HomeMy WebLinkAbout1992-004180 - retaining wall PERMIT
CITY OF ORbNO PERMIT TYPE: i1:=:ER DEFINED
1335 Brown Rd. Sou,h • P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS:
1565 ORONO f OAKS DR
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DESCRIPTION:
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User Permit. Type; AND AL_TE1;A'TION
PITY OF ORONO
F NAN TI E OFFICE
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°l1 GEN
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RECEIPT—THANK YOU
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REMARKS:
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FEE SUMMARY:
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Base Fee
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Total Fee $50 .00
CONTRACTOR: OWNER: - Applicant -
DALBEC JOHN
1565ORONO OAKS DR
ORONO MN55356
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received: ,2--
Date
2-Date Approved: 1 f 3 Q,2_
1
Entered By: ..(4, permit#: -//go
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ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
TBE APPLICANT IS: (circle one) (T or CONTRACTOR
JOB SITE ADDRESS: / S-‘,57 p/eaig9 0006. ZIP: SS3S
(work)
NAME OF OWNER: 5-0/1"-- (i9/d e c. PHONE: (home) `03-, ° 13?-
MAILING
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MAILING ADDRESS: /S C's 010a0 04K5 P4 CITY: v^-G /4/ ZIP: 5$ 5
CONTRACTOR: PHONE:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration x
PROPOSED WORK (describe in detail) : A 6 lee e-$ tv Tt/r"' AO r
Fe-.4,s2 6y Ca49O`,Y - /ea TAT-Pt/6 t/6 po eD Be,r e e,.- P11-4.e cv a75
1.°t° 50-r4 A)Pe �y GN 'CuPfr -e, r,.. 6o c..- 51)&7- Also... .50,K-e, A /I.-y-0/- R S eDr
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
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: DATE: l"
TL,J) 1L;J2
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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 you/
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.
3-0 flr" A . PA 16,e
First Middle Last
i s 5- G /e o „...0 (37.4-tc s !1411
Address
/o.�- C /-09-k t-e. eft�- S C 3 s- 6
City State Zip
Ll' 3- 708 `)___.
Phone
I understand my rights as stated above.
0,.....„4/ye--a_‘____.re
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS—473-7359
ASSESSING