HomeMy WebLinkAbout1994-006064 - re-roof/overlay P�1�,�1liIIT
CITY OF ORONO PERMIT TYPE: `�
2750 Kelley Parkway • P.O. Box 815 Permit Number: `_`°�-`'��-�-`�'`"�
Orono, Minnesota 55356-0815 �-"-'�=,�'�=°�
(612) 473-7357 Date Issued: ^ �A t F:�,,;,_:pi.
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SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: �- ��;_���1 i c�;-�}. - OWNER:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE
� r
CITy pF ORONO - BIIIZDING PERMIT APPZIC�,TION
��f � � Date Received:
Total Fee: $ � -
Date Ac�roved: �
Entered By: � Permit ff: �P ��° 7 � _ � .
AT•T• IP7gOgMATION MIIST BS SIIBMITTED IN FDLL BEFORE PLAN REVIEW WII�L BE S�`gRTLD
(See Chec3s-off List Enclosed)
_ ----T IS:� (circie one) --OidNER o R.ACTO
TgE APPLICAN �
` V ZIP:
JOB SITE ADDRBSS: �- �
� (work)
� � ����-e c g PSONE: (hoine)
NAME OF OWNER: \)/✓�r / .
� CITY: ZIP:
MATZ�ING ADDRESS: c�!"�S� i -
CONTR�C'SOR: a
p i r �-� ,e �`�a t-�,,c PHONE:
.� n CITY: �o�i� c ZIP: ��v?� ��
MA�Z�ING ADDRESS: 3�5� �����a� r' � �`
ST�TE LICENSE: � G � 3a
PHONE:
p�RCHITECT/ENGINEER:
��q: ZIP:
MAILSNG ADDRESS:
REGISZ'R�+.TION 4
N�:
Addition Accessory Structure Move �
TYPE OF WORR: New Renovate Land Alteration
D�o Remodel/Alteration
.1� . .e d-�
PROPOSED WORR (describe u le�
STORZES: S4• FEST OF EBCH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. _
gSTIMATED CONSTRIICTION VALIIATSON (eaclnding Ia.nd1 : $ �����_
1 for a building permit and I acknowledge that the information
I hereby app y that I
above is complete and accurate; that the work will be in conformaCn�cde With t e
ordinances and codes of the City and with the State Building e�it; and
understand this is not a permit and work is not to start without a p
that the werk wiZl be ia accordance with the approved plaa. _ .
DATE: S- �- S�_
APPLICANT'S SIGNA7.'ORE:
Y ♦ , �
� � (��['�'�' o� ��►(��1'O
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal O�ces
•
� _ � � On the North Shore of Lake Minnetonka _
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of sub erm t o=
da ta", w e w o u l d l i k e t o inform you that your request for a P r e u i r e
l i c e n s e f r o m the Cit y of Orono or any of its depar tmen t s m a y Q
you to furnish certain private or con fi den t i a l i n f o r m a t i o n.
You are notified that:
l. 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 withto processcthe permit or
federal agencies to the extent necessary
license.
4. If your requested permit or Iicense ublic res Councii ac��or.
to approve, some information may become p
�. You have certain rights under M.S. 13.Oa to review private
data on yourself.
6. Your full name is required to procsss this application or
pe�-mit.
�c<�G � -er��
Middle Last
First -
c� �7� �� ��^C9�^-� ��`/ t� P
Address
� 70 �,.� �l /�"� ,�. S-��� �/
City State Zzp
�/?/- �i��/
Phone
I understand my rights as stated above.
ignature � �
BUILD[NG&ZONING-473-7357 • ADMINISTRATION&FiNANCE-473-7358
� PUBLIC WORKS-473 7359
ASSESSING
✓
i �AT /�TIM
CITY OF ORONO CALLED IN � �� �
INSPECTION NOTICE SCHEDULED S��y / or�
PERMIT NO. ���o coMP�ETEo N r t •
ADDRESS �
OWNER -�J-z�- CONTR�(���-
TELEPHONE NO. `T ��'ClloZ �
� DESCRIPTION E -
� 01 FOOTING 11 MECH AL RI 16 WELL TEST PUMP
Q 02 FRAMING 71 MEC NICAL FINAL 18 EXCAV/GRADING/FILLING
� 03 INSULATION 24�25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
����• 12 WATER HOOK-UP 34 TREE REMOVAL
05� 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W ❑CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REIN3PECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. rrpHOTOTAKEN
INSPECTOR WILL RETURN
-' CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContrac �ite:
Inspector. �� <� �
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