HomeMy WebLinkAbout1990-003133 - re-roof � PERMIT
� �I�� OF OF��NO PERMIT TYPE: r, _�; r�.= �-.
1335 Brown Rd. South • P.O. Box 66 c.!F 1,��i l�,,�,
Permit Number: :j�_}_�i__�=
Crystal Bay, Minnesota 55323 Date Issued: i f i;�:=::�;r�=;i:?
� (612) 473-7357 _
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CONTRACTOR: _-- q�,�,� i��;;t- ---- OWNER:
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PF�� if.1l�E E SIGr� ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ � �� �S Date Received:
Date Approved:
Entered By: a -7
Permit#: �� ��
ALL INFORMATION MIIST BE SUBMITTED IN FULL BSFORE PLAN REVIEW WILL BE STARTED
----------------------------------- -�---------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
�- G�l � S � ZIP: ���'��t�C �
JOB SITE ADDRESS: „ f/� � � D� � � �
(work)
N� oF OWNER: �/9 � � 1 l�� � ' 1P1 .� � � � Psor�: (home) %I s-'�--J ��
MAZLING ADDRESS:� CJ ' Q c'� � � � CITY:��Z�S�ia� U� � ZIP: ���.�1 �
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CONTRACTOR: � �I� �� ,� ���7 ��� � `��r�� PHONE: /�2 `�
MAILING ADDRESS: CITY: f���✓c,(,l �'' ZIPs � J��C L
TYPE OF WORR: New Addition Accessory�tructure Move
Demo Remodel/Alteration Renovate �� I,and Alteration
PROPOSED WORR (describe in detai 1) : (�C ' � � L'+ /� u d hr ' S � ��- `-%/�J �i 1 �7 �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRIICTION VALUATION (excluding land) : $ 1�� �
I hereby apply for a building permit and I acknowledge that the informatior
above is complete and accurate; that the work will be in conformance with thF
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; an�
that the work will be in ccor ance�wit t e ap roved plan.
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APPLICANT'S SIGNATIIRE: - �'/ " �'`�V 4.�-� G7 -- DATE: `�/ �U
(Please fi o t the reverse sid of this form)
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� � fr�'�� �� �`�:� CITY of O�iONO
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�� ��d� ` _�` Post Office Box 66�Crystal Bay,Minnesota 55323•Municipal Offices
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�` �` On the North Shore of Lake Minnetonka
a ' 0�r �'�,
� DATA_PRIVACY ADVISORY
In accordance with M.S. 15.165, "Rights of subjects of data", we
wou2d 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
federal agencies to the extent necessary to process the permit or
�icense.
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 ermit.
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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 unders y right as stat d ab e.
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Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION dt FINANCE—473-7358 • PUBLIC WORKS—473-7359
A3SESSING
� DATE TIME
CITY OF ORONO CALLED IN l6 "" �� � �C�
INSPECTION NOTICE SCHEDULED !o -J�-qv �: 3d
PERMIT N0. -�� ��-� COMPLETED �� �_
ADDRESS �a �� ��'''�
OWNER�f`�1 �,.�c��.��a CONTR. —
TELEPHONE iVO. �� 7 5 � ��� � �
j; [_� FOOTWG ❑ MECHANICALRI ❑ SITEWELL
~ ❑ FRAMING ❑ MECHANICALFINAL ❑WELLTESTPUMP
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� ❑ INSULATION ❑ FIREPLACE/WOOD BURNER ❑ EXCAV/GRADING/FILLING
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Q ❑WALL BD. ❑WATER HOOK-UP C LAKESHORE/WETLANDS
Z I�FINAL L��'u`�-�� .,,4�/ ❑ METER SET/TURN ON �TREE REMOVAL
Q O DEMO�SITE � ❑ SEWER HOOK-UP ❑SITE INSPECTION
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� l; DEMO—FINAL ❑ SEPTIC MAINT. ❑ PROGRESS
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Q L_� PLUMBING RI ❑SEPTIC INSTALL. ❑COMPLAINT
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= I_7 PLUMBING FINAL ❑SEPTIC FINAL ❑ FOLLOW-UP
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� COMMENTS:
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d ORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
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� 7 CORRECT WORK&PROCEED ❑ CITATION ISSUED
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O i_1 CORRECT WORK,CALL FOR REINSPECTION �PROJECT COMPLETE
� BEFORECOVERING C� ISSUECERTIFICATEOFOCCUPANCY
�:1 CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
C 1 STOP ORDER POSTED.CALL INSPECTOR
i5 INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Caii for the next inspection 24 hours in advance.473-7357
OwnerlContra o.r�site:
Inspector. U
White Copyllnspector's File Canary CopylSite Notice