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2010-00142 - accessory structure
CITY OF ORONO PERMIT NO.: 2010-00142 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssUEn: 04/OU2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 525 LEAF ST PIN : OS-117-23-41-0020 � LEGAL DESC : STIELOWS ADDN � : LOT 012 BLOCK 001 ;. ��,� � PERMIT TYPE : ACCESSORY STRUCTURE� � PROPERTY TYPE : OTH Z� � ; . CONSTRUCTION TYPE : TENT ����'����� VALUATION : $ 0.00 NOTE: TENT PERMIT FOR A PIOTROWSKI WEDDING RECEPTION HELD ON 7/31/2010-EVENT WILL TAKE PLACE AT THE WOODS CHAPEL ON 525 LEAF STREET IN ORONO FROM 3:30 P.M.TO MIDNIGHT. SI"LE OF TENT IS 70 X 70 APPLICANT MISC FEE 25.00 J.S.M. INC. STATE SURCHARGE(VALUATION) 0.50 3920 HILLCREST WAY DEEPHAVEN, MN 55331- TOTAL 25.50 OWNER J.S.M. INC. 3920 HILLCREST WAY DEEPHAVEN, MN 55331- AGREEMENT A1vD SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced wi[hin 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � City of Orono����� r7 � ' 04 �O P o.Box 66 FOR CITY USE ONLY ° �. 2750 Kelley Parkway ����n ~ Date Received:� o Permit Fee: �5.�D , � . �, Crystal Bay,MN 55323 �<. ��A��y�� (952)249-4600 �(�,,� Permit Number: O;�`d� �� /� CITY OF ORONO - TENT PERMIT (All tent permits must be approved by the Fire Chie� �Ten�Informatian. y ' ���� � � ; �'� -. _ � � ,����� r , ,� � �' �.�� Date of Event: � �� � �L' Size of Tent(s): �� � �� Number of Tent(s): j Does the tent have sides? No Yes Please include Fire Retardant Informatio�z from the rental company for tent(s)AND a Sketch or Drawin�of where t,he tent will be located on the propertv along with this application. O��ner Infornlation: ci Site Address: ��o�� � �-u { �,��"e-e -f �' lt�� �,t,�aoc�� 6tc��-�_ � Owner. `T-�� � '� f`�C< <�� �'(��e�c � l Mailing Address: '���`��' �� ��C��Sf ��� city: -���� ��l�c� ��-� �, zi �� S 3� I P� Home Phone: _��J�� �f � � � � y -7 j Alternate Phone: �'�-� � � � �- `� � �— �ontractor�/Applicant Information: ���,���,��u���,�� � Contractor/App.:_ J�{� ` �'r<<<� �`t��t� Contact Person: �<< <t j �' 1�cc� � Address: ��`�,�-[�` �I-i� �_C ����S�-� �jCt=� City: �.7�'��'� �1Cc��c1 Zip: ���� ��t � Phone: Alternate Phone: =`..x�"��ti�� �F��� << (' e'�-�- Fax: �i �Z - �I �1 C� - C° �.��� Email: 1`�'��C C��L�i ►�1 C �� Y�tS r 1 .C C� u v� I hereby apply for a permit and aclrnowledge that the informarion above is complete and accurate; that the work will be in conformance with the ordinances of the City of Orono and the Minnesota Fire Codes;and I understand this is only an application for a permit and work is not to start without a permit. ���tCi.�'ti � ��t-�t" ��3 � /�-� l� Applica s Signature/Date Permit Approved By: Date Approved: (Teut P.ertnii 09.jf111Q9J m � wM O � � _... ... .. .. . .... ... .. ...... ... .. .. . .._. , . .. . . .. . . . . . . . .. . . ... . . . ... . . . . . . . ... . _ . .... � �! ��j, ����r�r�sr��►�r�sr��������� ���i������ ��P�tnc� m � � � � a � � ������� �� ���� ���5 � � � � i3EG�S�RATI�N �����Y Date ot Shipment t� A#�P�CA�30�9 � ��rzoo6 E" � � � NU�l11BEfi wousrm,� i ° �, E91A�S'Vt�LE, BN�iA{�1eA 47725 ;�e�deni°ifica4ion F�21.�1 �UTAAIt��ACTa1R��RS O��HE f1A1lSHED 0�128?466 J � T£9d'3 PRa�iJC�S DESCR6BED HEREtN � � � �'h�s is�o ce�#ify t�a3 &Me rraat�tials des�c�e�e� �ave��en�arn�setaf�ant trea�ed � � (or a;e ga��ig�ra�iy n��snfla��r►abls� and wrere si�p��i�d �o: . � '' S � � AARCEE RENTAL CENTER INC 3501 S HWY 100 N M o-� �N � �. 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