HomeMy WebLinkAbout2009-00335 - tent permit for wedding recep ` � � CITY OF ORONO PERMIT NO.: 2009-00335
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 07/02/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1725 BOHNS POINT RD
PIN : 16-117-23-22-0006
LEGAL DESC : AUDITOR'S SUBD.NO. 349
: LOT 000 BLOCK 000
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : UNDEFINED
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 0.00
NOTE:
TENT PERMIT APPLICATION FOR WEDDING RECEPTION ON JULY 18,2009.
APPROVED BY FIRE CHIEF.
APPLICANT pERMIT FEE SCHEDULE 25.00
HONOUR,MR. &MRS. STATE SURCHARGE(VALUATION) 0.50
1725 BOHNS PT RD TOTAL 25.50
WAYZATA,MN 55391-
OWNER
HONOUR, MR. & MRS.
1725 BOHNS PT RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permi[is issued shall be performed according to
the approved plans and specifica[ions,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not gran[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 with the State Building Code.This permit may be
revoked ja any time for due cause.
C. rn�+%�-�� �d �I b� �� � 0
Applicant Permitee Signature Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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` City of Orono
' Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
� Mailrng Address: Permit number: Q� '��- � ,��J
�,L,��� PO Box 66
� y:\ Q `� Crystal Bay, MN 55323-0066 Date received: /7�O�j
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a ��4-�;` �, i StreetAddress: Received by:
��'�,n�� ° �� �ti� 2750 Kelley Parkway Plan review fee:
�.rf�og,w Orono, MM55356
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— Total Fee: �j�—�D
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �L �
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: �z
Job Site Address: �7�S C�o(�r�s �U;✓t� �60�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �D
If�res, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ill be
� required unless applicant demonstrates sufficrent on-site parking is available. Non-permitted events will not be allowed. �
CONTRACTOR/APPLICANT NFOR ATI,ON•
Name: rS� cl��V1�� Z �1'� cMS�
State License# Expiration Date:
Phone: 2, g . S�,755.7q efifi��) _ (� cell
Mailing Address: (,{ � o� S��a Cit : S ---ZtP- —�fj
Contact Person: b ,s�S Applicant is: Contr ctor / Homeowners �c r�ie o�e�
Email and/or Fax: r�y�� �` , C ���P'��u:e-
PROPERTY OWNER INF RMATION:
Name: �� Q,�b� c��v�l�°� �a�r
Phone (day): �/S:f�� !�?,v - � I �3 7
Address: �'7,�� (��, 1�1� ���I City: ��'�No ZIP: �S ,��J�
Email and/or Fax
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PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits
❑ Door(s) ❑ Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration �ther: (specify) Phone: 952-471-0590
❑ Re-roof �-- y�'�(`��� Fax: 952-471-0682
❑ Fire Damage �� � www.minnehahacreek.orq
Overall Project Description: �����:fe`
c�� �� c..�r�� ��r= � �' C�e��c� �,���, � ��✓�.r �<�� IrS�,e�
Estimated Construction Valuation of Project(excludi g land) $
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the
data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Ou�
purpose and intended use o this information is to annually update our records and records of other governmental agencies
re uired b law. If ou refus t su I the infor tion,the a lication ma not be issued.
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Applicant's Signature: V '' Date: �/�lp �
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Las'.Update� 0�-04-20Q9 �