HomeMy WebLinkAbout1992-004479 - replace roof PERMIT
CITY OF ORONO PERMIT TYPE: BUILDING
1335 Brown Rd. South • P.O. Box 66Permit Number: 004479
Crystal Bay, Minnesota 55323 u7/09/S2
Y y Date Issued:
(612) 473-7357
SITE ADDRESS: 765 OLD CRYSTAL BAY RD N
.JB
P. I .N. : 33-118-23-21-0001
DESCRIPTION:
REPLACE ROOF
Building Permit Type , COM-ADD/REMODEL
Building Work Type RE-ROOF
CITY OF ORONOjr'l.1 NAM'�4L OFFICE
1313100000'. 44 31 31 00000 "
01 GEM 688.50
1222200000
it
01 'INN 57.00
i13 i
1 00000
J+.•J J1
01 GEM L'VVtv+3.50
CHECK IL 1434.00
RECEIPT-THANK YOU
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iTVIVV 4 V1 ! J• J
070919'.
REMARKS:
FEE SUMMARY: VALUATION
Base Fee $688.50
Surcharge $57 .00
Investigation
Total Fee $1 ,434.00
C aRTIRpfs1g - Applicant -
TINC 125:34441 RAMPli I DDLE SCHOOL
BOX 1482 765 OLD CRYSTAL BAY RD N
ST CLOUD MN 56:302 LONG LAKE MN 55:356
i 612: 253-4441 473-7 357
THE UNDERSIGNED HEREBY REQt JEcrE, PERM I _ ION TO MAKE THE REAL IMPROVEMENT-1F F.OVEMENT- I
SPECIFIED AND AGREE': Tu 'STRICT COMPLIANCE WITH AIL CITY �tF
ORONO ORDINANCES AND S TATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE 95)
.-.- r T APPLICATION
CITY OF ORONO BUILDT.NG PERMIT
ectal Fee: $.___/-4:1;422____j Date Received:
Date Approved:______
Entered
pproved: -r-
Entered By:, 3U9� 819 permit : C 7
rr INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
F (See Check-off List Enclosed)
OWNER or CONTRACTOR
TEE APPLICANT IS: (circle one) ' ' ZIP: ��
L Lecke_, PiN
,70H SITE ADDRESS: 7�S � C•. SJ 0- s t./ (work) „�5�- 4(1V,SS
FSI� ZIP:
� _ �IIarrE: t
NAI' : OF OWNER:.__ � CIT'Y:y� CJOud- 5 �� a_____MAILING ADDRESS;_�D
.lia_22-a_____________
.�r�� PC-- --- 44 CONTRACTOR. /�. Ca���e c f 4. • PgONE —
MAILING ADDRESS:
I�S� CITY: �f lac ZIPi _SL
STATE LYSE:
'nom: ��4.«� ii7t- o
ARCgITECT/E2tGINEER:_� .•c L__112__ ZIP: �7 �w -.-
MAILING ADDRESS:. LI a(e Ale CITY: �c e
REGISTRATION
Structure Mo�Te
TYPE OP WORK: New Addition Accessary Land Alteration
Mave
Demo�r Remodel/Altera.tion_
Renovate,
PROPOSED WORK (describe in detail) : —_-^
Loo,ce___Ino_c ,r42.6_,_daa_Ld___..._____.__( 0....0 ________________
STORIES:JA__
SQ. FEET OP FACE FLOOR:..-- --,.
NO. OF BEDROOM: RAGE STALLS: ATT. DET._ _
GA ,
land) : $ 111-1(1). --------------
��
ESTIMATED CONSTRUCTION VALUATION (excluding that the information
�'
I hereby apply for a building permit and f acknowledge
Complete and accurate; that the work will be in conformance wiI
h the
above is and with the State Building Code:
that nI
understand and codes of the City
d
understand. this is not a permitdce work the approved plan.without a P,
that the work will be in ac _ 4Gj
DATE:
APPLICA 7T':i SIGNATuKE: ,'i .
ri ri �Tr. -� � i •n � i,r,n r .i-n ter- ,I r. .I.,
• !
(\‘‘.- .
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Munidpul Offices
OF On the North Shore of bake innetonkce
ORONO
DA'T'A PR=VAS ADVISORY
subjects
In accordance with
M.S. 13.04, Subd. 2, "Rights of a permit of
r
data", we would like to inform you th of yourat request forts departments may req
license from the City of Orono or any uior
you to furnish certain private or confidential information.
You are notified that:
1. The information you furnis willebeeue se ded t.determine your
qualification for the permit or
1 data, but refusal may require that
2. You may refuse to supe Y
the City deny the permit or license. or
3. The information may be shared with other
ocal, state statepermit or
federal agencies to the extent necessary t
license.
4. If your requested permit or license relic res Council action
t
•
to approve, some information may bac p private
5. You have certain rights under M.S. 13.04 to review p
data on yourself.
6. Your full name is required to process this application or
permit.
I c',
.m_ - M dale a act
First 02
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Address tate ��-30,�
' . _ ( •_- PIN Zip
State City .
Hca- a<3 - -(4I
Phone '
' rights as stated above.
I understand my .
I'
/ 40011 '
gn7" urs /.�
BUILDING4 ZONING-413 7347 • AOM INIS CRnT10N A FINANCE-•473-7358 •
1,
PUBLIC WORKS-473.735•
ASSESSING
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