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Home My WebLink About1987-6267 (building) CITY of ()R()1T() Building Permit PERMIT NO. 6`�67 � AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED _ /�/�� P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 ZONING DISTRICT �� SITE ADDRESS - PROPERTY IDENTIFICATION NO.(PID) ��.�� ' FIRE DEPARTMENT LOT BLOCK SUBDIVISION POST OFFICE O NER (Nar�e) (Address) (Phone) /, . ,ll,�l�L' � ��..� '�.. VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family, Commercial& Industrial Construction Plans (Firm) (Address) (Phone) COND. USE DATE LOT AREA ILDER � (Firm) (Address) (Phone) f � / ) � WIDTI-� „` DEPT' .I ( C � � �� 1 C �� /" -- � ;'l , i II�� I • �/ y/ � - C :7 l: ' � TYPE OF WORK New Ad tion Remodel Renovate PR PO ED SETBA r �{�- FR T R.SMD � �1�, r 1 �-L_- 1 � CONST.TYPE BUILDING SIZE REA n L DE Estimated Construction Valuation / / LL,'t�k� L. - � W. / /C� / Ht.�� ' �7 �,�,�; Fj�^ LAKE ETLANDS CCUPANCY PERMIT FEES CLASSIFICATION f— �•—^ DWELL. BLDG. PERMIT � � � � � ACCESS STORIES B 1 2 3 -�. UNITS STATE FEE `�' �.� NEW EXISTING GAR. STALLS NUMBER OF BEDROOMS AGENCY-APPROV. DATE ATT. PLAN REVIEW CITY DET. SEPTIC APP. DATE SAC CHARGE COUNTY PROPOSED USE SEWER UNIT _ STATE PARK FEE PENALTY � �` �� PRIVATE EASEMENT COUNCIL APP. DATE OTHER REMARKS: TOTAL DUE `"> \ ��' � �a WORK REQUIRING ACKNOWLEDGEMENT PECTION REQUIRED SEPARATE PERMITS . . . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO �4AKE ' . . . . . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES ❑ . . . . . . INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- ❑ . WALLBOARD before taping ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE- . . . . WELL............................... .. . . . . FINAL before occupancy . . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- WORK BEYOND OR WITHOUT A RE- SEWER.............................. � SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE JECT TO PENALTY. V�/ATER............. ❑ OF MINNESOTA BUILDING CODE REQUIREMENTS. GRADING&FILLING ............... ❑ INSPECTIONS MUST BE CALLED-IN 24 HOURS IN ADVANCE. FIRE................................. ❑ ��e'�"'"'"f' ��x.rvt r�'C��S� Signature Date COPY:WHITE-FILE GREEN-FINANCE � CANARY-INSPECTOR GOLD-RECEIPT ` PINK-ASSESSOR Approved ' � �ity of Orono Brooklyn Prtg.&Ativ.Co.Inc. (612)561-0470 * �� CI7'Y OF ORONO � , BUILDING PERMIT APPLICATION BUILDING PERMIT APYLICATION REQUIREi1L'NTS Requirements to be handed in with Buildinq Permit Application: Construction Plans should include: � 1. Building Permit Application - to be filled out 6 signed. 2. Energy Calculations - filled out. 1. First floor plan. 3. Furnish Septic Report 6 Design. 2• Footing and foundation plan. 4. Furnish a Ceztificate of Survey, includinq hardcover 3. Elevations (of all sides). calculations and grading and drainage plans as required. 4. Wall sections 6 cross sections. 5. Fuznish 2 sets of Construction Plans: 5. Details - stairs and any special connections. a) 1 set for City to keep on file b) 1 set for builder to use on site 7*HE ABOVB INPORMATION MIIST BE SDSMITTED BEFORE PLAN RRVIEW IS DONE Work Beyond or without a required inspection will be subject to a penalty ' i ZONING DISTRICT SITE ADDRESS ' ��- � � � "-� �� c'c-> - ��, �- -�� PROPERTY IDENTIFICATION NO.(P!D) FIRE DEPARTMENT LOT BLOCK SUBDIVISiON POST OFFICE OWNER (Name) (Address) (Phone) �'�t! � �'� � �� i� ��..� � �� < � <x.. � ��`. r fr- i VAR. DATE ARCHITECT/ENGfNEER- Must Certify Multi-Family,Commercial 8 Industrial Construction Plans i (Firm) (Address) (Phone} -- , ' COND. USE DATE _� `� `' .�F'�' J� J7 � >`C' • �,,�;c__� C � : c� li BUILDER (Firm) (Address) (Phone) LOT AREA , � ' �~ � ,� ,� ��.-��i�/�= t- � s c /Il.�L c s y ��l Y . S f�� WIDTH DEPTH TypE OF WORK New Addition Remodel Renovate PROPOSED SETBACKS: ��y' �cv,^ % • i FRONT R.SIDE CONST.TYPE BUIIDING SIZE Estimated Construction Valuation I REAR L. SIOE � . r C'= �'� :)�r� t'- L C� / W. /l- Ht./-1 ��C C` f_ c r LAKE WETLANDS STORIES B � 2 3 PERMIT FEES DWELL. BLOG. PERMIT ' I ACCESS New Existing 5Q. FT. L`` � i UNITS . STATE FEE AGENCY: City Cty State i GAR.STALLS NUMBER OF BEDROOMS q�, PLAN REVIEW DET. SEPTIC SAC CHARGE APPROVAL DATE(S) : APP. DATE HARDCOVER � PROPOSED USE OCCUPANCY SEWER UNIT ' CLASSIFICATION Existing B: ; -� PARK FEE Proposed 8: � -..�, � /!/ �r � GRADING PENALTY ❑Staff App. Date I COUNGL OTHER ❑CUP Apo. Date APP. DATE TOTALOUE REMARKS: INSPECTION REQUIRED WORK REDUIRING SEPARATE PERM�TS ❑......FOOTIN�Defore Oour ❑......FRAMING roup�-in PLUMBING.........................❑ ❑......INSULATION MECNANICAL.......................❑ The undersigned hereby makes application for a building ❑......WALLBOARDDeforatepinp ermit for the work described, agrees to do all work in strict ❑......FINAI Detore occuDencY WELL...............................❑ P accordance with the ordinances of the City of Orono and rulings ❑......SITEINSPECTION sEar�c..............................� of the State Building Code Division, and declares that all WORK BEYONO OR WITHOUT A RE- SEWER..............................� facts flI1C1 representations stated herein 8T@ true and COrIE'Ct. QUIRED INSPECTION WILL BE SUB� yyqTEii..............................❑ GRADIN6 8 FILLING...............❑ J � / � / JECT TO PENALTY. � INSPECTIONS MUST BE CALLED�IN �- �� ' � / /� .-t� "G-Cc-� � t � l-� r{.��1``-- 24HOUFSINADVANCE. FiRE..•••••�•.•�.......•.�.......�.�� Date Signature �a . � 1� DATA PRIVACY ADVISORY In accordance with M.S . 15. 165 , "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 inform- ation. 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 require that the City deny the permit or license . 3 . The information may be shared with other local , state or federal agencies to the extent necessary to process the permit or license. 4 . If your requested permit or license req�ires Council action to approve, some information ma� become puAlic. 5 . You have certian rights under M.S . 15 . 165 to review private data on yourself . 6 . Your ful]_ name, and date of birth are required to process this application or permit. � ? � �,� l �: � � -- � �� <��-�... First Middle Last � Cc� �% -�� l. 'L C �j-f� � Address , �.�I � .�-(� f. Y �S rn % /�li? Sc� S� � / Date of birth (does not apply to building/general permits) L� 7 � ' ��r � 1 Phone I understand my rights as stated above. i X �� ' �<< <��`�.``--- Signature �.\ /' " \`�: �.1 j � � R�`;..L�r�,Gc ryrOL� � ^,/'� , � „O -i = „tr, � N � ` '��r.�'...��..� �� r �� '�_--�-• -_"�._ ��c` A W `!— --t�. ��'.N� .n�� }�s�✓ t----- - � ` � , 6� rj- �, �y� �r� ka✓�G�.-- � �� i . � �` � ;Zl�� Z � ' >i,,,� ''. Y U k ��-�" � � ,:_ —• -�._.__ I � �, �. � � � - � ______ I � ' ?-- _- � _ -� l , - _ � -- � i;, ��' i,,, � + _ � t: 4 ; od� �;`� p� � �� '� , � � � i � i� � � ! � ) � ��. � zi , � f �), ,+ �} ! . � fi �� ,� j �; � ' ' �'' '+; �;t;� . � � f 1 � {!; � g 1 ��i� � � � ;'!j �1 fi � ! � ' !� . i r ! i f� � i 1 i; #�� ! 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'. �.._.� � -:...' ..-.: _.:, �.��r ., , � � DATE -7 TIME CITY OF ORONO CALLED IN �� ?� / -� INSPECTION NOTICE SCHEDULED � � — �`�� J . PERMIT NO. ��-�4- � COMPLETED � '� �. '� � `7�'/� —� � � � ADDRESS � ' � "� � � �I�:�J � �� `� OWNER �L.{�� , L CONTR. l-��_c I c l -�� TELEPHONE NO. O,FOOTING O PIUMBING RI ❑ SITE INSPECTION �FRAMING ❑ PLUMBING FINAL � EXCAV./GRADING/FILLING � �O NSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS � ❑ WALL BD. O WATER HOOKUP O LICENSING � �FINAL ❑ METER SET/TURN ON ❑ COMPLAINT ❑ PROGRESS ❑ SEWER HOOKUP ❑ FOLLOWUP y O DEMO�. ❑ SEPTIC INSTALL. O SEPTIC FINAL Q ❑ FIRE PREV. G SEPTIC MAINT. O FIREPLACE/WOOD BURNER � ❑ WELL TEST PUMP ❑ Q COMMENTS: _ � � Q i ��v�-i�� (lu��O J Z / � — ,�:� /11r� (.I ){�`S � � � � � J O >. � O � W � Q � Z W � W � � d W � W WORK SATISFACTORY:PROCEED O PHOTO TAKEN � O CORRECT WORK�PROCEED ❑ CORRECT:NORK CALL FOR REINSPECTION BEFORE COVERING '� CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED.CALLINSPECTOR. G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site ,,/ Inspector �Xn /Ib1ti��.-' 473-7357 White/�nspector's File Canary/Site Notice