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:
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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 .
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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