HomeMy WebLinkAbout1991-003854 - replace cement block � , PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �'����-�`��'��'
Permit Number. i;i�:;;�;�q
Crystal Bay, Minnesota 55323 Date Issued: t i;;�'��_=��
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPL CANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE _.��¢�U''
• �- /
CITY OF ORONO - BIIILDING PERMIT APPLICATION `
Total Fee: $ Date Received:
Date Approved: `
Entered By:
Permit#:
AT•T• INFORMATION 1KDST BS SIIBMITTED IN FIILL B$FORE PLAN REVIEW WILL BE STARTED
----------------------------------- ----------------------------------------
� APPLICANT IS: (circle one) WNER r CONTRACTOR �
JOB SITE ADDRESS: � Z �D O �i� rl.lC� ��QCC� ZIP: SS3C'�`�
(work) �j�JB'���g
N�ME OF owri�x: 1�-tJC� ��D� � psorrE: c home) �7 j-�10 6 3
MAILING ADDRESS: SIQib � CITY: ZIP:
CONTRACTOR: PHONE:
MAILING ADDRESS: CITY: ZIP'
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate_� Land Alteration
PROPOSED WORR (describe in detail) : 1r�P ((����- �°--e �u%� h� � W���5
� Yj4�e ur� u.'r '�Z � �t,�k� �..�c�.(' �-i.( W es� wo�,�.('
STORIES: SQ. FEET OF EACH FLOOR:
�10. OF BSDROO1rIS: GAR�IGE STALLS: ATT. DET.
ESTIMATSD CONSTRIICTION VALIIATION (excluding land) : $ �, U O O.
� hereby apply for a building permit and I acknowledge that the information
sbove 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
-anderstand this is not a Fermit and work is not to start without a permit; and
that the work will be in accordance with the ap�roved plan.
�PPZICANT'S SIGNATQRE: l.-c ��1�._ DATE: � 7iZ �
(Please fill out the reverse side of this form)
�' i
�
wY� � - ..
� �ITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Officea .
•
� _ � � � On the North Shore of Lake Minrcetonka
-- - -
DAT�_ PRNACY �l_D_V��ORY
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 Iicense 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 Iocal , state or
f ederal agencies to the extent necessary to process the permit or
�icense.
4. If your requested permit or Iicense 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.
N I� N �-1 � l�� �c�2s d►J - -
First Middle Last
�? ca � S� Y��� �'� , .__._ - _ _ _---- ._.. .._--
Address
n� �1�J� � � � �� '�i6 �- - -- ---=
City State Zip
�-� � - ���.� --�---..._._.-----
Phone
I understand my rights as stated above.
' , (/l"-� --.. .--------
Signature
BUILD[NG&ZONING—473-7357 • ADMINISTRATlON&FINANCE—473-7358 • PUBLIC WORKS—473•7359
ASSESSIIG
1 DATE TIME
CITY OF ORONO CALLED IN �1 '��- `/
INSPECTION NOTI � L� SCHEDULED � -30 "9/ �G'�'d O
PERMIT NO. S COMPLETED �� �?
ADDRESS !02 CQ� �Yr�� � I I
OWNER ��U�� CONTR.
TELEPHONE NO. � 7� — �G�' ��
� DESCRIPTION � l b�C" r�--� �cC c P v v���.�,�
� 01 FOOTING 11 MECHANICA�RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 3
Q 05 FINAL 13 METER SETlTURN ON 17 SITE INSPECT
� 07 DEMO—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 P�UMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
° COM ENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra o �te:
Inspector. �-
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