HomeMy WebLinkAbout1992-004788 (re-roof) .�
PERMIT
� CITY OF ORONO PERMIT TYPE: �,ta������
' 1335 Brown Rd. Soufh • P.O. Box 66 PermitNumber: t.aty�.7;�:�c
Crystal Bay, Minnesota 55323 Date Issued: � �,!�;�/'f;�
(612) 473-7357
SITE ADDRESS: �
1��4.t� ERLL7�1�e F'A�ik:: f�D
_T� �
� ��. � .�. � t}_�—���—�:::_:—:_:�—ditl��
DESCRIPTION: --
Fi�—�I ii t� i l���ti �. ��1�'�fi
E�ua 1��in�� F�rrE�a.t TY�� '�F—ADD/F��t°1i�QEL
E:u�1����� �w�r�:: Ty�� - F�E—�%�fi�
; . ,
,
, _. - =
CITY a� Of'�tVT1
. FI�"�lt►�E �FF�'CL
� �° . 131a1f��t�t7 �
,4! GEdd �,.�.�
1�`��4 �
� ; ' , . . . �� GErY �i.l5
��t��'�—.�1 ��.7�
REMARKS: . f�C�l�T—�Tt�l+ ��d
- J � ��9.s�� ��?.� t'��t� T.�f:t�3
� - 1.����.'�'�
FEE SUMMARY:
� 4J�iL�ii�Tit��! ��:�,�.�t:y
�:�5� F�� ��.:;,i_ycj
=:I�i'c�'ic�r��e ------- _��.�.��
T��t•�cl F�e ��F•�k.7'�
CONTRACTOR: — t����1 i c��t — ':T. L I�.OWNER:
=�ELA Fi%�r'e�T�}G 1�::�_:_:���� 1de�i� A�IL��tE�#:�; F=::AfHV
:�:�:':ry HE�1t�EF'I iV AVE '� f:�q.�} EALD�J�t FAFk:: f�D
h1I�4�IE�9F'CtL�':_: . �i�I S��d�=: I�AY�ATA a f��! ��:�j��
��.Li� i�.,:.��%���.�i ����'yii��d,
- ,.€`�� #�t�tLgE��� Lft�fEC� f-1������ ;�:���:.���Ht'�'� =_�'���I'_.a:T!_iPd T��e I'i�la:� TI"lE .��FtE.. I M��'�.��'�E���i�•:� I
, : :. .::�'E�-I�F_ A� � °��'w, "(';��t.,;,��:�r���.:.t:..��r��;�,: I i� =:T�°i�:�' Ca e1�1�`L I r�i�!{�� ��:�T6�. f��.�. �.'I i'� �i�= �
�';r.'=..
r� �,.
�° v ��►F;s� _ �t�;�I� t� •E'= ��f�L� ,=�•��,�` `..��'.:;���[�IE:_:i tTf� E:t 1 I LC�I(��; �:��jC�E �`��'.��.�T`�C��t�t'�:'`-.. �
�-�t:;`
„��.� �
C �v /
APP CANT/PERMITEE SIGNATURE l fSSUEQ BY:SIGNATURE
� � CITY OF ORONO - BIIILDING PERMIT APPLICATION
�
Total Fee: $ `T"LA� �� Date Received:
� Date Approved:
. �- .�
Entered By: - Permit�: �'�' � � �
j�T.T. INFORMATION MIIST BE SIIBMITTED IN FULI. BEFORE PLAN REVIEW WILI� BE STARTED
(See Check-off List Enclosed) �
-----------------------------------------------
THE APPLICANT IS: (circle one) OL�INER or CONTRACTOR
� Jos sz� p,nnRsss: (3`�d �r�-1 �� �K �� zzr: �'��`l l
(work)
NAME OF OWNER: �pt-r��i �c 1 �d�C'zw S PHONE: (home) `-{�� • 2.8m 1
MATLING ADDRESS: t �`�U ��''`�-A'2 �� �� CITY: d�nN o ZIP: ��3� )
CONTRACTOR: W- �F� c N PHONE: U Z� �d�b
IKAILING ADDRESS: ��3 ��E"z►� CITY: ' � 11° �S ZIP: ��.d�
STATE LICENSE: # J�C7'7��
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRI3SS: CITY: ZIP:
NAM�: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move �
Demo Remodel/Alteration Renovate�� Land Alteration
PROPOSED WORR (describe in detail) : �1Z�nm�� mV�-°� J ��'i�f�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BBDROOMS: GARAGE STALLS: ATT. DET.
� ��O csc7
ESTIMATED CONSTRIICTION VALIIATION (excluding landl : $ �_
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with �he
ordinances and codes of the City and with the State Buildinq Code; that I
understand this is not a p . and work is not to start without a permit; and
that the work will be acco ance with the approved plan. •
. C ��-�`
APPLICANT'S SIGNATQRE: � � DATE: � � l2 �
_ �
�+I'�"I'� Of � �N�
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipai Offices
0
• _ � � On the Nor�th Shore of Lake Minnetonka
. 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
3.icense 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, s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to process th�is applica ion or
permit.
� ��. � �
1 �A 9 � ��-(/� �i
First Middle Last CI `j"'D r I
�
�Z3'� '�.�,� � �
Address ���� �
On,`,� f 5 �M,"�
City State Zip
� �--� �� � b
Phone
I understand my rights as stated above.
� , f� �
''�
Signa re • �
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ,,
ASSESSING