Loading...
HomeMy WebLinkAbout1992-004696 - permanent posted �'ERMIT CITY OF ORONO PERMIT TYPE: 1335 Brown Rd. South • P.O. Box 66 ''�''� Permit Number: C�;-�;A;_':4; Crystal Bay, Minnesota 55323 Date Issued: r ,: (612) 473-7357 SITE ADDRESS: -7-7ZATA BLVD 2; DESCRIPTION: .19n Permit Type PERMNENTirTFr) •ign Work Type SIGN Lerigt.h 1C_) FT ti IN Hei':_!th Ff 0 IN REMARKS: 1'!!�f !!i 'illi tdtf 1 41! ! L'1 L'111ATU, FEE SUMMARY: " 11 T L!f ilii OAA ', 1 N1 J..'vvvv T! AA -V.1 LLIt s..'V•LV 'ii�.t'11yy Ti if} fJi! L.•7lL 4!` 1L ov.6V BaE,e Fee ---T--- �� �_�0 !!L L•L 11 t 1 J1171 Sl1 7 L T!-!t•al Fee A.a=}� ti rrt 'JrlLV LIVV.L i6A TVV•�7 i lit if fc". AL:1L'/ le- CONTRACTOR: iCONTRACTOR: — r FDP l i r_-_W_1t _ OWNER: t ftp 1 EDT'If3=jhl =:T tt.;`v. 14 �;-7A41; �'AC'.L E NC; ;_s 1 :_CIAR ,HEAD RD _ _•1 ? `�i(�`rAT. BLVD LU M i idNETOW'A MN 5534S NG LAI.E d7•- x� � 1irtER��:I t� !FD HE BY R 1ttP ,T TON TCI t��:4�..F -E `IEIED AND AG�.rt T�� DO ALL ISS �•iRIrT 4: ��•1�=`!_It�ta� .E �ITi TATE OF MlNNE IIrA ELtIL1. I�` k� ...: ,a� _.. _ .a,.,. .-.. ,c Cms" ua` ...,,i.S:.,.�u,., .,`a.aa...a,�,.,ems.:,.., ,. ... ....,..., .-.... ... . .-,.•u, ..�.,,�,.d. -a�.va.,�.� ..`a. a,,, ry «1 i Aa ,v�• APPLICANT/PERMITEE SI NATURE ISSUED BY:SIGNATURE �a I � rn m , Zzz Z moi.. � v T I a CITY OF CRCNO - BIIILDING PERMLIT APPLICATION :)tal Fee: $ -77 0 Date Received: 16 : /3 _ y Date Apuroved: Ztered Bv: � po,,.t; :L INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) ----------------- APPLICANT IS: (circle one) CMi'4ER or CONTRACTOR )B SITE ADDRESS: / �D �o ZIP: 4-,A^11 j V � e) �� (work) 73-� � OF OWNER: l �� F'� i �lv c,, PHONE: (home) ;.ICING ADDRESS- a �CITY: © r-C /V-► ZIP: �3T_z2ACTOR- PHONE: It 7 3 -7 TING ADDRESS: y�-( 15 1st A6y: �D1"� zip: c5 c�3�fp 'ATE LICrENSE: L — i.. ;CHITECT/ENGINEER: PHONE: ILING ADDRESS: - CITY: ZIP: -----__ .2,iE- _�-- " REGISTRATION ' 'PE OF WORK: NewAddition Accessory Structure clove Demo Remodel/Alteration Renovate Land Alteration of JPOSED WORK (describe in detail) : i6U I -RIES: SQ- FEE T OF EACH FLOOR: _ OF BEDROOMS: GARAGE STALLS: ^IY.ATED CONSTRUCTION VALIIATION (excluding land) : S f�lJ•�� izerebv apply for a building permit and I acknowledge that the information ,v? is complete and accurate; that the work wil ' be in conformance with the 'finances and codes of the City and with the State Building Code; that I erstand this is not a permit and work is not - smart without a permit; and w.t the work will be in accordance with the approved plan. t,ICANT'S SIGNATURE: DATE: K Y {Z- ` W r NOW. CITY®f ORONO . . Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices 0 On the North Shore of Lake Jlfinnetonka 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 licensefrom 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 qualifi cation for the perm, it or license requested. 2. You may refuse to supply data, but re=usal 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. S. 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. Firsclt Middle p `La QTS- CAJ Address City State Zip 4f 7 3 -7 Phone I understand my rights as stated above. �EJN-0 • Signatu e 'ILDING& ZONING —473-7357 • ADMINISTRATION&FINANCE— 473-73:3 • PUBLIC WORKS —473-7359 ASSESSING