HomeMy WebLinkAbout1994-006506 - tearing off PERMIT
CIT)10F ORONO PERMIT TYPE:
2750 Kpr.ly Parkway- PO. Box 66Rt)I Li)T
Permit Number: 0 z,F,
CrfstalBay, Minnesota 55323 Date Issued: 0,107 94
(612) 473-7357
SITE ADDRESS:
/140 OLD CRYSTAL RAY RD
jB
PI . N. : 04-117-23 -0007
DESCRIPTION:
TEARING OFF
Building Permit Type RF-ADDIREMOOFL
Rwilriing Work Type RE-ROOF
e-77v r1r
UI
177iV4;447 .; -JL
REMARKS:
01 63.00
vl I.90
FEE SUMMARY: TDTAL. iJ4„50
EACH 7,;„i")0
U-I 1111 VALUATION $3, f;00
7 '71
ja4.1;
1747rr7nr Yr:if
Base Fee $(3,3 . 00
H1 rhar9e
TrA:AI Fee 00
CONTRACTOR: Applicant- q,7 d OWNER:
WR I GHT ROOF I NG, INC 1SS947.'SO RLAIR JANIS
Ni3RWO1-ji) LN OLD CRYRTAL BAY RD !E;
F'l YMOUTHMN 442 ORONO MN
473-4111
I I
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL, IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WO IN STRICT COMPLIANCE WITH, ALL CITY' OF
ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. ,
L 1
eml atAkciLza°
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Date Received
Total. Few'- $
Date Approved:
Entered By: Permits - __
_ _ r
ALL INFORMATION MUST BE SUBMITTED IN
FULL BEFORE PLAN REVIEW WILL BE STARTED
(Seeee Check-off List Enclosed)
TRE APPLICANT IS: (circle one) OWNER or CONTRACTOR
^ , b ,1 '`(,�.. L ./'',b ZIP:
JOB SITE ADDRESS: (work)
/ ' �rj A _ c_ PHONE: (home) 7 3 •
;Z OF OWNER: Oi �/�S
LL
r CITY: /;__ I� L ZIP:
MAILING ADDRESS: (3Pc� J
PHONE: � �/D
CONTRACTOR: ��� ',+ `~
�ob D CITY_ �'LY� � v-i+ ZIP: � � y��-
MAILING ADDRESS: 1135 L
STATE LICENSE: s I
PHONE:___________________
ARCHITECT/�GINEER: ZIP:
CITY:
MAILING ADDRESS
REGISTRATION
NAME:
TYPE OF WORK: New
Addition _ Accessory
Structure :dove
•
Renovate Land Alteration__
Demo Re_•nodel/Alteration_
PROPOSED WORK (describe in detail) : Zr
STORIES:___,___ SQ. FEET OF EACH FLOOR:
GARAGE STALLS:
ATT. .X. DET.
NO_ OF BEDROOMS:_• nn
ESTIMATED CONSTRUCTION VALUATION (excluding
land) : $ � (J 2l
for a building permit and I know be in conformance wledge that the f ath thn
I hereiy apply that the w Code; that I
e
above iscomplete and accurate; and with the State Building permit; and
understandndianaand codesnof the City
this is not a permit and work is not to start without a p
that the work will be in accordance with the approved plan.__
DATE:
C% �i
APPLICANT'S SIGNATIIRE:
ev__
st'- ORONO
-____ = _.-�. : CITY
_4_.:,1„:_4z.... -,_:.:'.� Crystal Bay, Minnesota 55323•Municipal Offices
Post Office Box 66•
--.•-;--::'=--:'''..01F..''"- :'-'; .
�" =Qr~ On the North Shore of Lake Minnetonka -_"- DATA PRNACY ADEITSORY
2, "Rights of subjects of
with M.S. 13.04 , Subd. permit or
license from the City of Orono or any
In accordance you thatrequire
data" , we would like to inform y your request for a p of its departments may
you to furnish certain private or confidential information.
You are notified that:
you furnish will be used to determine your"
1. The information • � or license requested-
cualif i cati on for
the p =-
emit
2. You may refuse to supply data,
but refusal may require that
den the permit or license.
the City Y with other o,- local , state or
federal agencies to the extent necessary to process
be sharede,-mit or
3 . The information may the p
license. action
license requy-"eS Council
4. If your requested permit or ublic-
�nformation may become p
to approve, some y
You have certain rights under M.S. 13.04 to review private
5
data on yourself.
this app licat.on or
6 .
Your full name is required to proceo ss
permit.
------ , J ON OISI
He oil I., Last
First
Middle
3C0 /6.0 ' 0A
Add ess
L ' trj U I L
Zip
City State
phone
I understand my rights as stated above.
If .
Sig ature •
• ADMINISTRATION&FINANCE-473-7358
• PUBLIC WORKS -473-7359
BUILDING&ZONING-473-7357
ASSESSING