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HomeMy WebLinkAbout1991-004008 - re-roof/tear-off PERMIT CITY OF ORONO 4' PERMIT TYPE: :UILQIhJG 1335 Brown Rd. South P.O. Box 66 Permit Number: )(}40 )i Crystal Bay, Minnesota 55323 Date Issued: 10/14/91 (612) 473-7357 SITE ADDRESS: y ORONO ORCHARD RD N LSV P. 1 . N. : 35-118-23-33-0009 DESCRIPTION: RE-ROOF/,'TEA R-OFF Building Perr�+i t ' -ADD/MODEL Building Work. Type Ft -.RLI F r ;. CITY OF ORONO ' FINANCE OFFICE 1313100000 01 GEN 25.00 . r 1111200000 u REMARKS: r' 01 GEN .50 ,; CHECA' TL 25.50 RECEIPT-THAN• YOU ff :' 190 0001 X101 T0° Z5 FEE SUMMARY: �� ,�" " ,� ;?�„� 10/14/F1 VAL�.T I ON ,,,,/M�,, „ '$1�,000 Base Fee $25.00 Surcharge 1-AO_ Total Fee $25. 50 CONTRACTOR: OWNER:FREEMAN - Applicant --- FREEMAN NOWELL P. O. BOX 737 WAYATA MN 55391 (A1-7-9720-2205 +^,+! 3. i f�_ -.r G ! t^R 3 r--•; �: r3 �+} z r I ti T l r, KE THE REAL L I MPR3_�'13E Ii:_N S v� •i E 3.__ _r., I:'I NFD !-,_lY.+_ ;_.=:” i _.3 i :_=:I _ 1 :li=;r, r"•+'r+' T T ^. A s+r., r;r._.+f._ ..+_., ALL +l.r T 3•.3 - - _.k_t„+ I t z;:E WITH +.. _ r. i DO i€LL_ .4€3. F':r•. 1N +R1 i ..•�_�riFL A It:r__ i4' t Sh ALL i:_ I i F i1 .j z;Io C'RO I t At',3�E'•_ A d 1' `i; ' I I\4 F' T: E�_!I LD I NG =- R�i;i l i `i'c-.i' � . L_ (7/re,,/ ___ ..---/ ..et--/t— ISSUED BY APPLICANT/PERM TEE SIGNATURE :SIGNATURE Cs�/ " CITY OF ORONO — BUADING PERMIT APPLICATION Total Fee: $ 440e1 A6(. Date Received: /' /Y.- 7/ Date Approved: Entered By: r/ Permit#: 2./(leg ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED THE APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: "Za C'© ) 01 - /7°39"2-,0 ZIP: l 7/4 V Z o%_ G4 /21/)/ (work) (y7'/—/F/ N2ME OF OWNER: PHONE: (home) 7 2 Za MAILING ADDRESS: .0 d)( 7 -7 CITY: ZIP: CONTRACTOR: / VU C// PHONE: MAILING ADDRESS: CITY: ZIP: TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : TEA- - 0-PP p �o STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ /D e 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: OGf /5, /7 ?/ (Please fill out the reverse side of this form) . a �`� . CITY of ORONO 1 rf Y;y Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices 4:00:240= On the North Shore of Lake Minnetonka : DATA__PRIVACY ADVISORX 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. Ato (41 L _.. _ --_ -- _._ - - -- - --- _______ -- - First Middle Last po eq.)c. ._. 737._ .. .Address - -� a y2 �-....._.._._ . 221 _ •S_. -9�. - City State Zip 7.c-r'-.J. ".! _.__ ..._.._.. Phone i understand my rights as stated above. Signature BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING