HomeMy WebLinkAbout1993-005694 - CB post off/re-roof PERIl�IIT
CITY OF ORONO � " � ' '
PERMIT TYPE: �;._:���r T f:a�_.
2750 Kelley Parkway • P.O. Box 815 Permit Number: ;��:;;;;;;�=;:�
Orono, Minnesota 55356-0815 - - -�=
(612) 473-7357 Date Issued: T � ,.•:;�_�_>>�;:_;
SITE ADDRESS:
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FEE SUMMARY:
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APPLICA T`FERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF OROI3�U '- �iUILDING PERMIT APPLICATION
Total Fee: $ 4 3 � ��S� Date Received:
� Date Approved:
Entered By: �'�'� Permit tt: � G ��
AT•T• INgpRMATION MIIST BS SIIBMITTED IN FIII�L BEFOR.E PLAN RE�7IEW WILL Bg STARTED
(See Check-off List Enclosed)
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THE APpI,ICANT IS: (circle ane) O�dNER �NTRACTOR
�� 1�.� �/�i11�IA � /�'� �l�) 7ilp:
JOB SITE ADDRSSS: /�.� ✓ ��� vw
(work)
�. J oh rv ��h���"�Sll�l� PHONE: (home)
NAME OF OWNER: !�V D
MAILING ADDRESS: �7�� I�P.`lt'_,�' J Ar��W� CITY: (���I�JY� ZIP:
- `^ ;,�-I � � PHONE:� � �".� � 1 �
CONTRACTOR• � �"�
MAILING ADDRESS: � 75 �-S p, � � 1 _ CITY: J�t.�;Nl�� ZIP: _
STATE LICENSE: # ��C��-�S�
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITY: ZIP:
NAME� REGISTRATION ,ur
TYPE OF WORR- New Addition Accessory Structure Move
Demo Remodel/Alteration � Renovate Land Alteration
PROPOSED
WORR (describe in detail) : � � ��1 r Q �r ���% � � ()2)� �NS����
' " � � � ►� � r � Z�s P b�. � � z���
�S�� �n;��,�, M � �, r� � � �.� � �.
r��w� rvr>�� s�sf4v� .
STORIES: SQ. FEET OF EACH FI+O�R=
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ � ��
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 wi�ha�hl
ordinances and codes of the City and with the State Building Code;
understand this is not a permit and work is not t start without a permit; and
that the work will be in cordance with a r ved plan.
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� � DATE: IC�"�� / �
APPLICANT'S SIGNATURE: �� ' ,
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r�� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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i _ � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2 , "Rights of subjects of
data", we would 3.ike 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:
l. The information you furnish wil.l 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 Iicense.
3. The information may be shared with other local , s�ate or
f ederal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii ac�io%
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 to proc�ss this application or
permit.
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irst Middle Last
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Address
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City State Zip
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Phone
I understand my ri ts s S �ed above.
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nature
BUILDING&ZONING—473-7357
• ADMINISTRATIO[Y&FI[YANCE—�173-7358 • PUBLIC WORKS—473-7359
ASSESSING
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION TIC 2 SCHEDULED
PERMIT NO. � COMPLETED
ADDRESS���� ��'�'��� ��' �'� _
OWNER � CONTR.
TELEPHONE NO.
� DESCRIPTION �6d
ly 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 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FIN 14 SEWER HOOK-UP 06 PROGRESS
h 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 OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
fl COMMENTS:
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d C 1 WORK SATISFACTORY:PROCEED - ROJECT COMPLETE
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� ❑ CORRECT WORK R PROCEED
W , SSUE CERTIFICATE OF OCCUPANCY
O �7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR — CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance. �73�J�T
OwnerlContra r o sit •
Inspector.
White Copyllnspector's File Canary CopylSite Notice