HomeMy WebLinkAbout1989-002181 - partial reroof PERMIT
CITY OF ORONO PERMIT TYPE: QUILINia
1335 Brown Rd. South • P.O. Box 66 Permit Number: t 1021 1
Crystal Bay, Minnesota 55323 Date Issued: {r'S/()._i 19,
(612) 473-7357
SITE ADDRESS: _ N RD
WA'TC T 1
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DESCRIPTION:
PART fit. RERob
Building Perri-dt Tree SF-ADD/REMODEL
Building Work Type -RE-ROCIF
REMARKS: 21-=
'='AR T I AL RER0-,tt~ OF AN t_-N I NHAB IJ1=D RESIDENCE
FEE SUMMARY:
VALUATION I .`600 __ 7
Base Fee $310 .00
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Q. SO
CONTRACTOR: OWNER: -- App l i c aii. 7-
.1 3T
-.13 t#683- PAUL
F0X T
�ONG LAKE MN 55:356
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APPLI E ISSUE BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By: permit - '1
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
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THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
y-L,,z � 3 ;?, - /1 �- -)--s ov /
U / �Jy.
JOB SITS ADDRESS:3 (/V 600a, ZIP:
(work)
PHONE: (home)
NAME OF OWNER'
MAILING ADDRESS: CITY: ���( & ZIP:
CONTRACTOR: PHONE:
MAILING ADDRESS:
CITY: ZIP:
Accessory Structure Move
Addition
TYPE OF WORK: New
Demo Remodel/Alteration Renovate Land Alteration_____
n
PROPOSED WORK (describe in detail) :
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
2
I hereby apply for a building permit and I acknowledge that the informat t.
above is complete and accurate; that the work will be in conformance with •t..
ordinances and codes of the City and with the State Building Code; that
understand this is not a pecrmit and work is not to start ordance with the approved plan.without a permit;
that the work will be in ac
APPLICANT'S SIGNATURE:
� DATE: ±�
(Please fill he �sthis
form)
4
(�JTY of ORONO
Post Office Box 66•Costal Bay,Minnesota 55323•Municipal Offices
8
On the North Shore of LakeMinnetonka
DATA_PRIVAC`I ADVISORY
In accordance with M.S. 15.165, "Rights of subjects of data", we
would like to inform you that your request fpr a permit
or license
from the City of Orono or any of its departments may require you to
furnish certain private or confidential inform tion.
You are notified that:
1. The information you furnish will befused to determine your
qualification for the permit or license r�qu
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 withjother local , rmit or or
federal agencies to the extent necessary too process p.
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. 1.165 to review private
data on yourself.
6. Your full name, and date of birth ire required to process
this application or permit.
First Middle
Address
City State Zi
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
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