HomeMy WebLinkAbout1992-004179 - reroof PERMIT
PERMIT TYPE:
CITY OF ORONO
1335 Brown Rd. South • P.O. Box 66 t't J I LD I NG
Permit Number:
004179
Crystal Bay, Minnesota 55323 Date Issued:
02/13/92
(612) 473-7357
1 SITE ADDRESS:
1: 95 ORONO LA
CH
- 006
P. I .N. : 02-117—.4z.--...
DESCRIPTION:
FERC
Building
Perrft, °` ' , SF—ADD/REMODEL
Building Wc► 'k ` Ty� : RE R F
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4Y
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REMARKS:
rITV��)OF OR O
FINANCE OFF, L
131310°ls00
FEE SUMMARY: ,',%pek�<,
01 CEN 1 D
VALUATION ' ' 29 i�.tac 4.15
Vi GES'
CHHECR PL 11=.15
BaseF 10 .00 RECUT'i—,, YOU jJ{
Surcharge
11 � . .L ViAat•4.
CONTRACTOR: _ A�, I i ;i . — OWNER:
SUBURBAN EXTERIOR INC: 14791910 NOLAND DICK
6000
HWY i 1395 ORONO LA
MAPLE'LE F`l_A I N MN 55 :�;� i iRONO MN 55391
t:t-,1.7,1 475-1`910
473--8002
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LICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURC e�.
v
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ /M./5 Date Received:
Date Approved:
Entered By: ,C%.i
Permit#: 4'4 '79
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
-73 THE APPLICANT IS: (circle one) OWNER or ONTRACTOR
JOB SITE ADDRESS: (RS bi2oNO LANE ZIP: S� 3`
(work)
NAME OF OWNER: O t L tL NJ l LAN 0 PHONE: (home) X73 -Fob
MAILING ADDRESS: 13►5 o(t030 L+RNf CITY: D(1_4NO ZIP: SS-1S-1t
CONTRACTOR: SV v(LP,p N PHONE: LI& Li-?°i -/CU 0 6 135
MAILING ADDRESS: la)LO t—k V ( L CITY:MA f t fLR4 N ZIP: 5S j S`i
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration v/ Renovate Land Alteration
PROPOSED WORK (describe in detail) : R-C.NIVW1V tu.JC, CtQA(2- 144In LES
1 -tQ1. 1ct✓ 1/..►� IL 1 CO � 5-74(+ ) ' L`4
STORIES: I lt-L SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ $%2q ra`'
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.
APPLICANT'S SIGNATURE: (44 ° cA' DATE: . (3 ei
, \
A.
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
ORONO 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.
Cele CKq-St-i Cc_ii1... E
First Middle Last
Address
ik4 A-91 �u i \J Nl r\) SS 3 StA
City State Zip
4-161 - tell 0
Phone
I understand my rights as stated above.
I
1.CL
Signature ll .
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
SUBURBAN EXTERIORS, INC.
9407
MN COMM 9407 02/ 11 /92
MINNESOTA COMMERCE DEPARTMENT STATE LICENSE
Q
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Dcr r_:..:�..; is Corirnerce
********$60 . 00
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