HomeMy WebLinkAbout1991-004028 - replc 2 windows/doors PERMIT
�1 OF ORONO PERMIT TYPE:
1335 Brown Rd. South P.O. Box 66 Bu I LD I Nv
Permit Number: tiii4i:;' ._:
Crystal Bay, Minnesota 55323 Date Issued: Vii/j :!_=ti
(612) 473-7357
SITE ADDRESS:
4017 NORTH SHS RE Di;
JB
P. I . N. 07-1 -2_:-44-()i3{Sri
DESCRIPTION:
BEF'L W I NDWSID�+�+p;
Building F' iari�i i. Typ SF-ADD/FERODEL
Bu i
• 1 d i nWorkTypeF IV VAT REMODEL
CITY CF Ckogy8
13131000°0
3 jlht4E OFFICE
01 GEN 25.00
REMARKS: 1 22200000 #
01 CEN .50
THECA• TL X5.54
EECEIPT-THANA YCu
w � ,;�l,. �, "w n ;
#226464 C441 P01 T49:4
FEE SUMMARY: 14.f1°11
VALUATION' $1 , '00
Base Fee $25 .{ +i
Surcharge -1.5
Q
Total Fee . B0
CONTRACTOR: OWNER: -- App l i c ar+t. --
THE+ BALI=: JOHN
4017
NORTF, �HORE DR
MOUND MN 5:364
472-4824
THE f iNDEi•;=_IGNEO 3 i=;�:i�1 :'` ;_ ? = :7""'ll
`i~ntiI: i UN T+ MAKE THF-,-,
REAL i.._ Ii;i=` +r�',T:t,F_7t% °:
rsr• rr=. z r•r. r. i t -•r Y-r. t i
dr,o)
CpEr:iF� ._i_3 ANC+ rEi :� _'_: �_; �,�.i :ALL ?;_Er r•. �t` i i1�:j t.,_tt'4r`LTHF-€-, 4 ? r t?1_..�_ �•i i i iir.
g•-i�'_�•'} r ear- x ..._ .} }.,--- T .t ._ -
_,,�i 111► IRO I NI-11141.-.c.
AN •t ;`i!s
11cl ,: hF i}siwi . : .
77
Iii. :is t"+i 1'iE�if :_E_+t A +t_1 i LO i�I�•.] f Ej �� E r -:
L
�_ /
APPLICANT/PEE SIGNATURE ISSUED BY:SIGNATURE ��
r CITY OF ORONO - BUILDING PERMIT APPLICATION
•
Total Fee: $ Date Received:
-Date Approved:
Entered By:
Permit#:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (circle one) OWNER • CONTRACTOR
SITE ADDRESS: / �
JOB °4/0 /4/ 2)&dlt / j ZIP:
(work) 931 5,07
NAME OF OWNER: Kvu 1 £r) PHONE: (home) //7 "/icl./6
MAILING ADDRESS: 6OI4/ /) kG1LQt.., CITY: 4.4244J___ ('ZIP: 55-5 T
CONTRACTOR: Z--,e4n_0"4.11-kebbk\/44PHONE: `t eld�' T Sz s‘
MAILING ADDRESS: (4) ('7 u) gvi.lol CITY: MOo A) 01 $) ZIP: S-5-36(7
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration enovate x Land Alteration
Re-pm:co)
PROPOSED WORK (describe in detail) : eckiDdi4-C L5- 1,49e/e../41.42f4)..5 d m (S
STORIES: SQ. FEET OF EACH FLOOR: 8449.240)
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. X
i� 0249
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ /4 k*
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.
'-.. .\... 9-SCZ DATE: �0 4/
APPLICANT'S SIGNATURE.:
(Please fil, out . e reverse side of this form)
,e CITY of ORONO
--r11(_: - Post Office Box 66.Crystal Bay,Minnesota 55323•Municipal Offices
t
ORD1alfl`.
On the North Shore of Lake Minnetonka
DATA_-RRIVACY ADVISORY
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 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
license.
4. If ycur 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.
Jan_ y0 F.- - /z-/g- 00 9/0/
First Middle Last
44P/7 /11( ?714 Y/l-e-?-& /J/2
Address daxortty)
./ G(_ _._.itneJ •._.. . - _ s5:36V
City State
Zip
--- -.6/? _=-5(7 ._- 60.ss
Phone
I understand my rights as stated above.
ilk t 'aft q\41
Si.nat e
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING