HomeMy WebLinkAbout1996-007902 - tearoff/reroof ,. �
� PERMIT
� CITY OF ORONO
2750 Kelle Parkwa P.O. Box 66 PERMIT TYPE:
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Crystal Bay, Minnesota 55323 Permit Number:
Date Issued: i;i a?�+t�:�
(612)473-7357 c�ri=,;;:�d.r��F.
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE / .�l�C,
• CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ Date Received•
Date Approved:
Entered By: ;-��lr A� "
Permit#: ` `�0=�
ALL INFORMATION MDST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER o CONTRACTOR�
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JOB SITE ADDRESS: 3587 North Shore Drive ZIp: 55391-9360
(work)
N1�ME OF OWt�TER: J a n n a S u n d b y PHONE: (h ome)
IriAILING ADDRESS: 3587 No . Shore Dr . CITY: Wayzata ZIP: 55391-9360
CONTRACTOR• Les Jones Roofing, Inc. PHONE: 8�1-2241
MAILING ADDRESS: 9�1 W. 80th St . CITY: Bloomington ZIP: 55�20
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : Tear off existing shingles . Reroof
with 25 yr . shingles .
�TJi iE�: SQ. ���"�' O� E1�CE F1r,O�JR e
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ 4, 153 . 00
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 SIGNATQRE: DATE: 4/30/96
lPlease fill out the reverse side of this form)
.
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CITY of ORONO
Post Office Box 66•Cryatal Bay,Minnesota 55323•Municipal Officea
Y
� _ � . On the North Shore of Lake Minnetonka
D�1�� �R�VACY A�DVV�SORY '
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 inf ormation you f urni sh wi 1 I be us�d to determine vour
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 license.
3. The information may be shared with other local, state or
federal agencies to the extent necessary to process the permit or
iicense.
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.
b. Your full name, and date of birth are required to process
this application or permit.
_ ..L�s_.�Qn��_. AQ4�.?�n �_.. Inc,._ ----. ....---- - . ._-------�----- --�---
First Middle Last
-----941__W.. .80th.. S.t- ..----...._ .._ --�-----------�..__.__._ ..__ ._. ------ _ .. ... _. ._-
Address
Bloomington, MN 55420 _ ..
._._. ....-----. ..------------- --- __.._...._._. .----� .--.-- -- - -------_..._.------..__ - --
City State Zip
881-2241 _
-- .__..... ...._ .__.._.._.
Phone
I understand my rights as stated above.
� --�----__ --- -------- -
ignature
BUILD[NG&ZONING—473-7357 • ADMINISTRATION 1&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSFSSING