HomeMy WebLinkAbout2012-00646 - tent ,
CITY OF ORONO * 2 0 1 2 - 0 0 6 4 6 *
2750 KELLEY PARKWAY DATE ISSUED: 07/16/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4355 CHIPPEWA LA
PIN : 31-118-23-42-0020
LEGAL DESC : N/A
: LOT 000 BLOCK 000
PERM IT TYPE : ACCESSORY STRUCTURE-TEMPORARY
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : TENT
ACTIVITY : O/S BUILDING- UNDEFINED
VALUATION : $ 0.00
NOTE: DATE(S)TENT(S)WILL BE UP: SEPTEMBER 1,2012
SIZE OF TENT(S): 40 X 100 FEET
APPLICANT PERM[T FEE SCHEDULE 25.00
MIDWAY PARTY RENTAL TOTAL 25.00
600 KASOTA AVE S
MINNEAPOLIS,MN 55402- PAID WITH CC# 5576
(612)238-0641
OWNER
YOUNG,JOHN&LYNN
4355 CHIPPEWA LA
MAPLE PLA[N, MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State I3uilding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance wi[h the State Building Code.This permit may be
revoked at any time for due cause.
/ / �� / /
Applicant Permitee Signature Date I sued By Signature Date
SEPARATE PERMITS REQUIRED FOR W OTHER THAN DESCRIBE A E.
,.�r=�"p`�`�.� City of Orono FOR CITY USE ONLY
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'� � ' Crystal(3ay.MN 55323 ����� "�'
��t�1�������� Phonc: 952)249-4G00 Fax:(952 249-4616 Pcrmit Numbcr v�Ol p2 00 (,�.��
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CITY OF ORONO - TENT PERMIT
(All tenl pernrits must be approvec!hy the Fire Chie�
Tent Information:
Date of Event: G � ` �-- Size of Tent(s): �'�X ��jb Number of Tent(s):�
Does the tent have sides? No Yes�
Please inchrde Fire Retartia�tt Informatio�:from the rentnl cvmpany for tent(.$)AND a Skc�tc/r
or Drawi�r�of w/rere tfre te�it wil!be located at the nraperty along►vith this applicalion.
Owner(nformation:
Site Address: "I�JS S CYl�fl(�'VV 4. �,���',
Owner: � �10�'C1 Mailing Address: �3�� C Y11�DC�WO� 1,.�'�� .
City: M���\� ���\`t'� Zip: �jS�j��
Home Phone: Alternate Phone: �-t�2 — 23 � `" (�q��'
Contractor/Applicant Information:
Contractar/App.: �l\t U�[ ;�l ��(� �P�'Contact Person:
Address: 1���.0��D�Z'a �-VC' �� City: �\'(��[1P(�V7u\� \� Zi ��� �
P��
Phone: �a�'z� 23�� � �� Alternate Phone: \D�l ' 2-� �"�' ���
Fax: Emai L• �(0 c�S ('.v M�1w p����l J-h��CP(l�l�.�. ��M
.�.�
1 hereby apply for a permit and acknowledge that lhe information above is complete and accurate; that the work will be in
confortnance with the ordinances of the City ofOrono and the ir ta Fire Codes;and I understand this is only an application for a
pertnit and work is not to start wilhout a permit.
i 2
Applicants Signature Date
--��--� ______�_Z _���_/.�_�
P rmit Approved By: Date App oved:
Reset Form `�aiPaiutOSt°""'
Driveway
S
i Neighbor's House
d
e
R
0
a
d Parking
Garage
Garage(used
for catering)
House
4355 Chippewa Lane Extend- Tent Space
ed
Drive-
�,ay 40x100
W
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oCeremony Space
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I['ance Barn (cocktail hour and
Floor dance)
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�' REGISTRAi'It�N Q =�c� �SSUED BY Date of Shiprzaen4 5�
� s �`;�0�:� �rzsizooa
^�. NUMBEF3 > iNousruies wc- 5f
S5 �
rF � � EVANSVILLE, ENDIANA 47725 Tent Identitication ��
j � F140.1 � � � MANi1FACTURERS OF THE FINISHED �
oa6rzos �
TENT PRODUCTS DESCRIBED HEREIlJ v
� This is to certify that the materials described have been flame-retardant treated 5
5 (or are �nherently noninflammable) and were supplied to: �C,
5 5 582193 Lj
MIDWAY PARTY RENTAL INC
5 2110 GILBERT 5
� SAINT PAUL MN 582193 5
5 5
5 S
5 Certification is hereby made that: 5
5 The artictes described on this Certificate have been treated with a flame-retardant approved S
5 chemical and that the application of said chemical was done in conformance with California 5
5 Fire Marshal Code.All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5
5 Serial# g044800(1) 5
� Description of item certified: 5
� FIESTA PLUS HULE LND 40N'X20 �
SNYDER WHITL VINYL
r�5� �lame Retardant Process Used Will Not Be Removed By �
�5 Wa�hing And Is Effecfive For The Life Of The Fabric � 5
��, � SNYDERNIFGNEWPHiI.ADFLPH(A,OIi Signed: —�---� � (�SL�y�j ,�
{ilf � Name ofi RppEicator ot Flame ResostanY Fir�ish f pi�GHOR NM�IDST�EBES�NC. ,�j
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