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HomeMy WebLinkAbout1992-10-30 Permit, Land Alteration #004755IV CITY OF ORONO 1335 Brown Rd. South • P.O. Box 66 Crystal Bay, Minnesota 55323 (612) 473-7357 SITE ADDRESS: E.2'7 L Y P . I . N. DESCRIPTION: REMARKS: PERMIT PERMIT TYPE: t-ISER DEFINED Permit Number i ii t4755 Date Issued 1 0 / _;0 / 9 FERNDALE RD N DRAINAGE SWALE User Permit Type LAND ALTERATION :WAL E: TO E E I ►J = TF'�l_i . C+ : F.' FROM (WETLAND FEE SUMMARY: Ease Fee Tc ,ta 1 Fee ICONTRACTOR: OTTEN BR +' IL LONG LAKE (F 12) 47:.3-S42 S ---------*5Q- ►Q $.50 . 0(.) CITY Of ORM FINWE OFFICE 1313300000 1 01 aw 50.00 Q ECK TL 50.00 RELZIPT-THANK YOU C 5T320 C001 R01 T14:1! SETBACK SHALL BE STAKED BY STAFF. c {r-0, fj!�r 6PPuIFe-3 -TV - Applicant. - 1473S4215 MN 55355 CUP 6iuus-.4`+, OWNER: iih+lN+=+ TIM FERNDALE RD N MN 55391 THE UNDER'_:I GNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DID ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF C+RC+NO ORDINANCES AND STATE OF MINNESC+TA BUILDING CODE REQUIREMENTS. APPLICANT PERMITEE SIGNATURE--ISSUEU9V SIGNATURE 6 -c/t J e1% CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ 5- e Z, Entered By:' Date Received: l0 Qy I Date Approved: 16 - 30 -biz.- I Permit#: AL ti ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check -off List Enclosed) ------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: C Z7 n 1 ZIP: ``,:: ,J� I I I (work) NAME OF OWNER: --rl M J U HAV „U 0 PHONE: ( home ) MAILING ADDRESS: b2-7 &Pj DAU- CITY: ZIP: CONTRACTOR: PHONE: y7 - Sys MAILING ADDRESS: I :-,U . Jk Z `: o CITY: zXW_4- Akf— STATE LICENSE: # 'MiCHITEf�WENGINEER:_ X ZIP: `'r 3; C, PHONE: `l13 Sys MAILING ADDRESS: Dh 2t9 CITY: &,ve, ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration_ PROPOSED WORK (describe in detail) : AIV6 /�L�fief}TIGN �O,c Uc. 61&1 ( STORIES: pKP /nJ /`►G SQ. FEET O W5� e F NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ L2DD . I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conrormance 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 accgrdance with the approved plan. APPLICANT'S SIGNATURE: / ' (� �' , %c DATE: