HomeMy WebLinkAbout1993-005577 - tear-off � .
PEI�MIT
CITY OF ORONO PERMIT TYPE: ;:.,:.;�; ��s t r:�,�
2750 K211ey Parkway • P.O. Box 815 Permit Number: ;���,:;��,;;� � �
Orono, Minnesota 55356-0815 " � � � -
(612) 473-7357 Date Issued: � F-y;`i;.L:'�a_;
SITE ADDRESS:
:'i��i_;'� i_:i:}'.�;�_iri =`E��i!�! �i�=
i{-;
. . . . . _.. . --i : �—�_.�:—��.�•.--!:4_?�.r_�.
DESCRIPTION:
. ._. i3: _.' '
L�}s i I i 7 t t�r; i`{�1'!'�i 1=•r ! `,i';� �+?e�:�i�ti��:��i�j°�iM<�J�L
i kyi
L;1.j j 3 i;!'f 'i:�j �tR,3�..+[�t:; � w'�:�t� �i�_.._s_t,:1�'-
� �'t - ..... �.
:'t,
.:t `
. . _ .... �. � -_k: . �
. .. ... _�7 .
� .... � :.11L1:�` �. . .... .-� .
--,T'
. . ' ' '�.j_S';t
. . � - .. ..._ I l.'.. .. ,_
REMARKS:
FEE SUMMARY:
�;,::�+ ; (• "i� 1 '�° :i'ii"'s
is_•:E-?�i .:�. �:::.� - - -
._. ;,..s.... 1-_- `�s�t:.';- . t_p(^i
����!'�"�!'i�:i'�;�� ---____ '`? • 'y�—"
_.,�:—
;�:��i.y� ? �E'=+_ �:-}C , u,._''
CO.�yTRAGT�F3: _ _ . , T �'�'`'� '�y.�''�. �_ OWNER:
'. ._. S T. .- -,i_.i�_'_- �it�t� _ 1:_'FM.!�:V„_, _.�"i'•_% 4 . _.. t_.^�:�...
_ ._ . .:. E �'#�t��:tai_I!_iE� �:�f'd�,� ,:_i=''= _ {•(-_•-'{--I_t �!�'j�•'� '•�}
�•i.Z�.(Vt..; ' t°i�:l '.'f_`,.n�, �L4i r'i�: k'!-� i:'�i•.� �..�_l.'ij�i
�.. � �. . _. _. �. t}i^ . __ f _. _. _.
. �'.�.... . . . a..�rs�,.'•..'! .'_ _ .:_i,=i
._.._ _
��-;L:: I}2`,=!;i-�;:�:�3 t_:;:�' _ _ _" _ �iG;•".f: "' :�r Y� _ ;f��,: - -- -•-��� "' s�;ir:<r - ;iL:' `_ _
_�, . .....
ti-.a . `•.•a ;-;;-==�t'��. ..� ..__ . _. .`"'{'�.. ._ _ _. .. _.� . } i_� . .. . .__ . s��. . .-'-�'=- -• '•' {fbF �
-, ;�` '
t ��
. . .:.._ -.. .�........ • _z; r . :�� ._. :. � . , , �.� � � . _. . __ __ . . _.
_ ._.._.. . .__. .���.
. -�,`�-�;y. I ; i f_t F .;;''+ �':�,:_�t_r..._,� _i�.i� ;J}; j s ���I � :'t:�� i'�;j�fi-`i :i;,`;_; rt T ;ry r:�j 1 i' _:iy
_ __ _ _ i-;i•.:.: =a�__:,.._...._. _. _ ._ . .....__ `r�_ ':t�. .L I'•-, _ . . _ . _ ._ . �_. .__ . s . . ..._� _ ._ . .
! i�:t;;'vi i 4 . ,r,� - "eE:€I -_ :r.:;y 1'iF�� :�' �il`:: �,I'; l f`; •�i:i r.F 1 ' ' E� "lI''-. i}' - •f.?�-T'.i : .
_.�"`._.. ._ �•.:: _ _ . _
r • :. .; , . , y ; . ... �:
_�5;_a_,t:r;,;:_..:_. :-;:'d�... ��• . . . . _. _.. . ..... .1 .__. _ . . . � _ _._...L :.. .._ _. ..�l.?._. . ._,_, €.�i:_. .__. . . ..
L �
�
APPLICANT/PERMITEE SIGNA URE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
s �
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit R:
AT•T• INFORMATION MIIST BE SIIBMITTED IN FIILI, BEFORE PLAN REVIEW WIIS, B$ STARTED
(See Check-off List Enclosed)
--------------------------------------
----------------------------
--------- �-�--�----
THE APpLICANT IS: (circle one) Oj�7NER o C�ONT__RACTOR
� (:��C:� � �-,�1 5 C f"' �%�. /�L� z I P: ��'���c� J
JOB SITE ADDRRSS: �-'
(work)
L-F't� � L C1 �/ / 7� ' PHONE: (home) 7 7/ - 7 �7S
NAML OF OWNER: ...> C � � �
MATLING ADDRESS: 2C��� L�S'CO �f , CITY: W�Z��,� ZIP: 5�� --� �7 )
CONTRACTOR: ��,j � S�� � �" �-� �-=�r�S� PaorrE: � 7�- �S`3�
CC' � � / �/ Z IP: S S _i �-- /
MAILING ADDRESS: J 1 7S �-i ivG��J,D ��✓�CITY: �'n.L ��--T-
STATE LICENSE: # ��"-� �'��
ARCH2TECT/ENGINEER: PH��'
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alterationi�,� Renovate Land Alteration
7 -.1�
v-� (> .-� �-�-,�_ - J.
PROPOSED WORR (describe in detail) : `�'/�^-
l �
- �.c,�'L �� ���f—
STORIES: SQ. FEET OF EACH FLO�R:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
_�,-�
ESTIMATED CONSZ'RIICTION VALIIATION (ezcluding landl : $ �
C� �> --
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 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 wil 1 be �in accord�e with the approved plan.
,�
C ��
� ATIIRE z ��.��� _ DATE: �� �
APPLICANT S SZGN
- �R;v: � " � »
��� �� �
�
� xi . CI'�I' o� �RO
:�,�
�:
' � � Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
!
� _ � � On the North 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
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:
l. The information you furnish wi11 be used to determine your
qual.ification for the permit or Iicense requested.
2. You may refuse to supply data, but refusa3. may require that
the City deny the permit or Iicense.
3. The information may be snared 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 ac�ior.
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6 . Your full name is required to proc�ss this application or
permit.
�
'� . f�� ��2 L�� _ _�� � ;
�
First Middle Last
�
S�i 7 s� L.�- �ti �L��� n /S L- ��-�
Address �
i t.. r--% i'� r—.J �� � S' �1
City State Zip
�� �� �- � �_� 1
Phone
I understand my rights as � ated�, abov .
�
l �.
Signa ure �
BUILDING& ZONING—473-7357
• ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G