HomeMy WebLinkAbout1993-005009 - re-side/garage doors PERMI� �
� - �TY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: - - '-`-�- '� ��
Cr stal Ba , Minnesota 55323 ���=�''�"''���.
Y Y Date Issued: -
(612) 473-7357 . --.' i'�1:'_. _.
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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� L�CA T P RMIT SIGNATURE ISSUED BY:SIGNATURE ✓ _
� - � CITY OF ORONO - BUIZDING PER�iIT A.PPLICATION
, �j�? ��' Date Received:
Total Fee: $ - / � -
Date Approved: .
- ,'�� .,�' �,
Entered By: �-- � ' permitn: -_>IJC�' �
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AI�L INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW W�I'r' B$ STARTED
(See Check-off List Enclosed)
-----------------------------
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TgE APpI�ICANT IS: ( circle one) OPlNER or ONTRACTOR
` _ ZIP: `� `-' ���-,
� JOB SITE ADDRSSS: ���� t`� ���=� �T
�--C`,��� �,;�-�_� (work)
�� ' PHONE: (home) �-�-�S- �c�-�•L
NAME OF OWNER: I� �t�t-' = C 1- '�.� ��',����-T`�c r�—
_. . �__--� �
MATLING ADDR.ESS: -��l l r� (Z x `�C , _ CITYs � t��'C� �,+? � ZIP: , � ,� �_
, PHorrE: 4 I� - ��-( E•`=�
CONTRACTOR: Li.-t'c� (��'��,��(.�C(� ��"�
MAILING ADDRESS: 2 ��I 1 �� � �_��1�-� I� i�7 CITY: `� ��f c`i��-1���'C�CI�� ZIP: � 5 3 `' (
STATE LICENSE: # �-��`� �
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITYz ZIP:
TIAMF. REGISTRATION T
Addition Accessory Structure Move
TYPE OF WORR: New Land Alteration
Demo Remodel/Alteration Renovate �'
PROPOSED WORR (describe in detail) : ��`-���'��'�-�- 1� (ST� �' ����i�"�' �
� -�,��t�� C 'Z�•�S � ���_�'�-r��: � 1.�� (vCc.v L L�'c�' �.�L��---C. �� (�,�-z`.
�. ��.�'-�-�c� c- �c'� 'w�' S .
STORIES: SQ. FEET OF EACH �I+OOR=
NO. OF BEDROOMS: GARAGE STAI�LS: ATT. �� DET.
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ESTIMATED CONSTRUCTION VALIIATION (excluding land) : $ �� C1' 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 Co er�it aand
understand this is not a permit and work is not to start without a p
that the work wil 1 be in accordance with the app roved plan. �
„ ,-- '��L, ���-L�CC DATE: ' �- (c�"-C��
APPLIC�NT' S SIGNATIIRE: -- � y �t'
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�� � • Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
s ' • o 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
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 Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or license.
3. The information may be snared with other Iocal , 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��or.
to approve, some inf ormation may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your full name is required �o process this application or
permit.
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Address
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I understarld my righ s as stated above.
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Signature__ . �
BUILDI'YG&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
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