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HomeMy WebLinkAbout1993-005610 - land alteration j PERMIT �Il`�'� OF ORONO PEFiMIT TYPE: "z750 Kelley Parkway • P.O. Box 815 Permit Number: �-�� '��` �'�� �fi`���j Orono, Minnesota 55356-0815 =}`-'�'`'��' (612) 473-7357 Date Issued: - 1C�I�.�;:`_'_, SETE ADDRESS: ."_ ��XFi�i;;G �u _ ��± , . i s�,—' i :, —-. :';.j,--i�,_;�,?�: DESCRIPTION: I 41!! V� Vl��LJ,TV t-�pi.��nc nre rC� � + p ! 1��i/,7tf/►L/�L VI f 1 ji .i J�.�r�il`V ifS%V f7 I {l� ��� .ri�r.vv ;�1�Clt T� �L'.�i' � ;�c�r�cT�r_r ' p� y: F . IZL4Lit ( !!��)�1�• /�U ���u���! ��t3� ki;1 ;�;:;� REMARKS: r t .�L .J:�.:...L: FEE SUMMARY: .=�-�-- ,�.- �,�-; i;t; _�!_J� i=_t� ---_____�:�s.�.a..� ����t.��, ���:;- $;{:! .=_iij CONTRACTOR: �-- ��:���'_ 3. _ =,�-=t� - OWNER: ��;�1'=�:r'�r°�;.��tt1 ;�i�L.E j�,.i.�.�:�.'.�1� ;I'<<l�1Ei=� �=;�i F' f���l.E.:� `�,.c���t��:F:�i?•��1 34 ��� �'ti �.j�; !^I��d_:�'i[} �'i�l �'���1 �Et�� tr�,t�_�y h�;,� ��q.�.�? !��+t��� L��::� [1�i ��:_:�r�. " _ :j- - _ — _�_ . ..�.- --— • — — r " - ' '_ �,�'+'il=_—.1'' ,'{���, '-s3= {,��:r",1 's�— �=°3,�=�;j � _ — s.) ;•i;;,��° �-�..�.� �;��{;i i,�� "_;{`;—��'���� ' '- _�I d ''`��'._':!'�._.: 1 ._. ..._.._ . ,::_ .;_�_��+ i`_� 't =i���: ..l =.. :'t�•.'=._' i i�_ . . _ i�... � , , ;_ :;'•'3' "'i�•�[...?' ' i 7 •i"" t': , r : i: : : ; ' ; . .� '° ; _ _. _. . ..�_ 5�.�'_. . . _.f' '; i r�;.,. _ :(_� .� f_.��;':i'�(:�.� ;=�. E �-: ('z�� t..._, f '„ _��' �. ;•,: � : .. �> � : r-„ � �. . ,. , t , .� � : : � { '"f .'_�.. ,1 .:_ _ .-. ;_, �_�e"' ! l I .:y:__#_° �i-1 ::� {z�L3!t'+it� ?_�__���� i���=a!�,'.E.I�`.':I'�+.`"._1'? � `:� ` _ _. _ . : i . ... , - C� _ �. - � x '� APPLICANT%PERMITEE SIGN RE ISSUED BY:SIGNATURE � - CITY OF ORONO - BUILDING PERMIT APPI,ICATION Total Fee: $ Date Received: Date Approved: /0- /Z'Ci 3 Entered By: r�� Permit�: � AT•T• INFORMATION MDST B$ SIIBMITTED IN FULL BEFORE PLAN RE�7IEW WILL BE STARTED (See Check-aff List Encl.osed) ----------------------------- THE APPLICANT IS: (circle one) OG�7NER or CONTR.AC OR JOB SITE ADDRESS: L < �� � ';x��� � ZIP� ��J S _ (work) NAME OF OWNER: '�" ��'tS � �� �`r PH NE: (home) MAILING ADDRESS: � � cz�: C_.�J zzP:55^3— CONTR.ACTOR: L�5 PHONE: �G' I I�__�__— MAILZNG ADDRESS: � Z CITY: � ZIP: STATE LICENSE: ,����" ARCHITECT/ENGINEER: 1� ��-�S �11,L PHONE: � �[Z�5 _ n /�r � ZIP: � Z MAIZING ADDRESS: I b � t�lk '`��ITY: NAMF: C S REGISTFtATION # � 1-t - TYPE OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration�_ . � �� ��c��r �� PROPOSED WORR (describe in detail) . (� G S t � �O In�o�Q..s STORIES: SQ. FEET OF EACH FI+O�R= NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ ��d� I hereby apply for a building permit and I acknowledge that the information above is complete and ac rate; that the work will be in conformance with the ordinances and codes o he Cit and w' th the State Building Code; that I understand this is not p i a d wor3c s ot to start without a permit; and that the work will be i a r n e with he app roved plan. DATE� l � !�� APPLICANT'S SIGNATURE: � '. � CI'TY o� ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices • � _ � � On the North Shore of Lake Minnetonka DATA PRIVACY ADVISORY In accFordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to in�orm you that your reques�, for a permit or license from the City of Orono or any o� its departments may require you to furnish certain private or confidential information. �ou are notified that: • " . ; 1. The informa�ion you furnish wil.l be used to determine your < rqualification for the permit or license requested. � 2. You may refuse to supply data, but refusal may require that the City den� tY�e-:.permit or license. 5 3. The information may be shared with other local, s�ate or federal agencies to the extent necessary to process: the permit or Iicense. _ . 4. ,If your "requested permit or, become e ub q�2res Caouncii. act�or. • to approve, some i�formation �ay P . �, 5. You hav+e certain rights under M.S.i 13.04 to review priva�e data on yourself. � � . • 6•. Your full name is required to proc�ss this application or permit. . � � . . �, �5�9 � 1 / C� G�`'o✓4- "� ��y Last • First Middle ��7�" �,�. .��b � Addre s A � �r l��1 �1 s-�Z City State Zip c���— ����"` Phone I u e stand ghts as s ate above. , i ature • � . .� • ADMINISTRATION&FINANCE—�73-7358 � PUBLIC WORKS—473-7359 BUILDING&ZONING—473-7357 , ASSESSING � " , � �� ���� �� . � � E ��� � ` � , , > - � i � , = i S 0 S 'i .. � ' � � � � � ! �, � .. , � � � ' � � �, i a � � � . � � ' � c, ; .� � _ � � � � �� � � . ;� � 3 ° � ! �� � _ _ ..._.�.� � � � � � � ;� � �° . � � � � `; , CITY OF OR4N0 `� � � _ A' SITE PI�AN �. G�.Y�DING P�AN � � ;� �'���'��OVED `� � . '�r'r'�=,�V�.t� N�;;�";-E h�.`:'I5'i��fi�l� � �3 _: �.�.�_.�. 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