HomeMy WebLinkAbout1994-006183 - replace patio door PF � �1l�IT
CITY OF ORONO .�.., PERMIT TYPE: V _ _
2750 Kelley Parkway • P.O. Box 815 '� `��` ` �`'��
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Permit Number: _:;.�,�;�;:_;
Orono, Minnesota 55356-0815 � Date Issued: -�,;� ;�,;•,��
(612) 473-7357 - -�• - - - - �
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: �-- r��;��;=�i i�_:��:t�. - OWNER:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO °._��--�„yI DING PERMIT APPI.ICAT�ON
Date Received:
Tota1 Fee: $
Date A�nroved: �
Entered Bv: Pe�nit� - __
AT•T• INgORMATION MIIST B$ SIIBMITTF.D IN FIILL BEFORE PLAN RE�7IEW WI� B$ S�`�T�
(see Chec:�-aff List Encl.osed) --------------
� p,ppLIC�NT I5: ���rcle cne) OS�ER °r CONT_RACTOR
: . ZIP: _�.._
JOB SSTE ADDRBSS: `� � �
(work)
�'T �n/ �1�� N�N PHONE: (hcrite) �r�n `i��/ -
�AME OF OWN`�: O A�
CIZ"Z: (, 2�N� ZIP:
2�..ASZ�ING A.DDRESS� I�1y'C �Ga ��0" �
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• ,---� p$orrE: Ll� - �1'�2 � —
CON�RACTOR. �
� �c cz�: �� c l��i�o zzP: 5S 5 l�
MATZ,ING ADDRESS: %5�`i� ��&'C�__.n�,c r
STATE I.IC�.r'NSE: T / � � t —
PHONE=
ARCHITECT/ENGINEF.R: � �
�/ - CI�•�,z ZIP:
MAZI�ING ADDRESS: �
REGISTRATION 4
NAME:
riove �
TYPE OF WORK=
New Addition Accessory S`yuLandeAlteration
De�o R�*nodel/Alteration-.-�: Renovate
\ ()/�`� Qr ^�� � 1`f 11��ec s w i�1
PROPflS� WO� �describe in
detail) = � 1 4� �,�r��'J,ti�T- ' � -
� � '+ ' v • �
�� � N� .F�.,Y-h � �
_. ______ __
T aF FA FLL30R: _..___ �.�
. SQ. FEE __ . .
STORSES. �--". _ DET.
���� gTAT,T,s. ATT. —
NO_ OF BEDROOMS:
�--� � , �
ESTS�SATE� CDNSTRIICTION VALIIATSON (���n�g lan'd� W i eQ e that the inf o�ati on
I hereby apply for a building permit and I ackrzo g
�z the
that the work will be in confo�Code;aithat 2
above is complete and accurate; and with the State Building e�it; and
ordinances and codes of the City
understand this is not a permit and work 1 e approved pZ� ithout a p
that the work wi l l be in accordarsce with t�i _ _ ___. __ :.
��
�'� DATE:�,. ,�� ��- iyyy
APPLIC�.NT'S SIGNATDR.E s
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�-� � � G���" o� ����"�
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Post Office Box 66•Crystal Bay, Minnesota 5a323•Muaicipal Qffices
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On the North Shore of Lake Minneton a
DATA PRI�7ACY AD�SORY
"Ri nts of subjects of
g
In accordance with M.S. 13.04 ,�Subd.ou` reQuest for a per:nit or
we would Iike to inform you `h o f its depart:nents may reQu�re
data" , o= prono or any
I. '_cense f rom the City , ; n=or*nation.
;rou to furnish cer�ain private or coniident�al
vou are notified tnat:
1. The information you furnisn
will be used to determ'ne your
qualification for the pe'-'�i� or Iicense �equested-
2, You may refuse to supply data,
but reTusal may require tnat
tne City deny the pe�i� ar license.
be snared w�th other local , s�a�e or
3 . The infor:nation may to rocess the pe'-�i� ci
f ederal agencies to the extent necessary P
?icense. , .
� Pe,-;nit or iicense re�ires Counc�l ac-'-or
d. ;L your recues�ed become DllD11C.
`O zpDrOVe� some insor�ation may .
You have certain rights under M.S. 13. Od to rev=ew griva�e
data on yourself.
6 . Your ful.I. name is required to proc�ss this apol=cation or
per.nit.
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First
:� � �� F«n A
AdGress
,�N �S�?
�1c� � fi � State ZzP
City
�"? ? �1`�'2�
Phone
I understand my ri�ghts as stated above.
-<��%'l F-�/1� ._
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Signature
�UILDING&ZONING-473-7357 • ADMINISTRATION&FiNANCE-�73-7358
• PUBLIC WORKS-473-7359
ASSESSIN G