HomeMy WebLinkAbout1992-004722 - tear off/reroof �- . . _ PERMIT
CITY OF ORONO PERMIT TYPE: �;ti���.;��:��,
1335 Brown Rd. South • P.O. Box 66 Permit Number: �it i�.?����
Crystal Bay, Minnesota 55323 Date Issued: i::i;'�-:_t�`'=��
(612) 473-7357
SITE ADDRESS:
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ICA PERMITEE SIGNATURE ISSUED 9Y:SIGNATURE
CITY OF CRC:IO - BUII.DING FER:�.ZT APPLICATION
iotal Fee: $ ��� ���/� Date Received:
Date A��ro�ed:
=ntered B� �'./L.' �. u. ���� 1
Pe�i� .
�,T.T. INFOR''iATION MIIST BE SIIBMITTED IN FIILL BEFORE PI,�N RE�7IEL�1 WI� B$ STARTED
(See Check-aff List Enclosed)
-----------------------------
THE ApPLICANT IS: (circle one) L�Ti�1ER CONTP.ACmOR
JOB SITE ADDR.$SS: � � C+ e�� v '`- ZIP:
(work)
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- � PHONE: (home) � � �
N�,ME OF OWNER- � ' � ��C '�/rl,�C����
MATLING ADDR.ESS• ��I � l�� �-'�l �''�/ CITY: �G/y C; G' � � ZIP:
��� �K �� �Jr°� L �r PHONE: ���'-��`��
CONTRAC�'CR: �,
J�� Lrr��/,`'' �� CITY: � �tGZ� ZIP:���'�
:��I�ING ADDRESS: � �� � �
STP,TE LIC?�SE: = ����ti�`��(
ARCHITECT/ENGIN�ER: P$���
C=Z•y: ZIP:
:KAII,SNG ADDRESS:
���_ R.EGISTRATSON �
':'YPE OF WORK: i7ew Addi.tion Accessory St�ucture riove
De�o R�*nodel/Alteration Renovate Land Aiteration
?ROPOSED WORR (describe in detail� :
���d`� � lL' �i'�� '�������'
,� ���� �2 Sc
�TORIES s ( SQ. FEET OF EACH FI�OOR:
�yp_ pg BEDROOMS: Gt�RAGE STAT�S- ATT. DE'�'.
c�:,
�—.
ySTIMATEI7 CONSTRQCTION VALIIATION (excluding Iand) : S
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= hereby apply for a buil.ding permit and I ackncwledge that the infor:nation
sbove is comolete and accurate; that the work will be in conforinance with the
�rdinances and codes of the City and with the S`ate Building Code; that I
:�nderstand this is not a permit and wor ' s not tc start without a permit; and
�hat the work will be in accordanc wit he approved plan. �
/ L� DATE: � ��'� '��
�pPLICANT'S SIGNATIIRE:
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� Post Office Box 66•Crystal Bay, Minnesota 5a323•Municipal Offices
01
� � - a �� On the North Shore of Lake 1�linnetonka
DATA PRSVACY ADVISORY
In accordance with M.S. I3.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
Zicense from 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
cua�.izicat�on for the permit or license recuested.
2. You r,tay refuse to supp?y data, but re=usal may require that
the City deny the permit or license.
3 . The information may be snared witn o�zer iocal , s�a�e or
f ederal agencies to the extent necessary to process tne permit or
iicense.
a. If your requested per^tit or Iicense _ecuires Councii ac�io%
to approve, some infor:nation may become pub?ic.
5 . You have certain rignts under r1.S. 1� .C � to rev�ew priva�e
data on yourself.
6 . Your fu1l name is required to proc�ss this appZication or
per;nit.
�� � � � ��(��" �`-
FirSt Middle Las� '
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Add��ss �
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C ' ty State Zip
---�`�;'��-- � �32- �
Phone
I unde=stand my rights as tate ab e.
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Signature , �
, •
Bli1LDf�G& ZO�I`G - 473-7357 • ADStINISTRATION& FN�NCE - 473-73:3 • PUBLIC�VORKS -473-73�9
ASSESS[v G
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DATE TIME
CITY OF ORONO CA�LED IN /O,�o %1
INSPECTION NOTICE scHEou�Eo �G' � � �
P�RMIT NO. `�7��-- COMPLETED U �"
ADDRESS �`�'3 � �`,'n = .-� '
OWNER s� -�' CONTR. ���u.�-
TELEPHONE NO. "�-���—�3-��
� DESCRIPTION ��.2��
� 0 OTING 1 ECHANICALRI 16WELLTESTPUMP
02 r AMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
O iNSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
2 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ORK SATISFACTORY:PROCEED C! PROJECT COMPLETE
� CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
V PERMANENT
❑CORRfCTUNSAFECONDITION WITHIN HOURS. pHOTOTAKEN
INSPECTOR WI�L RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the e t inspection 24 hours in advance.473-7357
OwnerlContr c o 'te•
inspector. �
White Copyllnspector's Fil Canary CopylSite Notice