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HomeMy WebLinkAbout1992-004702 - tear-off PERMIT CITY OF ORONO PERMIT TYPE: BUILDING 1335 Brown Rd. South • P.O. Box 66 Permit Number: 004702 Crystal Bay, Minnesota 55323 Date Issued: 10/IS/'-;2 (612) 473-7357 SITE ADDRESS: 232 5, WATEFtTOWN PD .TB P. I . N. : 03-117-23-22-0016 DESCRIPTION: TEAR-OFF Building Permit Type SF-ADD/REM=ODEL Building Work Typet, RE-ROOF 41 TY OF {i7Stl O F ►14MCE D, CE 13131�tt44# � Al GEN 7;:'.4V 01 GEN 2.50 CHECK TL 74.50 ,RECEIPT-MAW YOU #255490 C001 k01 T13:14 REMARKS: FEE SUMMARY: VALUATION $5,000 Base Fee $72. 00 Surcharge ---------12 -aQ Total Fee $74. 50 Cqff f OR• _ - Applicant - OWNER: H I F�' H �L �-i_�N'��7 19722716 KELLEY STEVE BOX 6..33 2325 WATERTOWN RD DELANOMN 55328 LONG LAKE MN 55355 (612) 972-2716 n THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS : SPECIFIED AND AGREES TO D13 ALL. W:iE`K IN STR i CT COMPLIANCE WITH ALL CITY 13F OF°t:iNO ORDINANC:E S* AND STATE ATS: ()F MINNESOTA E:L31 L D T N(=, CODE REQUIREMENTS . L_ APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE r CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ Date Received: Date Approved: Entered By: Permit#: ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) ---------------------- THE APPLICANT IS: (circle one) OWNER or C�ONTRACTOR JOB SITE ADDRESS: 35 x'o. �� �',�/aiv n ZIP: (work) NAME OF OWNER: S •�' v e PHONE: (home) MAILING ADDRESS: CITY: �� L d,4 ZIP: CONTRACTOR: �7` / I►'S - r, . PHONE: 7,V 7/ MAILING ADDRESS Q c•�c /,, S_`i CITY: /4� ZIP: c STATE LICENSE: # 6 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : E' m ° Y 6'�a S /� 1��!�`> 4- STORIES: SQ. FEET OF EACH FLOOR: - NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : 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 will be in accordance with the approved plan. APPLICANT'S SIGNATORE:���- �Y' �i�iJ � c zt DATE: Y - CITY of ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices _ 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 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 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 with other local, state or the permit or federal agencies to the extent necessary to process license: 4. If your requested permit or license requires Council action 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. /7/stsc. � First Middle L a X 1733 Address 'D Tr/ll� City State ZIP 1 - e7,9 - a 7/ Phone I understand my rights as stated above. - G Signature BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING CITY OF ORONO CALLED IN Q D/ D Z_ TIME INSPECTION NOTI E SCHEDULED �fL_L - a PERMIT NO.� I� 10 ;21 COMPLETED ADDRESS/�-Z 4 OWNER CONTR. .� TELEPHONE NO. DESCRIPTION W 01 FOOTING MECHANICAL RI 16 WELL TEST PUMP hFRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING OTTNSUL-ATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION 07 DEMO—SITE 14 SEWER HOOK-UP 06 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 Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO Z � COMM E TS: c oLW�I'lla+eArow04ee44400,0- oVV 0 a u( +iOo t A-6 Q C- — d c _ O � - [Ato u- VCS P.K tS W Q Z W z W cc dW WORK SATISFACTORY:PROCEED ❑ PROJECTCOMPLETE cc ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Ci BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN CITATION ISSUED El STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 Owner/Cont to,��Dn site: Inspector. u White Copylinspector's File Canary Copy/Site Notice