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HomeMy WebLinkAbout1991-003601 - re-roof PERMIT t � ' �F ORONO PERMIT TYPE: �:n Rd. South • P.O. Box 66 Permit Number: �iiil,�;i�;�,���' Crystal Bay, Minnesota 55323 Date Issued: ;,;_;;��,;i� (612) 473-7357 SITE ADDRESS: :�t�.i)S c€"1:_�i L(=i�-::E :_iT _T�, €�'. I . id. , i:i�,-� 17-:F:'t,-�.=;-�:sCs=:;= DESCRIPTION: f;E-f;+�i���� E�U: ldl.il�� �'�t'•fii3.'� Ty��� '_:i=—Fi:'iJ<`}i�s'f��+�'��_ E�t.�:il+�iii�� �,l��l�r:: �;���� Fs�—Fiir�i_j� � � . . . L.N. - . �_A:L� � .. �1.!Y7'!lTLL 4'!`1L1Li � .i.,:��vn� n ='Cu - �r� � � � . � . i.%l LLn �:. =�v - �� ....._ ... .. ._._ .. i. ... .:;�sy �r ��:`�::...:'i.•�t2� n t.t .. .. i 1R11 iMV r:6.t2' �{j r'r fif i'.AJ�!\ tL �...�.r+ltl .� __.�( �. _:�i:fh'� �'�fi: f�.'�'�,C'!�:!!7'^7!T!'L�'C� REMARKS: �t;<<�::`�:;� ,_�:;;'.;° �;',i� �;�::;,; _,_. __�.. ;� FEE SUMMARY: !:�iL�?�,i t�_��� �i ���_��:� ���t��L ��� �';_'� , iiC:; ���i.�i'r�..��i��� �.��;t� !;��t.M l ��� ___-----�,1-;, �i) CONTRACTOR: -- �����1 1=-11 t L• "— OWNER: i���tR i� '.�:F-i���Fi� Fit�tt=t�I h•Et� t� E:�i.:c f�.71'=�f��. i ii�CinE�c v`f L�CE��I)4I�_� ::��y�=�� hJi��;7,-i :=�?-I���r#� u i 1�,i i 1 �alc'=:T {�li=i i.=i=sTi-� E:�4'I� I�i�t 3I��ID ��i�i ��=r,�. L��i�li� L��::c fh�� ��;:�.;r. �:�f��:� �171-'_i i���. �7=�-`a�.�'=�7 ---- ----------------------_-------__-_______ — ---------- '----- --------__ ____ ----- _.i t... _. ,}. . .r., � 'r�r�r':•:; t--. - �:E � - r�:�- ''.,`t��� ���e - ttr• �- -�-� e�:��r:= r t r�i- -•t fr�• y !rf� t}34L+�F1:�,c,Eij�;��L+ t'I�f��.i'•a fl�.��t i����1 �� f"��1!'F�.r�:���i_i3'� i I_.� i'fl��'�.C_ ! �"i� T.��"t-FL S I!f'F1�_�'•,C_�=}r�4} :: � =��"�C�_�:�" 1''",.._�1 1-�Iti�� Yi���''•.i"_u:.�_� Ti.t U�_t (-i�_7� ��.t��f;i�•. i I�� _ '�f:1�_•� _•i_I`1�3L T 1-13�1�_� �31.i. S 'i� P�t1._L �,i�tT �_i� - �...,r,f.� t� -r,; - h . ��_�_. _r_ ir . �. .� �•.�: e T Tt _•' ',r' [�, '! 'F�.��.. i_it't�iI4{_� �_�P'4l.1'.!.{��?=il4�..•z�_� P�F4ii :�.�..Y � t-_ �_Ir �'t_i.i'�l4�..��Ij� F-{ ��t�l.�l�?].f��'� {.•�_I�,±L F"�i:_is�c��l�r!�C?��_� _ �� !� � _ v�� <<�� PLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE ��— CITY OF ORONO - BDILDING PERMIT APPLICATION i ' � Total Fee: $ Date Received; j Date Approved: ; Entered .By: Permit#: --� ��' / ; ; ALL INFORMATION 1KDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED THE APPLICANT IS: (circle one) OWNER o CONTRACTOR � JOB SITE ADDRESS: � -S ya � ,L � C�G�e � Z I P: (work) � NAME OF OWNER: -r-i,� is ,n_ ��c-�e v PHONE: (h ome) ����-5��7 c , o.i z�t r/ � CITY: ��r.,c ��,�e ZIP: i�S S'�� MAILING ADDRESS: /L O/ � L� � / �{ � CONTRACTOR: 'o S.,o � � o�, ,�-- � ,L�c �� �ors � PHONE: y7/ - j/��/ r MAILING ADDRESS: s�� ��-_� a .� i,, Sz CITY: /�c-�v��� ZIP: �S� y TYPE OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORR (describe in detail) : .� � � c�o STORIES:�_ SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALDATION (excluding land) : $ �/�� � I hereby apply for a building permit and I acknowledge that the informatio above is complete and accurate; that the work will be in conformance with tr ordinances and codes of the City and with the State Building Code; that understand this is not a �ermit and work is not to start without a �ermit; an that the work will be in accordance with the approved plan. APPLICANT'S SIGNATQRE: --4�j - r'= DATE: 3 -� / (Pleas fill out the reverse side of this form) � ' 1 4 � e � IY'��� c�F.�� .�'V . :9]��£ ,3, � �.��!P6 �Y���;t����t���, C ITY of ORONO .� � aE * 4': ����� ;i '.� -�� � 3 �� '� "''ry''` Post Office Box 66•Crystal Ba Minnesota 55323•Munici al Offices �;: �.F� _,*, Y� P ,-��``t,s�� sti��� ..��:.,����.�, :: i�. ..:��'*e,, On the North Shore of Lake Minnetonka DATA__PRIVACY ADVISORY In accordance with M.S. 15.165, "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 wili 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 shared with other Iocal , state or federal agencies to the extent necessary to process the permit or Iicense. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 15.165 to review private data on yourself . 6. Your full name, and date of birth are required to process this application or permit. / � d�..f�'��'C_�. _- _ ��-c ��_r�l _ �--�- - -- �--- _._. ,�./ _ _._ - _- --- � First Middle Last �7� 7 l/ ��cz r�- /��! U -� Address � ���� y--- ------- - ,l��✓.�.J [� City State Zip �i/- 5'!2- � - --- -----__----- Phone � I understand my rights as stated above. l-� _ ___._--__ __- - ------ ignature BU[LD(NG&ZONING—473-7357 • ADMLTVISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING