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HomeMy WebLinkAbout1993-005369 - reroof/tearoff CITY OF ORONO PERMITPERMIT TYPE: 2750 Kelley Parkway • P.O. Box 815 Permit Number: BUILDING Orono, Minnesota 55356-0815 005369 Date Issued: (612) 473-7357 07/26/93 SITE ADDRESS: 795 OLD CRYSTAL BAY RD N CH P. I .N. : 33-118-23-21-0001 DESCRIPTION: REROOF/TEAROFF Building Permit. Type INST-ADD/REMODEL Building Work Type RE-ROOF • CITY CIF vRiJNTIJ REMARKS: FINANCE OFFICE .1.E 1313100000 000 V1 ":EN 1 LLl-7 57 .VV f L22tVVV # 01 Cry '.12.5i FEE SUMMARY: CHECK TL 614.50 VALUATION $85,000 RECEIPT-THANK YOU #279870 / ``''�� YOU C0 1 !\V1 T09:58 Base Fee $572 .00 Vn ,l,, 6'93 Surcharge 142 Q Total Fee $614 . 50 CONTRACTOR: - Applicant - OWNER: Mie:; ROOFING INC: 17 :0.852 S ORONO HIGH SCHOOL 1615 99TH LANE 795 OLD CRYSTAL BAY RD N BLAINE MN 55449 ORONO MN 55356 (6,1 ) 780-8525 473-7313 TIE RS Iw o t Y REQUESTS PERMISSION,.TO MAKE x T Imo' T' ��TS SPECIEI D AIt TO DO x WRK STRICTCOMPLIANCE 4TH` ALL' TY OF ORONO GROI ANcE Ott M IOE OT ,+I . I LDINGf COIF RE4 UUIRE ENTS AP AN4/PERMITEE SIGNATURE ISSUED BY:SIGNATURE . • CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ &/114-56 Date Received: Date Approved: Entered By: (A, Permit#: 'j 369 ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) THE APPLICANT IS: (circle one) OWNER or(ONTRACTOR' JOB SITE ADDRESS: 795 OAU CAy5i/ L- 611y 24i1.o N ZIP: SS 354, (work) 4'73 -2 3/3 NAME OF OWNER: OP-ONO SC/fJoL5 /52) P Z 7 3 PHONE: (home) '/7 3 - 7 313 MAILING ADDRESS: b5 a L, (!g-374-t- t3ny 20 CITY: v/Z c'/✓' ZIP: .5S 356 CONTRACTOR: 14/1 4' 5 1204)Ft i)6j /N C PHONE: 7 170 - ' S Z `13 MAILING ADDRESS: JOS- ?? t('' L4NL CITY: et-4(N(j 414 ZIP: 5SYV 7 STATE LICENSE: # N//9 ARCHITECT/ENGINEER: 4(L o iv o l 5 e/w u�S PHONE: MAILING ADDRESS: / CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : TeA R ©r(- el Nn 2e PL 4 ce 3 5e c 1'a ivs OF O- dAi 04,040 MP/ $ CifvvL- STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 55 000,00 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. � L APPLICANT'S SIGNATURE: va— �l� '�'�' DATE: 71 6/93 3 /II 4- 3 I oepob, pvc, . , - - , . \_ A„ . . CITY of ORONO CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices oF Q RCI N6 On the North Shore of Lake Minnetonka DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "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. First Middle Last II( E 60Weiii /- 4l'- L4-Ne Address C12ci_e toiNe5i vt?,v 5.cO ly City State Zip 7iO- 8SZ$ Phone I understand my rights as stated above. Nedtet 44cet,,. Si /att BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING