HomeMy WebLinkAbout1991-003840 - re-roof PERMIT
CITY OF ORONO
PERMIT TYPE: ', }= r•T.�,>•
1335 Brown Rd. South P.O. Box 66ii`��,�`i++�7lW��
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
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APPL CANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO - BUILDING PERMIT APPLICATION >: a
Total Fee: $ 383.50 Date Received:
Date Approved :
Entered By:
Permit#: 3s'yc)
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: 685 Old Crystal Bay Rd. No. ZIP: 55356
(work)
NAME OF OWNER: Ind. School District 278 PHONE: (home)
MAILING ADDRESS: 685 Old Crystal Bay Rd. No. CITY: Long Lake ZIP: 55356
CONTRACTOR• Les Jones Roofing, Inc. PHONE• 881-2241
MAILING ADDRESS: 941 W. 80th St. CITY: Bloomington ZIP: 55420
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : Partial Roof Replacement
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; that the work will be in conformance with the
ordinances and codes of the City and with the State Building Code; that 1
understand this is not a permit and work is not to start without a permit; and
that the work will be in accordance with th proved plan.
APPLICANT'S SIGNATURE: DATE: / - "��"
(Pleas f side of this form)
CITY of ® ONO
Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
On the North Shore of Lake Minnetonka
DATA--PRIVACY 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 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.
1,es Jones Roofing, Inc.
First Middle Last
941 W- 80th St.
Address
Bloomington MN 55420
City State Zip
881-2241
Phone
I understand my rights as stated above.
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BUILDING&ZONING—473.7357 • ADM 'ISTRATION&FINANCE—473-7358 • PUBLIC N'OIZKS—473-7359
ASSESSING