HomeMy WebLinkAbout1993-005170 - re-roof �'ERM�T ! �
�:ITY-OF ORONO PERMIT TYPE: �.�;_; r`��;4�;
2750 Kelley Parkway • P.O. Box 815 Permit Number: ;;�';�; ;%��:
Orono, Minnesota 55356-0815 Datelssued: r_;�,�=°f�;;��_;_;
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — ��=��i ?�=�:����. —
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� � CITY OF ORONO - BUIZDING PER�IT APPZIG�TION
Date Received:
Total Fee: $
Date A�proved:
Entered BV: Permittt�
pg.MATION MIIST BS SIIBMITTED IN FIILL BEFORE PeI.AN REVI� �I`I' B$ STARTED
AT•T• =NF En c Z o s
(See Check-of� List _____________
-----------------------
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�HE AppI,ICANT IS: ( circle one) O��NER or CONT�ZACTOR ���� l
" S S ��Oti�� �� _ ZIP:
JOB SITE ADDRRSS: ��� (work) L�7.�"=S�l�7
(� 1 pHpNE: (home) ��7�. �c�,�
NAML OF OWNEI2: �1 /(� ��� �'"') \ C.�� Z IP: S S 3 �
MATLING ADDRESS: �l� S S , �5Y d W`� �� CITY: Y C���)
PHo�: �17�-� ��2-�
coxTx.Ac�rox: � " ��i�c- `� �cJ`"� n ZZP• s�S`�Ct �
�� cz�: C�y�� ��G
MATL=NG ADDRESS: ��� � �� �Y��`� `� U<
STATE LICENSE: �
PHONE:
ARCHSTECT/ENGINEER=
C=�: ZIP:
Mp.IZING ADDR.ESS:
R.EGISTRATION �
NAME:
Accessory Structure Move
TYPE OF WORR: New Addition Land Alteration
Demo Remodel/Alteration
Renovate
PROPOSED WORR (describe in detail) s
� r�0 C�� �rU t�S �
STORIES:___L___ S4- FEET OF E.ACS FZOOR: C�
NO. OF BEDROOMS: GARAGE STI�I,S: ATT. DET.
. � Q
ESTIMA�ED CONSTRIICTSON VALIIATION ��cluding I�d3 : $
1 for a buil.ding permit and I acknowledge that the informatic�
I hereby app Y that the work wil. l be in conformance Wlthath.
above is complete and accurate; and with the State Buil.ding Code;
ordinances and codes of the City y ermit; an;
understand this is not a permit and work is not to star� without a p
that the work will be in accordance with the approved plan.
DATE: � �^ �
APPLICANT'S SIGNATQRE: � ' �'�-
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��1 �-r�:-': Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� _ � '' o�'�' On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
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
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:
l. The information you furnish will be used to determine your
qualification for the permit or license requested.
2. You may refuse to suppl.y data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other local , s�ate or
federal. agencies to the extent necessary to process the permit or
license.
a, If your requested permit or license reguires Councii. ac��o%
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6 . Your ful.I. name is required to process this application or
permit.
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First
Middle Last
/��5� S . �✓�o� v. �c� ,
Address
� ��� � ss� � �
City State Zip
`�� �^ ��Z.�
Phone
I understand my rights as stated above.
,`�
' gnature �
, • PUBLIC WORKS —473-7359
BUILDING&ZON[NG—473-7357 • ADMINISTRATION&FINAhCE —473-7358
ASSESSI;YG
�
DATE c� TIME
CITY OF ORONO CALLED IN � 7 � (
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. ._.5/r/�� COMPLETED � `�_G�.
ADDRESS ��� � .� -c�v�- /�'G� '
OWNER /L� .�LPQ,cv CONTR. —
TELEPHONENO. �73 "--���'7
� DESCRIPTION �
� 01 FOOTING 1 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 1 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
� 031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 5 FINAL 13 METER SETITURN QN 17 SITE INSPECTION
� O—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOWUP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W CORRECT WORK&PROCEED !� ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REIN�PECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
- CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
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