HomeMy WebLinkAbout1989-001987 (building) PER
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd.South•P.O. BOX 66 Permit Number: r�it_1;t_!,;�,�:i=�
Crystal Bay, Minnesota 55323 Date Issued: �T�:�i`-j=i?
(612)473-7357 i_{f�}!�i.*'-:i;.==t
SITE ADDRESS:
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DESCRIPTION: '
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REMARKS:
FEE SUMMARY:
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CITY OF ORONO PERMIT TYPE:
1335 Brown Rd.South•P.O. BOX 66 Permit Number: ��=_��i_1?,�.i'a�::i
Crystal Bay, Minnesota 55323 Date Issued: `-"�-'=��='`=''�
(612)473-7357 i f;_%'i f'�%�__'�:�
SITE ADDRESS: APPLICANT:
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PERMIT SUBTYPE: TYPE OF WORK:
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CITY OF ORONO - BIIILDING PERMIT APPI�ICATION
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Total. Fee: $ � Date Received:
�, Date Approved:
Entered By: '
Permit�: � +1�J�
AT•T• INFORMATION MIIST B$ SIIBMITrED IN FULI+ B$FORE PI,AN REVIEW WILL B$ STARTED
----------------------------------------------------------------------------•
T� APpI,ICANT IS: (circle one) OWNER or CONTRACTOR
) �
JOB SITS ADDRESS: � CX U � �A S C. � P � � D ZIP:
(work)
NAME OF OWN$R: �C� �1�I-��� PHONE: (home)
MAIZING ADDR$SS: � S�n C �a �C� }�T- fZ .� CITY: (�,'�✓�4(Z� ZIP:
CONTRACTOR: � �T Hv � ��v�T^� e � PHONE: 1 �- �� 7 d`
MAILING ADDRESS: "� � �c d�%� S G�� /� �� CITY: �(VL��,'�.�v� ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : 1�� (�o o r l"�"t��� P C� �� � � �P
� � U r.:� � C�1I�'j � ►�
STORIES: SQ. FEST OF EACH FI.00R: -
NO. OF BSDROOI�LS: G�FtAGE STALLS: ATT. DET.
• � � ��_
ESTIMATED COASTRIICTION VALIIATION (eaClIIding la.nd) . $
I hereby apply for a building permit and I acknowledge that the informat:
above is complete and accurate; that the work will be in conformance with -
ordinances and codes of the City and with the State Building Code; tha;
understand this is not a Fermit and work is not to start without a permit; �
that the work will be in accordance with the approved p Ian.
�
� � /✓ � -
. ��I.� f J G�Z� � DATE: C� �_ � ,rY �
APPLICART S SIGNATORE:
(Please fill out the reverse s ' e of this form)
4
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C��� �� O���T�
al Post O�ce Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
e,
� _ �� � � On the North Shore of Lake Minnetonka
DATA_PRIVACY ADVI_SORY
In accordance with M•Shat �Iour request for a permit or license
wouid �ike to inform you t y
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
qual.ification for the permit or license requested.
2. You may refuse to suppZy data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other Iocal , state or
federal. agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 15.165 to review private
data on yourself.
6. Your ful.l name, and date of birth are required to process
this application or permit.
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First
Middle Last
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Address
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City State Zip
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Phone �
I understand my rights as stated above.
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Signature
BUILDiNG&ZONING—473-7357 • ADMINISTRAT'ION�FINANCE—473-7358 � PUBLIC WORKS—473-7359
ASSESSING
5
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �z2 -s�C� -�—J
PERMIT N0. � '� , COMPLETED �" " �—: � �
� �`
ADDRESS '2 GQ-�"�� Pi
OWNER ���'��"� CONTR.
TELEPHONE NO.
[- FOOTING � PLUMBING RI C FIRE PREV.
>.
� ": FRAMING G PLUMBING FINAL ❑ FIRE SUPRESSION SYS.
� � INSULATION �_ MECHANICAL RI ❑ EXCAV/GRADINGIFILLING
y C WALL BD. C MECHANICAL FINAL ❑ LAKESHOREM/ETLANDS
� �FINAL �fL�•C-�= L FIREP�ACE/WOOD BURNER ❑TREE REMOVAL
Q C DEMO—SITE r WATER HOOK-UP G KENNEL LICENSE
� C DEMO—FINAL ❑ METER SET/TURN ON ❑SITE INSPECTION
v i�,SEWER HOOK-UP ❑ PROGRESS
? ❑ SEPTIC MAINT. ❑ COMPLAINT
J G SEPTIC INSTALL C FOLLOW-UP
� C SEPTIC FINAL
O C;SITE WELL
� ❑WELLTESTPUMP
� COMMENTS: '
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W�ORK SATISFACTORY:PROCEED C PHOTO TAKEN
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WQ �' CORRECT WORK&PROCEED C CITATION ISSUED
Q ❑ CORRECT WORK,CALL FOR REINSPECTION C_ ISSUE CERTIFICATE OF OCCUPANCY
V BEFORECOVERING TEMPORARY
[ CORRECTUNSAFECONDITIONWITHIN HOURS. PERMANENT
INSPECTOR WILL RETURN
r STOP ORDER POSTED.CALL INSPECTOR
C INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.4T3-7357
OwnerlContractor on site:
Inspector.�i_� '� .
White Copyllnspector's File Canary CopylSite Notice