HomeMy WebLinkAbout1992-004592 - add/remodel T� ,T- ` _ `-r_. . � `. \ " _ �.. 1
� �ERMIT
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i335 Brown Rd. South • P.O. Box 66 PermitNumber: ��tj������'�`-'
Crystal Bay, Minnesota 55323 Date Issued: ��;;fiF.�,��-�
(612) 473-7357
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REMARKS:
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FEE SUMMARY:
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CONTRACTOFi: - A�=F�1 i c L�7t- - OWNER:
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APPLICANT/PER EE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF CRC:IO - BUILDI�IG FE��ST APPI,IC�TION
Date Received:
:.ta1 Fe=: $
Da�e ADD?"O�i 2C:
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Pe�it; y'��> / .:�_
�,'.. INFORI�IATION MIIST BE SIIBMITTED IN FDLL BEFORE PI,�'�N RE�7IEW WII.� BE STARTED
(See Check-off List Enclasa�
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�E APPLICANT IS� (circle one ) O�+T;�ER or�CONTP.ACmOR
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JB SITE ADDRSSS: l /�j �• ���'(-�-'� ������ � ZIP:
(work)
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(��,�w%,� r ,��-�_ ,, �.���"' i'l� (;�,.� PHONE: (home f � � _`
�ME OF OWNER: -
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'AII,ING ADDRESS: 1 ��l� �� l.��J�I� ��`. -
" 17� �; ,•-�:- ��'7 � � � PHONE:��� ' - ! -�j '� i
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PHONE:
:CHSTECT/ENGSNEER:
�'�IZING ADDR.ESS=
CITY: ZIP:
�MF_ REGISTRATION -
''PE OF T70RR: �7ew Addition Accessory Structure
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Demo R�*nodel/Alteration Renovate Lar.d Alteration
'be in detail) a+ :itf'Jt�t��� C;�i��,9,',� �i'li,�-�'? !�T,� ,i((�y�^ Y� � � :.�`��"
�OPOSED WORR (descrz . , �
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°'ORSES s SQ. FEET OF EACH FZ,OOR:
)_ pg BEDROOMS: Gt'�RAGE STAI.LS: ATT. DE'�'.
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.3TIMATED CONSTRIICTION VALUATION (ezciuding Iand) : 5 � �'��'-'
hereby apply for a building permit and I ac?cncw�e�ge that the in�or=nzt'on
�ove is complete and accurate; that the work wil _ be in conforinance with the
-dinances and codes of the City and with the S�.ate Buil.ding Code; that
7derstand this is not a permit and work is not y-c start without a per:nit; and
lat the work will be in accordance with the Papo�ved plan.
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a Posi Office Box 66•Crystal Bay, Minnesota 5�323•'dunicipal Offices
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: � - � g On the Nortfz Shore of Lake l�finnetanka
DATA PRSVACY ADVISORY
In accordance with M.S. I.3.04, Subd. 2, "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 confidentiaZ information.
You are notified that:
I. The information you furnish will be used to determine your
cua�.izication for the pe?-:nit or Iicense recuested.
2. vou r,iay refuse to supp?y data, but re=usal may reQuire that
the City deny the permit or I.icense.
� . The inf ormation may be s'r.ared w;tn ot:�er Ioca I , s�a�e or
f ederal agencies to the extent necessary to process tne pe?-mit or
?icense.
a. If your requested per.:.it or Iicense _equires Councii ac��or_
to a�prove, some infor:nation may become public.
5 . You have certain rignts under ri.S. 13.0� to rev_ew private
data on yourself.
6. Your full name is required to p�ocess this appZication or
per•nit.
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I understand my rights as $ta�ed �bove.
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Bl,'ILDI�'G& ZOti'1`G - 473-7357 • ADJfINlSTRATION& FIV��NCE - 4%3-73=3 • PUBLIC WORKS -473-7359
ASSESSIVG
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT CE• scHEou�Eo �
PERMIT N0. �� COMPLETED
ADDRESS����Z-d j�,,f n� . ��t1 .
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION �
L� 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� \ 7"B�10f0 D. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 0 -SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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 ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED ; SSUE CERTIFICATE OF OCCUPANCY
W
O �l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7357
OwnerlCont cto on s' :
Inspector.
White Copy/lnspector's File anary CopylSite Notice