?'-#� - = �� � ; c � �
� T.-; �r��°_.�_��a�� �r�► r��}::.� r�� �;��� �r•tt-��_v�r�rryz�_. �
'-:F'E r:I�1 E:ti f:;rL�: c=:t���F�'�� Ta:i {i��� �?L� �?���i�t��: I I� �����I�::j' i:�;���I�'�_I f���t:E �.+i�E-.'. �LL �:I�Y ��ii= .�
;��������i r ;��:;:D I 1�!Hi�.��;_�'_; r"�l��f� '=�T('-�T�= =ti!�= t�l�a�iit;t:'==►��T�i �;!1 T�C I�#�; t:����C t�°��s�+?I�i�t��i�li''�� . ;
� .� � -' _�
� �� �
APPLICANT/PER TEE SI URE ISSUED BY:SIGNATURE �—�/K�
d �
f
CITY OF CRC2I0 - BUILDI�IG FER:�T A.PPLICATION
� �
Date Received: G'��� �/l ��
'otal Fee: $ �
Date A�procec:
vZtered ��: Per*nit r: :,�; _ r.
=1,.L INFOR'+ir�TION MIIST BE SUBMITTED IN FULL BEFORE PI�AN REVIEW WZI..L BE STARTED
(See Check-Qr"f List Enclosed)
--------------------------------------------
-^HE A.PPLICANT I5 s (circle one ) OS�IER or CONTttACTOR
��B sz� �D�ass: ' -
� ' � � /'� zzP: �S �-�' -%� ���
,
3�-�/8- a3 3S� ���'c� (work) l"1( �- �='G�/�.
,;�ME OF OWNER- ,��,� �� jJ'1E �-� y������ PHONE: (home) �7� ---�j/�.�
:�AII,ING ADDRESS: � ` � `� CITY- / (C' '�) �' ZIP: .F .5 ��`�= /�� 7�
.JNTRI�C�'CR: � � � S PHONE:
:��I,ING P.DDRESS: CITY: ZIP:
:'�A�E LIC�7SE: T
/;)
'�.RCHITECT/ENGINEER: PHONE:
XAILING ADDRESS: CITY: ZIP:
,��: REGIST�TION T
�'PE OF WORK: New Additiar. Accessory ructure r!ove
Demo Re_nodel/Alteration Renovate� Land Alteration
�
�' �-� —� �2�? -�,�
'_?OPOSED WORR (describe in detail) : ` -
�
'""ORIES: SQ. FEET OF EACH FZOOR:
;p_ pg gSDROOMS: G��RAGE STALI�S: ATT. DET.
��-��J= � h-?�-��`�"SS D ��n
;�T=MATED CONSTRIICTION VALIIATION (ezcluding I.and) : $
�:.: ,�� ,
hereby apply for a buil.ding per.nit and I ac?cncwledge that the information
�ove is complete and accurate; that the work wil ? be in conforinance with the
_-dinances and codes of the City and with the S�ate Building Code; t�at I
aderstand this is not a permit and wor:c is not to start without a permit; and
.Zat the work wi11 be in accordance with the aporoved plan. �
/� , _ �-� � � 4; � �
.,�PLICANT'S SIG�7ATIIRE: ��- r . c_ DATE: �
� .
�
�.._' -
- �.
��` ����" �� (����T�
.� aa.
Post OfSce Box 60•Crystal Bay, Minnesota 5�323•Municipal Qffices
,;: O1
� - � �� On the North Shore of Lake 11�finnetonka
DATA PRSVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2 , "Rights of subjects of
data", we would Iike 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:
1. The information you furnish wiil be used to determine your
quali�icatien for the per-.nit or I.icense recuested.
2. You r,tay refuse to supp?y data, but re_usal may require that
the City deny the pe�-mit or license.
3 . The information may be snared with o�zer ioca? , s�a�e or
federal agencies to the extent necessary to process tne permit or
I.icense.
a. If your requested per.�it or I.icense =ecuires Councii ac�io%
to approve, some infor:nation may become pub�ic.
5 . You have certain rignts under M.S. 13 .C� to rev�ew griv��e
data on yourself.
6 . Your fu1Z name is required to process this application or
per:nit.
) �
�/� � /
�~ '�./�/ .Y�- �P�' � ''�i�-C� ,.��
Fi rgt Middle ,� Las�
a /
i
/� � � �`-�� , ,�!�
� � , ,
Addre
�t/�S A 1 i� _�-�^ ��� , ` `�=' ��
City State Zip
��� �O r � / �_,-��
Phone
I und ,tand my rights as stated above.
;� ,
� ,
��-�. '���� . ' ��
i�/'�� �—�.
Signature . �
� ' '
Bl,'ILDfNG& ZOvI�G - -373-7357 • AD.tii1NISTRAT10Y g FI`+'��`iCE - 473-73=3 • PUBLIC�VORKS -473-73�9
ASSESS(N G