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HomeMy WebLinkAbout1992-004574 - regrade _, PERMIT = CITY OF ORONO PERMIT TYPE: 1335 Brown Rd. South • P.O. Box 66 ��'_�E�� I�EF I l�EC� Permit Number: i yt a � Crystal Bay, Minnesota 55323 Date Issued: c_t;�;/�_�f'��. (612) 473-7357 SITE ADDRESS: i:��S Nia�CTH °=�H+��E ��t GH F'. I .f�. : f i 3-117-��:-�,:�:-Cii ri yi DESCRIPTION: RE�GF�t���}� tl�er F`��,rr�it• TY��� ��h#L} ALTERATIuN � � ����� , �� ����°� ����; ��� � ,; ���. � �.�`�� ��u���, � � '��° �"� ": , � a «� ���,� r�f � � � t� ��:�'a* � p ��` , t� v��,a � s� �; a. � `�' �.� ` r nx ' J i a� ,�` m u �,;k' Y�,� .. � �' ��t''���#� �d�'4'�''m�'�,*� "Yq� i=� . - ��� �Y � ����i � y �s.�. h�� '�= ��rc � �.. �R�i p'��,�r��'.����"�'nw ° � y� [�q ,�x� � � � ��r w����t�`+Y ��r„� �' � � an �t,wr qq a€: 4 -. . �r �,� ��.��/ � � e��� ,����� �` ... . �k �ry �(i � R ' 4 + �� Y : �y'��a����u ^�Fi�r � i 5z2a � s�i r� 2 , �, �r� �.��� � 'p�� * . v � "� .;r r r�n-,. .. ��� �*���' ' +� � a� � � �� °, � "' ti � � � � � � �v ���M�. � m ,��u�3'�ys� k.+,�:, ¢ �.� i- � � :� � . � �r.��n h.��'�'',r��.�'ss�. ` _ "„�.�r 4 ��. +� •_. '3� f - �,s�3�t?�}4�1} # REMARKS: .;t1 ��N .50 FEE SUMMARY: �,1���i �� - �3��3�t� � . ,41 GE� .54- E��►s� F�� --------�����i�f� �J1;f;�0�}t�114 J� T�_�t•al Fee ��i�. i�ti ;�f �1� 54.� CHEt�t:.. T� ��}.�l t"�E'L�I�T'-Th�►+It' Yt1U ����'ti4 �t�1 k61 T43:OP �� 48,�19J�� CpNTRACTOR: - A���1 icai�t• - OWNER: YER i�;AN �:r�N�=:TRt��:�'�i��� C:+_i 1444�:�:�: Mt j����Hy F::I NCi'=�LEY �,�itl7E 4, E,��X :�;�� '�'�' l�i�+�TH '3�i��RE L7� I��F�NTI �'`�'� MIti! ��;i�t(.i� R;;iR���hlE:i t:F 1'�:� 444-S:i�:i MN ��:;�: - ----- ------------------------- ' ------_ ----_, _..:_---_ _----- _ ..__ Z�HE li��rrEfi�'_;�r,�:��:C� NE��E�� �;E�;}���:��,���_: F'E�;fi�I';�'��I�_t"� �::► �1�:��::E i�H� �F�L I�'i�'��:��1Et�'fE�'�T:_: �=;�`EC:I F I F D AI�IC� At:i�Ei�'..� T�i L7��t ALL W.�i�;��:: I td '_;f�i I Ci` �.:�►t11='L I raN!�:E W i i�i A►L i_I T v ���l= i—irr'�.'fvl�t_t f_i�C}�r�IhP��::�:'=; r:f�iC� '::`#��-: i i�' t�^I��1��IF'�.i�iT� E.�1I�.Lt 1��% �:�=�C�� F��f;�t t t��t�#E:h�#T'=� . � � �3� � APPLI NT/P IGNATURE ISSUED BY:SIGNATURE �� , CITY OF ORO'•i0 - BUII,DI:IG FER.tiLIT APPLIC.ATION Total. Fee: $ _ �( �"Z Date Received: Date Appro�ed: Entered By: ,C/✓ . Pe�iit'�' '��7 �� AT•7• INFORMATION MIIST BE SUBMITTED IN FIILL BEFORE P?1AN REVIEW WII.L BE STARTED (See Check-off List Enclosed) ------------------------ THE APPLICANT IS: (circle one) OPTNER o ONTRA '" R ' " � 1� ' C� v z1P: �S�3�i JOB SITE ADDRSSS s �a�-6 � Iva'"ri► Shc^� ��'�ti E'_ °� �1�-' (work) NAML OF OWNER: � n�,s'a...�"�ciY�r�.� l"✓l;�rf�� _ _ PHONE: (home) MATI,ING ADDRESS: �-��J �i�-�'�� S�v�� �,'���%� CITY: �,�%��7-Ti ZIP: ���'il i �, PHONE: �'1`�LI�S 3�,3 CONTRI�CTOR: y�r qc� G�� '1 S - .ti3AILING ADDRESS: 11'�' `7 �x• �S �`7 _ C=�: �54;��f ZIP: ���OL/d STATE LICENSE: � ARCHITECT/ENGINEER: PH��" MAILING ADDRESS: CITY: ZZP: NAMF: R.EGISTRATION T TYPE OF WORR: L7ew Addi.tion Accessory Structure rlove Demo Remodel/Alteration Renovate Land Alteration�� P�OPOSED WORR (describe in detail) : ��,�-,�,v� ���f �,Z 't�fc��'+'� '�i1�� �'��� �r�'r`'�e d STORIES: SQ. FEET OF EACH FLOOR- NO. OF BEDROOMSs GARAGE STALI�S: ATT. DET. ESTIMATED CONSTRIICTION VALIIATION (ezcluding Ia.nd) : $ I hereby appl.y for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conforinance with the �rdinances and codes of the City and with the S�ate Buiiding Code; that I •�nderstand this is not a permit and work is not to start without a permit; and :hat the work will be in accordance with the approved pl.an. � �.P PL I CANT'S S I GNATURE- �� 3 I,l�c--, `--> DATE: �"'I`� �>�- - �- �- �� -� C���'o� O�►��TO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices 0 s - � v On the North Shore of Lake Minnetonka DATA PRIVACY 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 yau 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 3icense requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The inf ormation may be shared with other loca 1, s�ate or f ederal agencies to the extent necessary to process the permit or I.icense. a. If your requested perntit or Iicense requires Councii ac��on to approve, some information may become public. 5. You have certain rights under M.S. Z3.04 to review priva�e data on yourself. 6. Your full name is required to process this application or permit. (� � i ��l�c e� U �-f, First Middle Las� �� " i IJQ�r � 0� � Address T�,�� r��, s5^C��iD City State Zip ��/4 -535' � � Phone I understand my rights as stated above. � Signature . BUILDING&ZOyI�IG—473-7357 • ADSIINISTRATIO[V&FINAYCE—473-73:3 • PUBLIC WORKS —473-7359 ASSESSIYG