HomeMy WebLinkAbout1993-005604 - tearoff/reroof PEI�MIT
� �TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 �;!-�?�-���{-�
Orono, Minnesota 55356-0815 PermitNumber: �;;.���,�;�
(612) 473-7357 Date Issued: f {_}t�.i f,�::;
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE_ 'C,.0 .
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CITY OF ORONO - BUILDING PER�iIT APPLICATION
Total Fee• $ � 5 `�� Date Received:
Date Approved:
Entered By: �'/ pe�nit tt: i ((�'1 �
ALL INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN RE�7IEF1 WILZ BB STARTED
(See Check-off List Enclosed)
------------------------
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TgE APPLICANT IS: ( circl.e ane) ��INE� or CONTRACTOR
JOB SITE ADDRBSS: 3- 3 1� ��L -C �a�--� �� ZIP: .�^S 3�t �
(work)
,�(�� PHONE: (home) 1/7/ ��l`s
N� OF OWNER: �� ��f� A���� 1 '���'
MATLIr7G AD�xEss:�-3 J� ...�`��',���r-� r��� cITY:�G� _�.- zIP: ,�".�3 �r'�
/,� PHONE: `�" 7� ` 7 7 r �
CONTRACTOR: �l� �-�-����22'���"
MAII�ING ADDRESS: CITY: ZIP:
STATE LICENSE: �
ARCHITECT/ENGINEER: PH��
MAILING ADDR.ESS: CITY: ZIP:
N�,ME: REGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :
�2�-c
STORIES: SQ. FEET OF EACH FI+O�Rs
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding landl : $ -�f�����`���� —
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 wil 1 be in accordance with the approved plan. �
`�.,� ,�,s�--<l DATE: �° /'�� � �
APPLICI�NT'S SIGNATURE: 7%!�'�f�'�
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� _ � � 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 Iike to inform you that your request for a permit or
Iicense from the City of Orono or any of its departments may require
you to furnish certain private or confidential information.
You are notified that:
l. The information you furnish wil.l be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or 3icense.
3. The information may be shared with other Iocal , s�ate or
f ederal. agencies to the extent necessary to process the permit or
license.
4. If your requested permit or I.icense requires Councii. ac��or.
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.
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'� ��''� Last
First Mi dIe
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Address
`�_ ..S�S-�3 i�
,,�;2 � ��-
Cit State Zip
�J� .���- � ,s�
Phone
I understand my rights as stated above.
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Signature �
BUILDING&ZONING—473-7357
• ADMINISTRATION&FINANCE—373-7358 • PUBLIC WORKS—473-7359
ASSESSIN G
DATEp TIME
CITY OF ORONO CALLED IN -�0 ' .� � ��t
INSPECTION NOTICE / SCHEDULED
PERMIT NO.��/� COMPLETED �
ADDRESS 3��
OWNER LJ�[' h«-t'.� ONTR. �
TELEPHONE NO. �7�� �a'�
� DESCRIPTION
� 01 FOOTING 11 MECHAN L RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILIING
y 031NSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z � 12 WATER HOOK-UP 34 TREE REMOVAL
= 5 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGHESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
��,, COMMENTS:
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d WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WiTHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on '
inspector.
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