HomeMy WebLinkAbout1992-004583 - land alteration PERMIT
1% CITY OF ORONO PERMIT TYPE: _
1335 Brown Rd. South • P.O. Box 66 Permit Number: t-t�' ; yE� I NED
Crystal Bay, Minnesota 55323 Date Issued:
08/26/92(612) 473-7357
SITE ADDRESS:
245 Ti=1NKA AVE
F . I . N. 06-1 1?-
DESCRIPTION:
0 YARDS
User Permit Type , LAND ALTERATI'-
.,
6.
gyp; TId
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PITY OF �r
OFFIt �
L'I'rY�#f'd�E
31 BOOM
r: VU SEN 5 .
CHECK • TL 50.00
#25019C001 /Citi ufi`•L'
REMARKS:
HARL-AN OLSON TO INSPECT UPON ON c'i MPLET I ON,
FEE SUMMARY: ' }
Oast Fee
Total Fee $50 .00
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CONTRACTOR: OWNER: - Applicants -
ADD I_Ii iN ESTHER
33'8BAYSIDE RD
LONG LAKE MN 5535E
47 3-7190
THE UNOER':-;I(jNED HEREBY REQUESTS, �'E�'C°1} -;I���`_ F+�i HE i•1�`RI f v'Et1E _
AND T R _ N . ,
F I LLf t�I4? H ;�iEE'=; Ti:.i ;�ii:i ALL ijli4l�; :: _IN C,TR 1 i:; :i lt�4 L_T Ah��:EE LL —.—, Tv, T�iF
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STATE
' I; ►h1i > ., :, AND I I 4 E i t� :I - � F
_t- C•1 I i4i:l'-'.=;i.}-'., _.1 I L C i sLtE -
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
4 .J* CITY OF ORONO - BUILDING PERIHIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Wintered Bv: Permit r:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
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----------------------------- -
:.M APPLICANT IS: (circle -one) r CONTRACTOR
;OB SITE ADDRESS: Z`-1� ,1��1 ZIP:
(work)
VAME or OWNER: PHONE: (home) 4-13-71100
�j `��/�
I�.AILING ADDRESS: `�M CITY: 4)" `' ff--- ZIP:
PHONE:
CONTRACTOR:
:-AILING ADDRESS: CITY: ZIP:
STATE LICENSE: T
RCHITECT/ENGINEER: PHONE
,AILING ADDRESS: CITY: ZIP..
1AME: REGISTRATION T
-yPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
?ROPOSED WORK (describe in detail) : IFALI— Psi,—X> LEP���-
i
,TORIES: SQ. FEET OF EACH FLOOR:
No. OF BEDROOMS: GARAGE STALLS: ATT. DET.
eSTIMATED CONSTRUCTION VALUATION (excluding land) : $
hereby apply for a building permit and I ackncwledge that the information
move i s comp 1 ete and accurate; that the work wi 11 be in conf ormance with the
rdinances and codes of the City and with the State Building Code; that I
aderstand this is not a permit and work is not to start without a permit; and
.zat the work will be in accordance with thea proved plan.
DATE:ajA
'.PPLICANT'S SIGNATIIRE:
CITY ®f ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
0
On the North Shore of Lake lifinnetonka
DATA PRIVACY 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:
1. The information you furnish will be used to determine your
qualification for the permit or license 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, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Council action
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.
PirstMiddle Last
Address
V01\-b
i -
City State Zip
4-�,�- -11 cl
Phone
I understand my rights as stated above.
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Si n u
BUILDING& ZONING-473-7357 • ADMINISTRATION&FINANCE -473.7353 • PUBLIC WORKS -473-7359
ASSESSING