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HomeMy WebLinkAbout1991-003709 - grading/filling PERMIT �CIT� OF ORONO PERMIT TYPE: 1335 Brown Rd. South • P.O. Box 66 ���-'�U-�����`��-G Permit Number: �;i�;;;4�_� Crystal Bay, Minnesota 55323 Date Issued: t�y�f��;�;�'_�� (612) 473-7357 SITE ADDRESS: �'.�`�.!� �1i��`TN :�Hf1hE d�i T�.td �'. I .PJ. . 1 i:�-f 1:-i=t-ti:t-�:�i����i DESCRIPTION: ��;i��T t�l;�.`;=;L.l_I k�� ����1' �'H1'fitl'�• �y;=�� �...f-�i��}J �1����if;�1.1l� fic►E��i�t::s F'r��;��;I tdt� L+4T A�;EA'=� �rti� ����a ti�p�`�����i �i�� �'�� ���`���4"����^����� �� � . �� � � � n ��� �� � � '` ����ak�"�� �,; ^C�� r���� 5'��i ��n� n a w � "� �� �� � ��, ����ro3�"�i *�.a w� � �r� ��v��v"a'^' � 7��a� ���3 �4�� r p��`� '�a�x '�"^�"�_..�'"�,,�^ �u�. ��Hi ����� . � � � � � �i� � � �' �����4 +� w a+ll M�tA��5p�4�e �����-nr���: +�� 1 1 � f � a �'ti d tl q � � .. 4"�`�p�°. r� pd ��""� ��}�Hh'4� ,�Y-�4: d "�" 3k^y'9I 6} p-` � ���'�" ��e � pa6��'���� `�'�,�' n` �r7y `�^,�n_. � � ;���'�'*u�',�- tl�i im�dn r�,����iir',� N�i �'��"" � ��'�= �A ��`�1�,���r✓i �l ti '�� 4' ur a�l�`��`�'�w ,�x� � n 'pi w � �' ���9� �� +'��Y'�� � � ���u�'i�' �� m�rt ��r*� � 'v J�-"�ik�'& �rm � �i.r s,�'�, ,s n��n'� '�,'���W, � � ���,i�.��� ��� 4 s � r- , �-� .'µr a '"'�` ,�+ g rt � h �` Y� .l^ ����� � � �fl��� � �� �''fi a � r�" µ� y'�� � � � �. a�x,.� ���r'� �l€�, �nAs ,�,�" '` �w.��«�n i�� � .�, , <<-',� , . � . ,... . . . ��� � .. ' . . f.�rl�.'F� ��— V)1V1�V — lr5i��1f11-�i�1l.V �r�IYL REMARKS: :ti��;�f�nnt, +� .td1J+J='='VVi' #t i t'�lt �r'i 4di r�+ vi t-•_�r v./�v i,r�Li,� �i ��.ilv iii��T=T_eii�ilii'i �Uil FEE SUMMARY: �::'�,?��� 4l3"1 �'�;;� ?;:u:y'� ,''�,.`i:t���� E:a�� F�e ________��t��tyt3 l'���t•�l ��� ��i;, c;�:� CONTRACTOR: OWNER: -- AF��-�l i c�ti-►t. -- AhT C:E{VTE�' t�iF Pti��::�, :�:'�_�.tx N+���;TH =�Hr+�;� C�R i I�i,J�i I �1t`� �+�+_�`�1 �� a;_ � �,.`!.-�r- ::� :-.. � t:-r-::--�• �•i- - r::-�:��: - r. r_.,., :•s- '-e- 7 rr�:1- -s irr,�i- - (� �t�;.���l�� � :., �,._-. ! ,:; [� .�, . � i 1` .'�v�.IL_ .�� . i�..� i'i:�f'•.���:� i'.S__;�r�_�r.=:z!��� 1'"i::t:E E I��. ����_�:� �i_� i'�a-li•..C.. �C"�'s� i'i�".:i� s M1 (� i _ dC_1 ii_.���1 i '_ ..�.�..s : • -r.��. j,r.�,,_r.r, — r,r; _ F ,- .• *�.a -•�-�,r -� _:r - ��.'r-.-- � t--rt : ,_. f -� ; � , .-.,- r-,- • ,-._ _ _ �:��jCE�!P" .i.i:»3% F^11�I-1 t-it=�i?E:E=._• ! i_� i,j�_• i={E„I_ �fi_.i^,��.. s}� _� 1 �?J.�..• I '_•F_�I'iE'"L_.t.!-:?�I!,�:. Lu i. ! €i f�=?L!._ ;_•1 ! �F� i_�I" '.�� :Ij�tiS_I;t.ji_I i li'.L.=a.�Y�lf':3•_•C�_ ryi`I�.,F _� �t�t 1 L_ i it- �'i T��'a;i.�%:y.l��I i i t:�t.}L L_t.J.�fs�':� E_�_��J�'_ E'4t�la�i 7.!i"l�i°iS::�;� i ��� . .� . . � -� APPLICANTiPERMITEE SIGNATURE � ISSUED BY:SIGNATURE ` • �' CITY OF ORONO - BIIILDING PERI�IIT APPLICATION Total Fee: $ Date Received: Date Approved: Entered By: Permit#: ALL INP'ORMATION MDST B$ SQBMITTED IN FIILL BSFORE PLAN REVIEW WILL BE STARTED -------------------------------------------------------------------------------- TH$ APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: �LD �//LL .SGHe�L �,� Aa�- gIp: ��1I (work) N1�ME OF OWNER: �� C�� �� �� A'�S PHONE: (home) I�IAILZNG ADDR$SS: 21$p N. Stibi2E' l7r2 , CITY: a�cYVO ZIP: �.�1�� y�S /63 f CONTRACTOR: �A�� ������ PHONE: �7� y31L MAILING ADDRESS: �Z3�yv�1Q D�(�E CITY: ��l�IZ4r+� ZIP: ��lf TYP$ OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration c� PROPOSED WORR (describe in detail) : ���''��G�A�CE �vr�1 l�GE�.ei�,¢S 'G'-��EErr�t'yvt" z3�7� <l w�E 2 !�$rf STORII3S: SQ. FEET OF EACH FLOOR: NO. OF BBDROOMS: GARAG$ STALLS: ATT. DET. $STIMAZ'$D CONSTRDCTION VALUATION (eacluding land) : $ ��r 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 Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATORE: DATE: " +'� (Please fill out the reverse side of this form) f ' ` � � C ITY of ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal OfScea • o . � A On the North Shore of Lake Minnetonka DA,T�f, �R�VAC7�.2�DQ��9�� � 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 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: . 1. 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 shared with other local, state or federal agencies to the extent necessary to process the permit or license. � �,- 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. h9A,G7� $• S�f'it� �da,�' .7�2�(00 First Middle Last V �Z3.�' ��.Iv� ��. - .----_ __._ .- - -- .._ Aaaress G��yz�r'�1 I'r�1� ,��`�'1 -- -- - ---- - City State Z1p . 6f'L �T,�'___3l�__..--�-�------...------ Phone I understand my rights as stated above. � ._ ..__._----.._. .----� ---------- Signature BUILI3WG&ZONING-473-7357 • ADMINISTRATION 8c FINANCE-473-7358 • PUBLIC WORKS-473•7359 ASSESSING `-,� i'F.�TFk �R]"S P��� . ,.,►. �.� .-• � �.� � .. .;, .. . . .....,...:�..._,....�.�-.,w1'"''V`�`Q�Q �....��;w... -.- r ., . • � . . �a:3�.��._ �;+` �+ � ; .� �:c r - - , � - _ _ , . . 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