HomeMy WebLinkAbout1995-006879 PERMIT ��n�- "��-b� �
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 r 1 Permit Number.
Crystal Bay, Minnesota 55323 . _ ._ -. _
(612)473-7357 Date Issued: ` � _' _
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SITE ADDRESS:
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REMARKS:
FEE SUMMARYe �
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BIIILDING PERMIT APPLICATION
,fS , i � ` ' Date Received:
Total Fee: $
Date Aoproved :
Entered By: =��.2�U �k�� �
Permit n:
AT•T• INFORMATION MIIST B$ SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
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TgE APPLICANT I5: ( circle one ) �S1NE or CONTRACTOR
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JOB SITE ADDRBSS: ��� ln� �
(wo rk) ��� �� �' ��
4 � 1 L�d�r L Co i i��� 1����� PsoNE: (home) �7� ���7�I �r
N� OF OWNER: I -
MATZ,ING ADDR.ESS: j� (r� O �� 7.S/�� �' CITY: �YJd�Y�� �L�¢/j'U ZIP: -5.5��_� `?
PHONE: ..
CONTRACTOR:
MAILING ADDR.ESS:
CITY: ZIP:—
STATE LICENSE: �
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITY: ZIP: _
N�ME. REGISTRATION n
TYPE OF WORK: L7ew Addition Accessory Structure
Nlove
Demo Remodel/Alteration Renovate Land Al.teration
PROPOSED WORR (describe in detail) : Itfl��S � ��-�- ✓���'��� 5���/�Cr3 —! �
STORIES: � �Y SQ. FEET OF EACH FLOOR= � � ��� �'
NO. OF BEDROOMS: G�GE STALLS: ATT. DEm.
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ESTIMATED CONSZ'RIICTION VALIIATION (excluding land) : $��`"o U � -------
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 W1thathI
ordinances and codes of the City and with the State Building Coermit; and
understand this is not a permit and work is not to start without a p
that the work will be in accordance with the approve3 plan.
/)��� ��X� ` � �/,�iv" 'G-'tC+Q'!�' DATE:
APPLICANT'S SIGNa�: l:� '
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n � Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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� _ � v On the North Shore of Lake Minn.etonka
DATA PRNACY ADVIS�RY
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
Iicense f rom the City of Orono or any of its departments may require
you to furnish certain private or confidentia3 information.
You are notified that:
1. The information you furnish wil3. 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 Iicense.
3. The information may be snared with othT�r sscthe permit or
federal agencies to the extent necessary to p
Iicense.
4. If your requested permit or Iicense requires Councii ac��o%
to aporove, 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.
NI I C, � A-e� ���� �n � f"� !�3��-�ti��;
First
Middle Last
�`�(� � ��'� �1 ��S ��.� �'� ,
Address ��� ���
i YI� �'L--� !=%:��'; r �' �^�' /�i�, '
City State Zip
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Phone
I understand my rights as stated above.
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Signature �
BUILDING&ZONING—473-7357 • ADMINISTRATtON&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G
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DATE TIME
fY OF ORONO CALLED IN
�NSPECTION NOTICE SCHEDULED -%�i i��'-3� 1__ '�-_
PERMIT N0. �-� %C� COMPL ED
ADDRESS U T�
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION ___Vl�l� a- �i Q�11. ��C, t�c J/�
� 01 FOO`G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FO�LOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d /VORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� �5 CORRECT WORK&PROCEED C= ISSUE CERTIFICATE OF OCCUPANCY
W
O i-� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN NOURS. ,_ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract n s'Ft�
Inspector. -v
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