HomeMy WebLinkAbout1995-006916 - tear-off/re-roof PERMIT
CITY OF ORONO ' ` PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: - - _
Crystal Bay, Minnesota 55323 ; � _ - -
(612) 473-7357 Date Issued: - :
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT� ERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORU2vv -� BIIILDING PERMIT APPLICATION
Total Fee: $
� �. �s/ Date Received: � � � - �S ..
/� Date Approved:
Entered B '
y' Permittt: .�' y/�-
AT•7• INgpRMATION MDST BS SIIBMITTED IN FIILL BEFORE PI�AN RE�7IEW WILL BE STARTED
(See Check-off List Enclosed)
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TgE APPLICANT IS: (circle cne) OWN or CONTRACTOR
/J��i�,u.-'� /i � ZIP: ��� � /
JOB SITE ADDRSSS: , ; r�� v ` �
(work)
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NAME OF OWNER: _ �'=�! '�- l!'L!'.�'1/�'` � C � ���'����� PHONE: (h ome)��� �-
MAILING ADDRESS: ����S ✓��� �! ��%' � CITY: �,�����'�"�/� ZIP: S-�����
PHONE:
CONTRACTOR:
------. CITY: --------- Z IP: ___ _
MAII�ING ADDR.ESS: �
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STATE LICENSE: #
-----_
__ _ PHONE:
ARCHITECT/ENGINEER: ----- - - -
CITY: -----_
ZIP:� _. _ _ _
MAILING ADDRESS: ___—__
_- ----
NAME: __ _ __ _ REGISTRATION n —.
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration_� Renovate Land Alteration
PROPOSED WORR (describe in detail) : �l� G��! �1���✓
STORIES: �_. SQ. FEET OF EACH FLOOR= �� �
NO. OF BEDROOMS:� GARAGE ST�LS: ATT. DET.��
� /�'� CE
ESTIMATED CONSTRIICTION VALIIATION (egcluding land) : $____yL�S�`---J ._.._
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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 thE
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; ari
that the work will be in accordance with the approved plan.
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f�,�� �Z,,u,�.�-- DATE: ��y /<
APPLICANT' S SIGNATIIRE: � � ' C�'�
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c�TY o� o�aoNo
Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
•
� _ � � On the Nortlz Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of
data", we would Iike 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 confidentia3 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 reguire that
the City deny the permit or Iicense.
3. The information may be shared with other Iocal , s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii ac��or.
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 full name is required �o proc�ss this appZication or
permit.
,�;'r,� ��r-� ��%�5����-
First Middle Last
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Address
C -6 �ii�/�- f�'��''� ��-����
Ci� State Zip
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Phone
I understand my rights as stated above.
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Signature ��
BUILDItiG&ZONING—4'13-7357 • ADMINISTRAT[ON&FINANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G
DATE � ' /TIME �
CITY OF ORONO CALLED IN �"V'''��5 `� � ' S �'-'-'
INSPECTION NOTICE ��i I 4' SCHEDULED �.,�-�� ��, �
PERMIT NO. COMPLETED " �
ADDRESS ��� '' �'G z,ci� � �� _
OWNER �.-�"t',�;•��, �^,�� CONTR.`<�,�:,���Z�CI� �FL�.
� ��_,f %�, ._ �-� �:<� '
TELEPHONE NO. '
� DESCRIPTION_,L�� �� �`�'
�
� 01 FOOTING 11 MECH rjICAL RI 18 EXCAV/GRADWG/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FIN 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED PROJECT COMPLETE
� C CORRECT WORK&PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOfl REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. i_; pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR -' CITATION ISSUED
C INSPECTION REdUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra on s�e:
Inspector.
White Copylinspector's Fil Canary CopylSite Notice