HomeMy WebLinkAbout1995-007093 (re-roof) PERMIT
r CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 _ _
Crystal Bay, Minnesota 55323 Permit Number: _ _
(612) 473-7357 Date Issued: - _ � - _ -
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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� APPLICAN RMITEE SIGNATURE ISSUED BY:SIGNATURE �� �
� � CITY OF ORONO - BDILDING PERMIT APPLICATIaN
�
Total Fee: $ Date Received:
Date Approved:
Entered By: �.l permit;: '�n l 3
AT•T• INFORMATION MUST BE SIIBMITTED IN FULL BEFORE PLAN RE�7IEW WILL B$ STARTED
(See Check-off List Enclosed)
------------------------
TgE APpI,ICANT IS: (circie one) OWNER o CONTRACTOR
JOB SITE ADDRBSS: � � �-U `, � ZIP: _
(work) �� �
� ��
,/� n {� PHONE: (home) J ' �
NAME� OF OWNER:���/G����� � �� � V�' �
MAII,ING ADDRESS: ��� � c�'CG ��� _ CITY: ��vvL� ZIP:
CONTRACTOR: �� G-��' G�� 'c PHONE: ������
MAILING ADDRESS:
�� • � r i . CITY: �� ZIP: r
STATE LICENSE: � ����
ARCHITECT/ENGINEER: PH���
MAILING ADDRESS: CITYs ZIP:
N��: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure biove
Demo Remodel/Alteration Renovate Land Alteration
.�- � � -� �
PROPOSED WORR (de cribe in detail) : � �
; , ; �
STORIES: / SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI�LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding landl : $ ���G
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 with the
ordinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit; and
that the work wil 1 be in a, ordan with the approved plan. �
,� DATE: ��
APPLICANT'S SIGNATURE:
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�` ` �'`��a . Minnesota 55323•Municipal Offices
Post Office Box 66 Crystal Bay,
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� _ � � 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 like to inform you that your request for a permit or
license f rom 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 Iicense.
3. The information may be snared with other local , s�ate or
federal agencies to the extent necessary to process the permit or
I.icense.
4. If your requested permit or Iicense requires Councii ac��or.
to approve, some information may become public.
S. 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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First
Middle Last
�`� a , /� �r,T� .��
Address �
/ r^.._..
r.� y
/�]�(/C C� C� �� �—� � ��
City State Z1D
S �� � -7�% OC -
Phone
I understand my rights as stated above.
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S ' nature
BUILDING&ZONING—473•7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS —473-7359
ASSESSiN G
�`�
ATE TIME
CITY OF ORONO CALLED IN �' � ���'
INSPECTION NOTICE SCHEDULED G�-26/y� �Y ��L_,
PERMIT N0. � �- i3 COMPLETED ��( r�
ADDRESS �C' � �- .
OWNER � Y'`r � � CONTR. '��-/�.�
TELEPHONE NO. _��3 -"7�t! c�
� DESCRIPTION .%��-an��
� 01 FOOTING �1 ME�IANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� EMO-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 OWNERICONTRACTOR TO MEEf YOU:_YES_NO
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� COMMENTS:
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d ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� ❑ CORRECT WORK 8 PROCEED [7 ISSUE CERTIFICATE OF OCCUPANCY
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� Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
C1 CORRECT UNSAFE CONDITION WITHIN HOURS. _, PHOTO TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C7 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContracto n it :
Inspector. ✓
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