HomeMy WebLinkAbout1990-003267 - re-roof PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: _;���� �i�}y�
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357 ''��=;'��_,f
SITE ADDRESS: " �" 1 ' � � '
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FEE SUMMARY:
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CONTRACTOR: I OWNER:
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APPLICA PERMITEE SIGNATURE ISSUED BY SI�,NP.I URE
CITY OF ORONO — BIIILDING PERMIT APPLICATION
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Total Fee• $ ��• Sb Date Received: �/ 7`��
� Date Approved:
� Entered By: ��'�
Permit#: ✓� Z�7
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' ALL INFORMATION MDST BE SUBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED
' -----------------------------------------------------------------------------.
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: ��C� � , ��D ��/� ��L� �' ZIP: J 5�� � �.
/ (work)
x� oF owrlEx: ��� l��� � � ���� `� �-� PsorrE: t home) ��7�����1�
MAILING ADDRESS: �� �J� ��� CITY:�' �� �'�' �<(-' ZIP: v�l����
CONTRACTOR: �—�' , � PHONE:
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : %/�£' � �����'' �
STORIES: � SQ. FEET OF EACH FLOOR: ,
NO. OF BBDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ `�l�C�'
I hereby app ly for a bui lding permit and I acknowledge that the informat�
above is complete and accurate; that the work will be in conformance with -
ordinances and codes of the City and with the State Building Code; tha
understand this is not a Fermit and work is not to start without a permit; �
that the work will be in accordance with the agproved plan.
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APPLICANT'S SIGNATURE: ��(��"L�; ��C- � � DATS: i /
- _ (Please fill o,_, the reverse side of this form) _ -
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. ��� � CI'�Y of UROI�TO
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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! On the North Shore of Lake Minnetonka
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I DATA_PRIVACY ADVISORY
� -- - - -- - - - -
In accordance with M.S. 15.165, "Rights of subjects of data", we
! would Iike to inform you that your request for a permit or Iicense
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 Iicense 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
license.
4. If your requested permit or license requires Council action
to approve, some information may become pubiic.
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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I understand my rights as stated above.
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Signature ,
- _ _ . _ _
- BUILDiNG dc ZONING—473•7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLiC WORKS—473-7359 .`:
A3SESSING
DATE T�ME
CITY OF ORONO CALLED IN U'�+y'��
INSPECTION NOTICE SCHEDULED ��—y�' ' �°�'
PERMIT N0. �`�l0 7 COMPLETED � �/
ADDRESS �� S `��'`�'-'^ �`� •
OWNER � �tJ��i'+-r� CONTR. ,.�L�—�
TELEPHONE NO. ��3 �-'�� y�'
j; [ i FOOTING ❑ MECHANICAL RI ❑SITE WELL
~ ❑ FRAMING ❑ MECHANICALFINAL ❑WELLTESTPUMP
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� ❑ INSULATION ❑ FIREPLACFJWOOD BURNER Ci EXCAVIGRADING/FILLING
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O ❑WALI BD. ❑WATER HOOK-UP ❑ LAKESHORENVETLANDS
Z �FINAL ❑ METER SETITURN ON ❑TREE REMOVAL
Q ❑ DEMO—SITE ❑ SEWER HOOK-UP ❑ SITE INSPECTION
_
� Ci DEMO—FINAL ❑SEPTIC MAINT. ❑ PROGRESS
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W ❑ PLUMBING RI ❑SEPTIC INSTALL. ❑COMPLAINT
_ ❑ PLUMBING FINAL ❑SEPTIC FINAL ❑ FOLLOW-UP
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� COMMENTS:
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d ��WORKSATISFACTORY:PROCEED ❑ PHOTOTAKEN
� i CORRECT WORK R PROCEED ❑ CITATION ISSUED
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O i-; CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
� BEFORECOVERING ❑ ISSUECERTIFICATEOFOCCUPANCY
CICORRECTUNSAFECONDITIONWITHIN HOURS. TEMPORARY
INSPECTOR WILL REfURN
PERMANENT
C_;STOP ORDER POSTED.CALL INSPECTOR
i=; INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract�s�i :
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Inspector. �
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