HomeMy WebLinkAbout1993-00505 - vinyl siding/trim PERMIT
CITY OF ORONO PERMIT TYPE:
1 Ir IN'G
2750 Kelley Parkway - P.O. Box 815 Permit Number:
R i j T T
Orono. Minnesota 55356-0815
Date Issued:
(612) 473-7357
SITE ADDRESS:
N CI 1311-HS 'E"I 10
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY: i-JITAMWU
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CONTRACTOR: !_'T . Ljr .OWNER:
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/App1L__1CA`NT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO - BUILDING PERMIT APPLICATION
Date Received:
Total Fee: $
Date Approved:
Entered By: (' r`t permit tt:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
_ --------------
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THE APPLICANT IS: (circle one)
OwN''E/R/ or CONTRACTOR
JOS SITE ADDRESS:
dr'/� 'e �- �� ZIP:
(work) e/,2-
PHONE: (home)
NAME OF OWNER: AlW �"
�w�
p / /^ CITY: CUnv ZIP:
MAILING ADDRESS:
.� .,��s�'� _ PHONE: �S'�� /-;;;V/
CONTRACTOR: Oie'
MAILING ADDRESS:
/25 fT �j CITY: f�l'w c ZIP:
STATE LICENSE: # S
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITY: ZIP:
REGISTRATION #
NAME:
Addition
TYPE OF WORK: New Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) :
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. _ DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; y h
a dw work wi l
with theState1 be lBuild ng C deW1th thatthe hI
ordinances and codes of the City
t and work is not to start without a permit; and
understand this is not a permi
that the work will be in accordance with the approved plan.
DATE:
APPLICANT'S SIGNATURE:
CITY of ORONO
Post Office.Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
• o On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 21* "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 your requested permit or license requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to process this application or
permit.
Pa te C on
First
Middle Last
Address
City State Zip
Phone
I understand my rights as stated above.
Signature • '
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING