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HomeMy WebLinkAbout1993-005098 - re-side PEI�MIT f/ CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway • P.O. Box 815 • � � �=�'i'.L�.%I���t� Orono, Minnesota 55356-0815 Permit Number: - - - I.•f 1��_?;-#�-� (612) 473-7357 Date Issued: � � - -- � - :'t a7.r'�"�J�'-!:�: SITE ADDRESS: ,�?,1�_; �!i_,t', «i..r �=��1 �' . I .��d. . �_��.—: 1 ;�—;���:—:�.�_—ir�;�; DESCRIPTION: ��—�,��7F� ���jl1 �.��'! }j�_ �=`?�'}';'{';y�. �VC=_` _��"'(-�i.1LF;t1�;•F(_!lf�i ����i }.f�:r;�� ��_�,~��: �;'f-��= �;�—=:Iix` �:..:�� ��� �;r�u�''.�u 1 1 TI'7!�L-L u��14L 7 i! i t!i lilf�f! �d 1 J 1�1 V�.�V L�V TY V.L ULt7� •VV T:i:r''�'lift�t�i� {+` 1tiL�4�uVVV �Y L�1 LLlT� T�VV �i.iCf•E•' �i i ri'' t11 1�•/1LLf1 iL 11�JsVV t',:i•L'i l�r`_i'i_:i:�i�' 't'f!i i � l�L4L1t � 11!l71Tt\ t L'L' i�%ii+ri:•i i"(�/ii i_rti T�i-+r;i !fC f i 1 V V LVL 1 ltYl !V!•�'T i'}:i i•�t il_•..' V T.•L 7/!s� REMARKS: FEE SUMMARY: s'�=,??1aT I t+i;; �;_ .�:��:;�:� ���_� ��� �°�°�? . i:�Ci `4:t���r1��i����� -------- w:7. t(a; ?"�_�f.cjl F�� ��;1f��,`�itt'i CONTRACTOR: — ��.�,�, i,,,��i+. — �_;�i . �f�: .OWNER: i:;i E3i�1 '� =- X F �ii -�c:, �e- - r• �-� c { _:L_ �=:_ _. E I F�_. _.F�:=: T t�dC: i . _7, _ .::i; =,�;t}'=� ,�}F;c._ ��cL_ _�!i, ��H a:'1�_1 1 � 1 TH Lt�{ ._:"�?�=3. F�►_ _�1�� #�:�:ia�f��,� �:°r:��i�y�=, tit=; �;�.�x:�;:=: r_�����t���:? �t�! �,L;�:1 ,.,�,1��:; :''=,i . .� _ = t:r,i��:}�.;:�;—__�.;: �.. .� �I"v,��{?'-i-;'j; 'i•ii-'} �i-i��-:�` �i(={��!t-`-: t :- i-•F���;`�.i7 �3't s'`':I !�{_! ':i�-:t'� �`,t-'� =t_ ?T°;�'i-�':�i i�-T t�-i•,� ( '- z�-i,.- -E !..L. _.i:i��.._r 'i'�.._. .-- --�--. _. `G. . :f.`•' _. t. ...2 . . . . �e... . . F=iL _ . ._.4_t _. 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J Y, � (.�`� �YLl�i.-�L C�ti �� � APPLICANT/PERMITEE SIGNATURE ' ISSUED BY:SIGNATURE ���� � CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ �� ? y �' • � Date Received: Date Approved: Entered By: .f�11� permit tt: l `f ,� AT,T• INFORMATION MIIST B$ SIIBMITTED IN FIILL BEFORE PI+AN RE�7IEW WILL B$ STARTED (See Check-off List Enclosed) ------------------------- ---�-�------- -------------------� ------------------ THE APPLICANT IS: ( circle one) OAlNER o CONTR.ACTOR� JOB SITE ADDRBSS: � �� � �' Y S r ZIP (work) NAME OF OWNER: ,�� �� rtC !ti EJ ��' S � �' � PHONE: (home) `�?,�- �y 7� MATI�ING ADDRESS: � / �� f v;� S�r CITYz G'-�"��`. c�� ZIP: � � � CONTRACTOR: �j /(��6Ct> � Xy��' �� ��� c', PH�NE: /3 7 - �) � L� MAILING ADDRESS: r� � -�� /�� 7�L �'� CITY: C._�j(i,�� �"�'-L �j _ ZIP: S� �'-�� STATE LICENSE: � �� G C ,5 �Z �J ARCHITECT/ENGINEER: PH��� MAILING ADDRESS: CITY: ZIP: gAMF: REGISTRATION � TYPE OF WORK- New Addition Accessory Structure Move Demo • Remodel/Alteration Renovate �- Land Alteration � PROPOSED WORR (describe in detail) :_� / �, `=/ � �a�re 4,.-., /�� .7�-, . � STORIES: SQ. FEET OF EACH FLOOR= NO. OF BEDROOMS: GARAGE STAZ�LS: ATT. DET. ESTIMATED CONSTRIICTION VALIIATION (excluding la.nd) z $ ��� QC?C: . �r' I hereby apply for a building permit and I acknowl.edge 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; and that the work wil 1 be in accordance with the app roved plan. � .=�� , �� DA�: �i-�y y� APpI,ICANT'S SIGNAZ�DRE: �- R � • ~ �. 'n=J� �� _ � �, ., _._ �� ����� - � �.�� �..i��� ���t�r 01 : Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices • s _ � o On the North Sh.ore of Lake Minnetonka DATA PRNACX 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 license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: l. The information you furnish will be used to determine your qualification for the permit or license 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 local , s�ate or federal. agencies to the extent necessary to process the permit or Iicense. 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 ful.l name is required to proc�ss this application or permit. � ��/ �,�. � �Gl �'I � u � l � .�✓l���-.� � v N First Middle Last � � � � �j� ��� �� ���J Address �� c� �, ���'��S �� �5��� -� � City State ZiP ���- ��� �, Phone I understand my rights as stated above. % l%' - ;:�=; _ � Sign re � � i BUILDING&ZONING—473-7357 • ADMINISTRATIOIY&FINA[VCE--i73-7358 • PUBLIC WORKS —473-7359 ASSESSING