HomeMy WebLinkAbout1992-00483 - re-roof barn so � PERMIT
CITY OF ORONO PERMIT TYPE: BUILDING
1335 Brown Rd. South • P.O. Box 66 Permit Number: 004483
Crystal Bay, Minnesota 55323 Date Issued: 07/14/92
(612) 473-7357
SITE ADDRESS: :025 WAYZATA BLVD
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P . I .tai. r 118-2-,-3-23-000 1
DESCRIPTION:
RE-RC-tt=tF BARN
Building Permit. Type_, SF-ADD/REMODEL
Building Work Type ' RE—ROOF
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FEE SUMMARY: VALLfAT I ON � � 7U47
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Base Fee Y_;
Surcharge �
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Total 1 Fee
CONTRACTOR: R: Applicant
ROBERT
3026 WAYZATA BLVD
LONG LAKE MN 5535h
473-9538
THE UNDERSIGNED HEREBY REGI JEST'=: PERMISSION TO MAKE THE REAL IMPROVEMENT':-:
�VEMENT';:
SPECIFIED AND AGREE'::;; TO [.10 ALL WI�tRF': I tai ' ; 'I F:f �:C_1h'F _ _FE I T T A � T 1 , -.
e=Rt_xNO ORDINANCES jNi7 STATE OF t•1 I tt,NE'=,t_;i , III-DING Ct�i�E RE;;U I ,El~iEr�i
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APPLICANT/PERMITEE SIGNATURE A I SSUED BY SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
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Total Fee: $ �� Date Received:
Date Approved:
Entered By: C ' r
Permit tt:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
-------------------------
THE APPLICANT IS: (circle one) ryry�n, OWNE or CONTRACTOR
JOB SITE ADDRESS: �'�y� r�<�t� ZIP: S S J S
(work)
NAME OF OWNER: U _)r PHONE: (home)4/7 , - 0
MAILING ADDRESS: Vt [— CITY: ZIP:
CONTRACTOR: -S�,-e71- SO cy, PHONE: //7.3--� C)
MAILING ADDRESS: /-0 K E CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION n
TYPE OF WORK: NNP w Addition Accessory Structure Move
Demo Remoode_j Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : PCIF 16-t�U S;11' 11VC
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ r Uy
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. a - nc with the approved plan.
APPLICANT'S SIGNA DATE:
CITYof ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
0
_ On the North Shore of Lake Minnetonka
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.
First Middle Last
<�` 6 -12�1V Gox
Address
hk:� - /lam
City State Zip
J-/ 2:?
Phorfe
I un d my rights as stated above.
Sig re
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING