HomeMy WebLinkAbout1994-005908 - tear off/re-roof PEI�MIT
= CI�'Y OF ORONO PE�RMIT TYPE:
-:::,� �5�r;t�.
2750 Kelley Parkway • P.O. Box 815 Permit Number: ;.ti;;.;;.,,:�:°,; ;
Orono, Minnesota 55356-0815 - - - - - -
(612) 473-7357 Date Issued: _;^;,;;-�� ;�_a�
SITE ADDRESS:
,__'k_.• f_'.i i�:_, ?�i i`}:,� ;-��;��
.4�:
"•.C:__; i" - _ -
DESCRIPTION:
t �Fif'[ 7_:�: - ____i.i��.��_.;�'.. .
���11+�I�;;� �'=i'�iil' ? ;�'���� _�--�=�!_'ij�'{'�i"�'�i_F;;�1__
�:�`t.?1 �l�i!"i'� L;i:'s'��: � �'f'� �:?'�_..C•,'�„3I_E:-
i"�i i V i�C t si:�:'sii:
tr1 I / L�f L�t1VliLt
I i[�!'71{L�L L�li1r1L��
T tt�:'+.+tflrSflrZ �i
1�J 1+11 1'1.�V V V }7
?!• ! L�! f�f�
V1 1]L!t �,lT�1L•
!�j-;:;:r}{}t{rSi! is
1LtLa'�VVVVV 71
f!'� !=A� � ht'
tti L•Ltt 1+T!
!'!1: �' Tt Pr 4:
L•l144l1 - !L L�:'7!
f�Cr�L'7��T_iuJ'��i• Ytiii
11LL•L1t 1 ffI1TlTf�• f VV
:4`:��14 'I� t�f'ttre [i�i ''�a•'t'
!7i!L•1'7V L�.��!1 ll�.�l f 1�J•V t
!f!fi f 7 'L+:i
Vif Vl!!'7
REMARKS:
FEE SUMMARY:
�:��!�_����'_��:�; �=�� .�7�=
�:.�.__ ,-�,;, �.�;:� . ;:�t;
;. .._ � _ � ,;;,
-.1�;•r;-a_-t)'�?r� ------- s.� ...-,
!s_�'�._;�, t"�,�,_ �i;`'` ._
CONTRACTOR: � � :=��= 'i=������ � OWNER:
,-�.:..;-�-;: a p.i..., i.�,_�.T: r,— - -�r����-� — --�
_. .._ . . . ..��` . .-- -.. _�y t� ?,. , _�;.�._;'_t �_..._.-.. . . . : i `i"t;
L_,:.., - i�li:l�—:.—�;3� ;Va� ��� - — — — -riFTC� +�i3i:_
...._ . _ I.._�Y: : _+�.: � V a__ _ �_C�.(:_`=� F t L L_:�:� :"'1 r{_»
tf(t�i�i;'-�S� �.�V _�._7.'��'.:a t_�(1�{_}�i��_�F �i:�':� �..�''�f'..,Cy
�' ...'�'_ :. ....� ... ._ . . ��- . .,
�i�;`,' i ir.'!_!C:t.'��_='!:�e..i�. �..s _V=' ' ' iC'�_ t� �L.i,.r ' ' ' F:: ' "3 L.:[_,,' C�' '.7 " ai�..'`'' . .'r:'j_.i 3�=�'
� , , .:,, i-• .i•; - � �"�=.: i ; F�:� .FFs r;sl�.,` , t.
E . ::_. •.r` .1?L...�....'.j. .... ........ . .�.�?t.. .' ! �_.�. _ '"'�'!! ... _._ . ._. _ .. _. ...i't . _. . .. . ._... . . !L-. . . .L.. _.. .. _. . _... "' . . _.
' � } r- '� - � �.� :#�' -, - - - ;-z i j;'! �,f�;i�:.� �� - - *{-' 1 i;-iF-`i ;% `•:�(_; ir:i i; �_, ..,; :-i��
�. ,_... ._. i`:_� . .�'�_ ''c. . '.C_'_+ I•., ._ _. . ._� .;,:s:. . _., . _ . �'•'.i _ . _ _. .. .__� i4i_?� ., _ : . . i•i'.._=``_._ _. s ' . _:
�
' r':;-:=.a;: - r_._.,
:� �_ .�." h•:.. . = v._ :t " "'i i tj... li 3 �iL..�� _ i� t��.: _ "i� . :— '.P� dsE...�'."I'�V.
_�+•;� :�y._,c t..:�z�}_:V��-i.�•_.•s...._. i�i;;i�_F _, . . e E .,�_ _.. . ...(ili,�f..._. _. . . . _. �1.t_L�..i�K__ _ _,._t�. I-:��_i':j...�':"�<. :f._:1 t
� _ .. . �
� � �� ���
APPLICANT/PERMITEE SIGNATURE ISSUE�BY:SIGNATURE
w
_ ~ CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Bate Received:
Date Approved:
Entered By: Permittt:
ALL Ir7gpRMATION MIIST BE�S� Che�ckD-off FListBEn�close� �VI� �� BE STARTED
------------------------
THE APPLICANT IS: (circle one ) O��INER or CONTRACTOR
JOB SITE ADDR.$SS: ZIP:
(work)
4 J, PH x�:: (home)�� S-`-'7 I �
, �� _� p
NAME OF OWNER: ��f; � ��l 1'� -��-- � ,�:.:�jl-�>��,�
MAILING ADDRESS: �-�J ;� C',iZC_=S� v� c.�ti.J CITY: L�-''��` ��= �'1� �<< ZIP: SS � S" �
CONTRACTOR:�� ' t JI�'� I�M^t C.-��'����' C�'�-�J PHONE: ����,�-- ��-� j
MAILING ADDRESS: � `% �� L i G 1,' "L'���i�
��(��,� CITY: ���„! )�,�����,_ ZIP: �S _��
STATE LICLNSE: # �`� '� ��'`��)
ARCHITECT/ENGINEER: pg��
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTFtATION tt
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration_`T Renovate Land Alteration
,- _;__. .- .{� '.� _
PRO
POSED WORR (describe in detail) : \� � �� �. � ' �` � \� � `� �� �
STORIES: SQ. FEET OF EACH FLOOIt:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
� _�=-�
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ Z� �� � � ^
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; anc3
that the work will be in accordance with the approved plan.
` �,i-� (� \� ' l DATE: Z I (I �
APrLICANT
'S S I GNATORL�: � �.��-- _�;��
�
V
r 1
�*..:t.�i��M
�`��� ` C�'�Y o� OR�IIOTO
, },;
`�.� __
��: ��,
Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
!
� _ � � On the North Shore of Lake Minnetonka
DATA PRNACY 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
Iicense 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 wil.l be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to supply data, but refusal 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 public.
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 appl.ication or
permit.
i
' , ���;�� � � .
'�j�l�,'Z, � �, �_���
� I
First Middle Last
�� �l � � �/������ �� i� � L�.� i.��
Address
� � �� �-,_ /
� �' 1 � � r� 4 � �� � ��� ' ' � �" �f
City State Z1p
� �-� � --E. c- .� �j
Phone
I understand�.�ny rights as stated above.
� / � 1\ J��
� �, �--�,�,> _
Signature
BUILDING& ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING