HomeMy WebLinkAbout1990 - 003331 - sheetrock PERMIT
C ~ OF ORONO PERMIT TYPE:
33 wn Rd. South • P.O. Box 66 Permit Number: BUILD'NG
Crysta ay, Minnesota 55323 Date Issued: 003331
(612) 47,3;7357 lt'l;liij'ri_l
SITE ADDRESS :
1270 WILDHURST TR
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DESCRIPtION: 117
23
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SHEETROCK
Building Permit Type SF-ADD/REMODEL
E.uildin; Work: Type REM-NATE/REMODEL.
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FEE SUMMARY: ...... :ti'v -'. :J. -:J::
CIF ORONO - BUILDING PERMIT APPLICATION
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Total Fee: $ �7 TY ODate Received: /0 -- 1e ' go
Date Approved:
Entered By:
Permit#: 33I
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (circle one) WNER or CONTRACTOR
JOB SITE ADDRESS: 7,,. ._). 76 X11 i /cIA /,1, i S IkA 1 I ZIP: ��, ( V
(workg26 3.3
NAME OF OWNER: J 1111 f" RITXX,0/1-eS i /C— -34612_ 6
MAILING ADDRESS: ca., //t CITY: U `at 6 C.1-- ZIP: SS 3 6 V-
CONTRACTOR: °Q ( 1 PHONE:
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration v/ Renovate Land Alteration
PROPOSED WORK (describe in detail) : Slie.cikook
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 4606 , 6 6
I hereby apply for a building permit and I acknowledge that the informatics
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 permit and work is not to start without a permit; ar
that the work will be in a ordance wit- "th. approved plan.
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APPLICANT'S SIGNATURE: i Orl(i1%1 v7 14L4'-- DATE: /C '/6 - C
(Please fill out the reverse side of this form)
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*-�ry� - CITY of ORONO
Y. '.` Y Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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*.d..-;-----4, ,, On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 15.165, "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. 15.165 to review private
data on yourself.
6. Your full name, and date of birth are required to process
this application or permit.
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Paaii
First Middle Last
la o Wttot h .v- "t Tira'- 1
Address
C)V 61') 0 M.10 , 6-.5 31,e, q-
City State Zip
Phone
I understand my rights as stated above.
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Sign ture
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING