HomeMy WebLinkAbout1993-005526 - tearing off . ,T PEI�MIT
�CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 �°� `•f#_C�:;:�j;�_
Permit Number: �•_�=
Orono, Minnesota 55356-0815 :f=�`��'��_�
(612) 473-7357 Date Issued: __ ' _
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SITE ADDRESS:
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REMARKS: _ _ ... . : -
FEE SUMMARY: --
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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R-�'a� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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� _ � � On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2, "Rights of sub erm t or
data", we would Iike to inform you that your request for a P Ze uire
Iicense f rom the City of Orono or any of its departments may q
you to furnish certain private or confidential. information.
You are notified that:
l. The information you furnish wil3 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 Iicense.
3. The information may be shared with ot�o esscthe permit or
federal agencies to the extent necessary to p
I.icense.
4. If your requested permit or Iicense requires Councii ac��or.
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your full name is required to process this application or
permit.
,,L/s�i t1�D /"'Lf34iLi ///�-4- G G s���'�
First
Middle Last
'`7 G� .�/Z G:G-L -�G �� �'
Address
U/ZG%�i' > N�� �- �c- `�
City State Zip
`f7i -pSzO
Phone
I understand my rights as stated above.
,� ��/,G �'�-f'-� �
Signature �
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS—473-7359
ASSESSING
CITY OF ORONO - BUILDING PERMIT APPI,ICATION , ` 1
/
Total Fee• $ ��1� Date Received:
Date Approved:
�
Entered By: Permit�: `> 5 �--�
AT•T• INgpRMATION MIIST B$ SIIBMITTED IN FIILL BEFORE PLAN RE�7IEW WIZ.� B$ STARTED
(See Check-off List Enclosed)
---------------
-------------------
TgE APpI,ICANT IS: (circle one) WNE or CONTRACTOR
JOB SITE ADDRSSS: /�. `f�% .�i�i���/G � /��_ /it. �` ZIP: .S�S'=��° `�
(work) `�`�'S� �G z�.s'
NAI� OF OWNER: /J i� !� �i� �/� ° c� v-=/Z
PHONE: (home) y?� -��`G
MAILING ADDR.ESS: i z �`O ��/L•�G�- CITY: / r�✓„✓! _ ZIP: �S".�C. `i
PHONE:
CONTRACTOR:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: n
ARCHITECT/ENGINEER: PH���
MAILING ADDRESS: CITY: ZIP:
N��: REGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : -�fT�y�� �--
STORIES: / SQ. FEET OF EACH FI+OOR: �"U U
NO. OF BEDROOMS: _'� G�GE STALLS: ATT.�_ DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ �? iU�
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 wi�ha�hI
ordinances and codes of the City and with the State Building Code,
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.
Ci�-> -�G 3
APPLICANT'S SIGNATUI2E: ���1�? � � liv�-���v�• DATE: � e i i
DATE TIME
CITY OF ORONO CALLED IN f/-�- g3
INSPECTION NOTICE/:j�� SCHEDULED i/--3 -f'�'-�
PERMIT NO. � COMPLETED � � "
ADDRESS r�`�0 .a��-�-�- /"'E��
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OWNER LL��t(�L�s z¢.:� CONTR. �—
TELEPHONE NO. y%�- ��5�� �"' �ll� yas--���s (u�
� DESCRIPTION - �.r-�
�
� 01 FOOTING 11 MECH ICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECH NICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
05 FINAL . 13 METER SETITURN ON 17 SITE INSPECTION
� —SITE 14 SEWER HOOK-UP O6 PROGRESS
� 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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GW �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� CORRECT WORK&PROCEED C:; ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
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.473-73�J7
OwnerlContr r site:
Inspector. .
White Copyllnspecto's File Canary Copy/Site Notice