HomeMy WebLinkAbout1991-004076 (Reside) PERMIT
_ A:o��TY OF ORONO PERMIT TYPE: E;t_;�:_ii��,#i;�
Y �335 Brown Rd. South • P.O. Box 66 PermitNumber: '-'`-'�'-'r'=
:ystal Bay, Minnesota 55323 Date Issued: � �?�y==��j�
(612) 473-7357
SITE ADDRESS:
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REMARKS: � ��
FEE SUMMARY:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY SIGNATURE
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ 7 `T� 5� Date Received: /�":��—��
- - Date Approved : f
Entered By: _ �
Permit#: '� U 7 �
AT•T. INFORMATION MDST BE SOBMITTED IN FIILL BBFORE PLAN REVIEW WII�L BE STARTED
THE APPLICANT IS: (circle one) OWNER or CONTRACTO�
JOB SITE ADDRESS: ! '�`�(,P ��.'���%� - � ��_ ZIP:
(work)
N�ME OF OWNER: T��'--L �-7� � PHONE: (home )
MAILING ADDRESS: � �-�(o ��L�'.!:�- ��� CITY: ('����t��� , ZIP:
�-� _
CONTRACTOR: . (�/J� - PHONE:���, � �� oC��'
MAILING ADDRESS: �� � �'r�IV���4�L7.�i`� CITY: �i C-tiTT'7f.-�-Z-� ZIP: d��?�('7.7
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TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORR (describe in detail) : �G`�j,.i�"`— H- �1 `��-���
STORIES: SQ. FEET OF EACH FLOOR:
:�0. OF BEDROOMS: GARAGE STAI,LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ �P���
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
�rdinances and codes of the City and with the State Building Code; that I
understand this is not a Fermit and work is not to start without a permit; and
that the work will be in accordance with the aFFrove plan.
APPLICANT'S SIGNATURE: _ DATE: �'� Z �= 1I
(Plea fill out the reverse sid of this form)
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.����`-" CITY of OlE�OI\T
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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On fhe North Shore of Lake Minnetonka
DATA__PRIVACY ADVISORY
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 Iicense.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
�icense.
4. If your reguested 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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First Middle Last
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Address
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City State Zip
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Phone
I understand my rights as stated above
S ' ature
BUILIIING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSI\G
/
DATE TIME
CI fY OF ORONO CALLED IN
INSPECTION NOT CE SCHEDULED
PERMIT N0. � COMPL�o � � -
ADDRESS � L
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION St���
� 01 FOOTING 11 MECH NICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z ,0�4 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q/05�INAL 13 METER SET/TURN ON 17 SITE INSPECTION
�07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 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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W� DG,WORKSATISFACTORY:PROCEED '-: PROJECTCOMPLETE
W �❑�CORRECT WORK&PROCEED �: ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. _ pHOTO TAKEN
INSPECTOR WILL RETURN
f_l STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
i_; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr or,Qn site: _
Inspector. U
White Copyllnspector's File Canary CopylSite Notice