HomeMy WebLinkAbout1989-002055 - reroof PERMIT
CITY OF ORONO PERMIT TYPE: ,;, i„ i T ;;
00.;_t,
1335 Brown Rd.South•P.O.BOX 66 Permit Number: ,_ ';,-„,
Crystal Bay, Minnesota 55323 Date Issued:
(612)473-7357
SITE ADDRESS: 1:389 oh€iN€iA
_ •- -: 000;
E' . I •N • : 117-- =4-:
DESCRIPTION: ; .
tEFtC )F
Building `Per,m� t Type SF-ADS/REPO/REI r
Building Work Types RE—ROOF
r
i
REMARKS:
FEE SUMMARY: VALUATION $:3,300 i.44
Base Fee
$k 3.00
Surcharge .
Total Fee :=,4.fir,
Apt.,,i i L -€t.
COIi4TRAl [�Rr_10F I ND SYSTEMS 1 937252:-.4 O R: HENRY
4575 W 7 7TH :=•T i ,1 1:389 € RON€ LA
4�1INNEAE`ifL�
MN E54:=:E IIRONt�t MN SSI;� I
(61.7,) 9:37--254:i,,,_
:7--'2529
` THE. ,�U ERS I GNED E# 4' REQUESTS PE ISS ON TC KE THE' `� A v : . `
SPECIFIED AND AGREES TO DO ALL WORK IN ' TR I CT '''-'77..t:07111-‘'L IAN WITH • I}TY '
L €ORO€Ni O ORDINANCE AND STATE OF M I NNESO A BUILDING,CODE Q I ' IS.` ' ,...,,,..§,- ,
APPLICANT/PERMITEE S / ISSUEI/:SIGNATURE Y/
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ (641. G 5 Date Received:
Date Approved:
Entered By: t,K5
Permit#: c9d56
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: / 389 /oile J'p ZIP: S
(work)
NAME OF OWNER: #./7!" PHONE: (home) 417 -C49167
MAILING ADDRESS: /3 42 O/`v %c.arre CITY: ZIP:
CONTRACTOR: / I (r`1 a-""j PHONE: 973.7 v `)`(
MAILING ADDRESS: 4< s--7s- 7 )f 5K k CITY: "� ZIP: 5&-i/
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : g' ,"CNIF.7-
O p}f 750
S`
®F a c 16i7f
STORIES: 2 SQ. FEET OF EACH FLOOR: 50()cy
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 3, 300 . 0 6
I hereby apply for a building permit and I acknowledge that the informatic
above is complete and accurate; that the work will be in conformance with t:
ordinances and codes of the City and with the State Building Code; that
understand this is not a permit and work is not to start without a permit; ar
that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: �'�!�LAr - �► DATE:
(Please ill out _the revers - - :de of this form)
4
CITY of ORONO
- crre _ Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
QF
QRQNC1 On the North Shore of Lake Minnetonka
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.
mA Dt-viez ,efIch.4:;)
--- ---..._--• Middle
FirstLast
3.67 dvf "my
Address
City State Zip
Phone
I understand my rights as stated above.
X11
Signature
•
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
5