HomeMy WebLinkAbout1990-003142 (Addition/Remodel) . — �'T'T - - l
P'ERMIT �`.
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CITY OF ORONO . �ERM[T TVPEo �
1335 Brawn Rd. South • P.O. Box 66 Permit Number: � j
CYystal Bay, Minnesota 55323 Date Issuecl: E:IIT LD I(��i '
' (612}473-7357 �,�j���,� I
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APPLICANT/PERMITEE SIGNATURE iSSOED BY:SIGNATURE
CITY OF ORONO - BIIILDING PERMIT APPLIGATION
Total Fee: $ � �. �7/ Date Received: � '��- q�
i�� Date Approved:
Entered By: ,�/��
Permit#:
ALL INFORMATION MIIST BI� SIIBMITTED IN FOI,L BEFORE PLAN REVIEW WILL HE STARTED
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T�: APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: a� $� �}131NGbOy�1 ��1� ZIP: 553��
(work) S�f�-13��
NANII: OF OWNER: �oH+�1 `�C �}�y�LIS �'?}t���ToN PHONE: (home) �{73-�$7�-
MAILING ADDRESS: 33Fst3 1°�I�G D�o1•! Wl�y CITY: LoNG L1�}!L6 ZIP: $�3;s'�
L .t.c)• P3 _�' ,� 2�tC . b�S�?4
CONTRACTOR: �,yV L p i�tV iS �4 S�EM g 0� � �-1 I�LS PHONE: �y5�-1 rs�
MAILING ADDRESS: I(o31 C_'�� � �a� CITY: H1Na1�'1°tAD�. [5 ZIP: �"�2,.5
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : ����� � l��bk�lc� ek�+µ v►Q-ti�
{'�\kOil II�� 1(�L�Lt.� �k�•QY`i1i� fitie� Y�fca.Y '�C �LLGIn.� .
STORIES: �- _SQ. FEET OF EACH FLOOR:
NO. OF BBDROOI�IS: GARAGE STAI�LS: ATT. DET.
ESTIMATED CONSTRUCTION VAI�IIATION (exclndinq land) : $ 5��lo���
I hereby apply for a building permit and I acknowledge that the informatioi
above is complete and accurate; that the work will be in conformance with th
ordinances and codes of the City and with the State Building Code; that :
understand this is not a permit and work is not to start without a permit; anc
that the work wi 11 be in accordance with the approved p lan.
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APPLICA�T S SIG�AT�E: ��°� � _ DAT13. o �a.
_- - " - (Please fill out the =reverse side of- this` form) �� - - -_ - -
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CITY of �RUNO
Poat Office Box 66•Cryatal Bay,Minneaota 5b323•Municipal Offices
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� _ � � On the North Shore of Leke Mi�csietonka
D���.���CY AD_�_O,�tY
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:
l. 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 local , state or
federal agencies to the extent necessary to process the permit or
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. 15.165 to review private
data on yourself.
6. Your full name, and date of birth are required to process
this application or permit.
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I understand my rights as stated above.
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Signature
� BUILDU�iG�ZONING—473-7357 . - • ADMINISTRATION 6!FINANCE—473 7358 f_ • � PUBLIC WORKS—473 7359_,- _
ASSESSING -
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CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED a �'�'3a
PERMIT NO. � a COMPLETED �(
ADDRESS � � �
OWNER l��OL�Q�"l� NTR.
TELEPHONE NO. ���'�R�_ � �. �
� ❑FOOTING 0 MECHANICALRI ❑SITEWELL
~ ❑FRAMING p MECHANICALFINAL ❑WELLTESTPUMP
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Q ❑INSULATION ❑FIREPLACE/WOOD BURNER ❑ EXCAV/GRADING/FILUNG
� ❑WALL BDr� �����,�� ❑WATER HOOK-UP ❑ LAKESHORENVEfLANDS
Z �FINAL \,./�' W/�t�METER SET(fURN ON ❑TREE REMOVAL
Q �DEMO—SITE ❑SEWER HOOK-UP ❑SITE INSPECTION
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J ❑DEMO—FINAL ❑SEPTIC MAINT. ❑PROGRESS
�Q ❑ PLUMBING Rt ❑SEPTIC INSTALL ❑COMPLAINT
_ ❑ PLUMBING FINAL ❑SEPTIC FINAL ❑ FOLLOW-UP
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W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
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� 0 CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLEfE
V BEFORE COVERING ❑ ISSUE CERTIFiCATE OF OCCUPANCY
❑CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contr o�c�n site:
Inspector. .V
White Copyllns tor's Flle Canary Copy/Site NoUce