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HomeMy WebLinkAbout1994 - 006455 - temporary sign PERMIT vTY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: (612) 473-7357 SITE ADDRESS: DESCRIPTION: ' LNHopAl-rof !7.HGN : ;i Wcrk Type TL fl.ru17% !tJU REMARKS: '4!.1:CHEYER FEE SUMMARY: CONTRACTOR: OWNER: - KLArRS WEST SILE PLVD MN S5356 THE UNDERSIGNS.) HEREBY REQUESTS PERMISSION TO mnKE THE REAL IMPROVENE\ITS SPECIFIED AC A(.4,:EP 0 DO AL'.. WORK IN STRICT COMPLIANCE WITH ALL CJTY 0:42NO of7.zn'NAP „:"Es JF WNNESOTA BUILDING CODE REUIREMENS . -00411F AP ICANT/PER !TEE SIGNATURE ISSUED BY:SIGNATURE 4-,/ CITY OF ORONO - BUILDING PERMIT APPLICATION . Date Received: Total Fee: $ - Date Approved: Entered By- Z Permit 6-4" ----s-- - ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STAR (See Check-off List Enclosed) THE APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: -3e° L.J . co, KIJ ZIP: (work) K ! .. (� K` v4 �‘�v`<-SL PHONE: (horde) 6(76,-g673 NAME OF OWNER= ZIP MAILING ADDRESS: CITY: : PHONE: CONTRACTOR: CITY: ZIP: MATTING ADDRESS: STATE LICENSE: PHONE: ARCHITECT/ENGINEER: CITY: ZIP: MAILING ADDRESS: REGISTRATION NAME: Accessory Structure Move - _*nTYPE OF WORK: New Addition Land AlteratMon Demo Reodel/Alteration Renovate PROPOSED WORK (describe in detail) : . J G-207- 14/7c-Y-e. • VL_47_ ___ i� S cv' ` 7 4 te f1��v, 0 / (cr.,.J 1n C��Y d� S 7�' 'e_. (/1 _--7-q"(5-y\-\-- U STORIES: SQ. r�.e OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ permit and I acknowledge that the information I hereby apply for a building that the work will be in conformance with that the above is complete and accurate; Code; ordinances and codes of the City and with the State Building and understand this is not s ac ort ace with the approved plan without a permit; that the work will b • DATE. �/LL� �,' APPLICANT'S SIGNATURE: �rl� 1111 ' n �r` 6ral /firs-a; ,± • *1-5 t_ 55- -t' . _----- . ... ...: cT `Z/ �r (' S CITY of ORONO - __"-= Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices Q On the North Shore of Lake Minnetonka DATA PRSVAC'Y ADPTSORY Subd. 2, "Rights of subjects of In accordance with M.S. 13.04 , 1 our request for a permit or data", we would like to inform you that y 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. be shared with other local , state or 3 . The information may process rocess the permit or federal agencies to the extent necessary license. 4. If your requested permit or license requires Council action nformation may become public. to approve, some i You have certain rights under M.S. 13.04 to review private 5. data on yourself. 6 . Your full name is required to process this application or permit. CJu2._. 4 S, , / 0,-'--eA—_ a. • •., S Middle Last First L lk Address �5� - {' Zip City ____LI:IL.12________ State Phone • I understand my rights as stated above. Signat $ 'WILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING