HomeMy WebLinkAbout1995-007195 - re-roof PERMIT
CITY OF ORONO PERMIT TYPE:
4 2750�Kelley Parkway- P.O. Box 66 Permit Number: ':-'�=��='A�"�3
Crystal Bay, Minnesota 55323 -``='�: ` ��'`'°
(612) 473-7357 Date Issued: :
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY: -
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APPLICANTiPERMITEE SIGNATURE ` ISSUED BY:SIGNATURE- �'C�'I .
CITY OF ORONO - BUILDING PERMIT APPLICATION
�r'otal Fee: $ Date Received:
Date Approved:
Entered By:
Permit tt:
AT•T• INFORMATION MIIST BS SIIBMITTED IN FIILL BEFORE PLAN RE�7IEW WILL B$ STARTED
(See Check-off List Enclosed)
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THE APPLICANT IS: (circle one) 0��7NER or CONTRACTOR
JOB SITE ADDRRSS: 1L10 c��wrJ �ro�G (V ��Tla ZIP: SS 3S�
(work) y73�7.�$�
NAMF: OF OWNER: S�n�' ��N�� �A/I'4 CjuST 1� _
PHONE: (home) y�3- ��Zg
MAIZ,ING ADDRESS: sf4-►'�'�.1� CITY: (�^�, � ZIP: SS ,3.��
CONTRACTOR: �W�'C R- - pH���
MAII�ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PH���
MAILING ADDRESS: CITY: ZIPz
N�: REGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : TC�2 ��� fi �R'��
STORIES: SQ. FEET OF EACH FLOORs
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ �� , b00�
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
ordinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit; and
that the work will be in accordance with the approved plan. �
APPLICANT'S SIGNATURLr: Llr--�C�- �., L DATEs 7�2� "y �
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£�������r
�����`� RONO
}� �I'TY of O
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':� . Minnesota 55323•Municipal Offices
Post Office Box 66 Crystal Bay,
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� _ � o On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2, "Rights of sub eerc�t� o��
data", we wou3.d like to inform you that your request for a p
Iicense f rom 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 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 oth��r e scthe permit or
federal agencies to the extent necessary to p
license.
4. If your requested permit or I.icense requires Councii. ac�ior.
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your full name is required to proc�ss this application or
permit.
5co-r-r R /�'lA(��sTN
First
Middle Last
_]�(� 1'�3 0 �(Lo W N ,`^'`
Address
J � S3"`3 S�
City State Zip
y� 3 �s�ZF�
Phone
I understand my rights as stated above.
— � �� •�j�l�' �✓.��/ i: �
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� Signa ure
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BUILDING&ZONING—473•7357 • ADM[NISTRATION&FINANCE—473-7358
• PUBLIC WORKS—473-7359
ASSESSIN G
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED � �
PERMIT NO. �COMPLETED
ADDRESS � �'"^N � �
OWN ER CONTR.
TELEPHONE N0.
� DESCRIPTION �� ���
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 0 D. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FI 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-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 ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED SUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r' pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r: CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ion 24 hours in advance.473-7357
OwnerlContr tor n it
Inspector.
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