HomeMy WebLinkAbout1991-003740 - tearoff/re-roof V PERMIT
CITY OF ORONO PERMIT TYPE: E:UILDlNG
1335 Brown Rd. South - P.O. Box 66 Permit Number: G��:�74{j
Crystal Bay, Minnesota 55323 Date Issued: 06/06/91
(612) 473-7357
SITE ADDRESS:
2985 WATERTOWN RD
JIB
P. I .N. : 04-117-23-21-0001
DESCRIPTION:
TEARING OFF/RE-ROOF
Building Permit Type SF-ADD/REMODEL
Building Work Type RE-ROOF
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01 &EV 63.00
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V hErCK TL 126 a 50
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WARNING-VIOLATION OF UBC SD T. NEXT OFFENSE-C I TAT I M/
WILL BE ISSUED WHICH REQU I R 10 AND/OR _0 DAYS IN JAIL.
FEE SUMMARY:
VAL :d,
Base Fee $63.00
Surcriarsl $. 60
Investigation --------113-QQ
Total Fee $126.50
RR����T�R -- Applicant -- OWNER:
CO
IYE� CR&LD 14737169 TROWBR I DGE DON
2832 TAMARACK DR 2_85 WATERTi AWN RD
LONG LAKE MN 55:356 LONG LAKE MN 55:356
(612) 473-7169
""777—
THE UNrERS1rNE- HEREBY
REQUESTS PERMISSION TO MAKE THE REAL
IMPROVEMENT:`..';M r _ E,EN:•r.
SPECIFIED AND Hl.7t'iEES TO DO ALL WORK IN STRICT COMPLIANCE WITH f-L CITY
OF
IrrNO ORDINANCES AND STATE Or MINNESOTA BUILDING DE REQUIREMENTS . w
APPL ANT/PER ITEE NATURE ISSUED BY:SIGNATURE
41_ CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit#: 7 D
v
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS:
(work)
NAME OF OWNER: !'��S d/a /�� �/ �`r PHONE: (home)
MAILING ADDRESS: CITY: ���y't'-" ZIP:
CONTRACTOR: /� �`L lPHONE: r �
MAILING ADDRESS: �iZ / �'fijC�'< ✓� CITY: ZIP: 5J 3J�AC
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) :
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ D�
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 will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE-:-6 1�
(Please fill out the poverse side of this form)
J
L -
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
WiNg
On the North Shore of Lake Minnetonka
D,�jTA PRIVACY ADV��Q�JC
In accordance with M.S. 15.165, "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. 15.165 to review private
data on yourself.
6. Your full name, and date of birth are 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