HomeMy WebLinkAbout1995-007054 - land alteration PERMIT
CITY OF ORONO PERMIT TYPE:
42750 Kelley parkway- P.O. Box 66Permit Number: NEµ
Crystal Bay,;Minnesota 55323
(612) 473-7357 Date Issued: 06/ ;9.5
SITE ADDRESS:
340 oLn CRYSTAL BAY RD S
P . {• _:1: – 1 _ - —1S
-0001
DESCRIPTION:
s zYARDS
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CITY OF CRiW
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TL OFFICE
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V.,. f !Y 50.00
L.11Er1 Ti. 50.00
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REMARKS:
FEE SUMMARY:
17..n0 00
CONTRACTOR: OWNER: Applillant -
MINNICH ROONEY
`„ii I: cRysTAL BAY RD -.
ORONO MN SS:S5G
473-6461
THE UNDERSIGNED HE CEE Y REQUESTS PERMISSION TO MAKE E THE REAL IMPROVEMENTS
PRO4 EME1
SPECIFIED A# D AGRE4p TO DO ALL WORK IN STRICT L I ANCE LJ I TU ALL 'CITY OF
ORORONO + '=.OINANCEA40 STATE. Cl- MINNESOTA BUILDING CODE E � IFSEi ENT .
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A'PLICANT/PER ITEE SIG NATURE ISSUED BY SIGNATURE
CITY 1OF ORONO - BUILDING PERMIT APPLICATION
' • Date Received:
Total Fee: $ ,
Date Approved:
Entered By: Permits
IN BEFORE PLAN REVIEW WILL BE STARTEDALLINgpRMATION MUST BE(See Che�-off S Enclosed)
-- --i
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
DRsSS: � .2. 4 c:D c2`IST[L 4 ' / L) S ZIP: ��3 v
JOB SITE ?� (work) 3V--70S7
PHONE: (home)NAME OF owxER: IZo N L�� I✓I.lNluIc� ' r6zIP- S-S.3S�
CITY: O)2 Q)
HASLING ADDRESS: S/4-M �
SELF PHONE:
CONTRACTOR:
MASLING ADDRESS: CITY:_______ ZIP:
STATE LICENSE: #
PHONE=
=�2CATTECT/ENGINEER: ZIP:
CITY:
.AILING ADDRESS:
REGISTRATION z
LAME: _____________________
AME:
Addition Accessory Structure —
:YPE mF WORK: New Move Renovate Land Alteration
Dem __Remodel/Alteration
PROPOSED WORE (describe in detail) :
0
STORIES: SQ. r.&.6. OF EACH FLOOR:
NO. OF BEDROOMS:
GARAGE STALLS: ATT. DET.__
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
e that the information
1 for a wilding permit and I acknowledg
I he-eiy aPP Y that the work will be in conformance Code;i bathe
e
above iscomplete and ccurate; and with the State Buildingpermit; and
understand and codes f them taCn
understand this isnot a permit and work is not to start without a p
that the work will be 'n accordance with the approved plan. - _ -
DATE: 6 -- /3_ 5
APPLICANT'S SIGNATURE: /,'/
f ORONO
- C
_ _ _ So
=-„,... :
-- Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
-CIS; = On the North Shore of Lake Minnetonka
- _- DATA PRSVACY A02SCRY
"Rights of subjects of
Subd. 2, permit or
In ' accordance with M.S. 13. 'that your request for a
data", we would like to inform you of its departments may require
license from the City of Orono or any
you
to furnish certain private or confidential information.
You are notified that:
information you furnish will be used to determine your
1.
q The 3 permit or license requested.
qualification for the p uire that
City deny refuse to supply data, but refusal may req
2. You maythe permit or license.
the
with other local , state or
be shared rocess the permit or
federal agencies to the extent necessary to p
license. aC`i or_
permit or license reauireS Council
4. If your reques,.�p.-d
some information may become public.
to approve, ; va�e
5.
You have certain rights under M.S. 13.04 to review pr-
data on yourself.
6. Your full name is required to process
this application or
permit.
gop/xE/�/ L -1 MANNfef�'
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Middle as
First � ��v 7793irO 0L- A c/e)15-7 B Y /
Address M 5.5-3 j-�
���NO State Zip
City
q---73 -c 44.6-/
Phone
I understand my rights as stated above.
i S ' • at e •
• ADMINISTRATION&FINANCE-473-7358
• PUBLIC WORKS-473-7359
BUILDING&ZONING-473-7357
ASSESSING
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• CITY OF ORONO . •
SITE PLAN PK GRADING PLAN
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APPROVED 6 e C.A.$131C Ykee.05
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LI APPROVED WITH REVISIONS
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