HomeMy WebLinkAbout1995-006806 (Re-Side) R�
. PERMIT
: CITY OF ORONO PERMIT �rPE:
2750 Kelley Parkway- P.O. Box 66 F:�!s�,�;i i�i�
Crystal Bay, Minnesota 55323 Permit Number: ::;;;;�„_,�,;;
(612)473-7357 Date Issued: ,�_;�t�'!��.•_��
SITE ADDRESS:
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APPLICANT/PER TEE SIGNATURE iSSUED BY:SIGNATURE ��.
� CITY OF ORQNO - I3IIILD�NG I'L''RMIT APPLICATION
Total Fee: $ �� Date Received:
Aate Approved:
Enterec3 By: p�zmit�:����'�'?�
ALL ZNFOAM.ATION MUST B� �trBM2TT�n rN FIILTa ��ox� P?.Aw x�vi�r WTT�r, �� sT�ut�
(See Check-off List Encxased}
THE APPLTCANTYIS:�y(cirCl.e�one)` OSdNER Qr CONTRACTOR
JOB S�TE ADA�tESS: � Z=P' `�`���� -
(work) 9,�����
NAME OF OWNER: �-��Ell/�� PHONE: (hom�) -5`�3
MAIZ�ING 1�DDRESS: /_�,����}s� CITY: /1/i�6��_ -- ZY�: S .�
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CONTRACTOR: �J�1��Y���•��11��„ ��� PHONE: -
MASY,ING ADDRESS: ,/�//� fYir-,� CI'1`Y: 2IP: �� _
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ST,ATE LTCENSE: #_���, --
HYTE /ENGINEF.It: PHONE:
MAIL� ADDRESSr CITY: ZIP:
N � REGYS'I'RATSON �
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TXPE OF WO�: New Additian Aacessoxy Structiur.� Move �
Qemti Remrac e/AlteXati.on P.endvate L�iiB A�terat3,G�n,,,_�
PROPCISED WORR (describ� in det�il? : � , � °�
STORIES: I SQ. FEBT OF EACH FLODR=
I�ip. pF �BDROOMS: GARAGE STAT�•S: ATT.��^ DET.
Ov
SS7.'IMATED CONSTROCTION VALIIATZON (eaclading 13nd? _ $�,���� -'
z hereby apply �or a building permit and Z ackaawledgc that the infoxmation
above is cornplete and accurate; that the w�rk wiil be ist oQnformanCe Wi��ha�hl
ordinan�es and codes of the City and with �he Stiate F�uildinc� �Qde=
understand th3.s is not a permi� and work i� not to start w�thQut a permi�; and
th�� the wo�k w���. be in accordance With the approved pla�. �
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f APPLICANT'3 SY�AIAT[TRL s � �� ,,,� DAfiE:
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� 22�17�95 17:l]9 THE C I TY OF OROhJO 61 c-47,a-7?57 bN2
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CI'�Y o:� t)RUN(�
Post O[fice 13ox l3t3•Crystal IIay,Minncciukt.r+Fi3�•Muni�ipel�ffiee�!
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� � � UR the North �Sh�re oF Lake Min�cetonka
DATA PRTVACY 14DVISQRY
xn accordance wi�h M.S. �3.04 ► Subd. 2� "R�ghts of subjec�s of
data",: we would like to inform You that your rear�men� r�$P�r� lxe
iicense f xom the City of Orono ox any df its dep y q
i �ou to furn�sh certiaxn �xiva�e or confidentia�. in�ormation.
� You are notified that:
l. The informa�ion y�u fuznish w�ll be used �c determine your
qua�.�.fication for the per�nit er lic�nse xeQuested.
2. Xou may refuB� to su�p1Y data, buti refusal may req�ire that
the C�.�y deny the pe�i� ar l�cense.
3. The in�ormati,on may b� shared with other :� �cal , e�� e�
f e d e�a l �gencies to �he eXt�nt neregsaz� to process the p
licens�.
4, �f your r�quested germit or �.ic�nse zec�uir�g Councii activn
to approve, some ��format�Qn may become pub�.ic.
�. You have certain righr� uncler M.S. 13.�4 to r��'-ew priva�e
data on yourself.
6. YouX �u3.1 name is requ�.rec3 t�� �rocess �khis app�ication or
� perm�.t. _
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City State �iP
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Phone
� Y understand my rights as stated above.
�
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� Signature �
� sC wORKS—a�3•7359
� BUILDING�tONiNC—473•7357 � AUMlNISTRATtON d2 FINANCE—477•7338 • pV��
�►SSESSiNC
D TE TIME
CITY OF ORONO CALLED IN .� ��
INSPECTION NOTIC SCHEDULED si �'S _9;.��
PERMIT NO. �6 COMPLETED �- ���—
ADDRESS
OWNER CONTR.
TELEPHONE NO. ���'�(o/.�
e
� DESCRIPTION_._/f'�i��1, =
� 01 FOOTING 11 MECHANICAL RI 18 IXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 IAKESHOREM/ETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FI L 14 SEWER HOOK-UP 06 PROGRESS
� EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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� ORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ext' spection 24 hours in advance.473-7357
OwneriContra o n si e
Inspector. '�
Whlte CopyAnspector's Flle Cenary CopylSite Notice