HomeMy WebLinkAbout1990-002940 - renovate/remodel PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 ��;���������
Permit Number ::,�i',�'�,:ii�
Crystal Bay, Minnesota 55323 Date Issued: i:ir.;`i;�;;==;ii
(612) 473-7357
SITE ADDRESS:
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FEE SUMMARY:
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APPLICANT;PERMIT IGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit#: o29yU
ALL INFORMATION MDST BE SIIBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
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THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: ��� ���'����v��� ��. ZIP: ,j��,j�p
(work)
NAME OF OWNER: ���� ��j��� PHONE: (home)
MAILING ADDRESS: !�l�� i%���2��� CITY: ��C,�� ZIP: v�s.3��o
CONTRACTOR: 1�...�i�/�'RJ /<-,T��C��`'r/�� �. PHONE: �G ` ,�
MAILING ADDRESS: ��!�� � CITY: � ZIP: `��3�
TYPE OF WORR: New Addition Accessory Structure Move
Demo�` Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : �1���0 L/��~�'1i6�l2. 1�7Ll�
/2f� - �!/�L/U� ���0�=�0�
STORIES:�_ SQ. FEET OF EACH FLOOR: / �OO
NO. OF BEDROOMS:�, GARAGB STALLS: ATT. DET. �
ESTIMATED CONSTROCTION VALIIATION (excluding land) : $ � B � �� ��
I hereby app ly for a bui lding permit and I acknowledge that the informatio:
above is complete and accurate; that the work will be in conformance with thF
ordinances and codes of the City and with the State Building Code; that _
understand this is not a permit and work is not to start without a permit; anc
that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE:��� DATS: ���` ��
(Please fill out the reverse side of this form)
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G���f������f�`�:� CITY o� OIiONO
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��`�-; Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� 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 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 �icense.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
Zicense.
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 full name, and date of birth are required to process
this application or permit.
/�����'�',f� ,Gv�C-�S � � - -- - - -
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.
-------__. .___ ..-----.--__ .
Signature
BUILBiNG�ZONING—473-7357 • ADMINISTRATION�FINANCE—473-7358 • PUBLIC WORKS-473-7359
A3SESSING
� DATE TIME
CITY OF ORONO CALLED IN � �- `I�'
INSPECTION NOTICE SCHEDULED l�- �- ��7 � �'
PERMIT NO. ��`� ���� connP�ErE� 4_ �%
ADDRESS � �� �G'�E�-c�`-cr�''�--'
OWNER ����.✓� ,��-�.- CONTR. �����i'i�'J �r'�'Lc-�,.�,:tu:��
TELEPHONE NO. �''� ?`� � ��'� �
j: ❑ FOOTING ❑ MECHANICALRI G SITEWELL
~ ❑ FRAMING ❑ MECHANICALFINAL ❑WELLTESTPUMP
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� ❑ INSULATION ❑ FIREPLACE/WOOD BURNER G EXCAV/GRADING/FILLING
�
Q ❑WALL BD. ❑WATER HOOK-UP � LAKESHORFJWETLANDS
Z G FINAL ❑ METER SETITURN ON ❑TREE REMOVAL
� I�DEMO—SITE ❑ SEWER HOOK-UP �SITE INSPECTION
� G DEMO—FINAL C7 SEPTIC MAINT. ❑ PROGRESS
J
Q G PLUMBING RI ❑ SEPTIC INSTALL. ❑ COMPLAINT
W
_ ❑ PLUMBING FINAL ❑SEPTIC FINAL ❑ FOLLOW-UP
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� COMMENT :
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d i�WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
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� i CORRECT WORK&PROCEED ❑ CITATION ISSUED
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Q �. CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
� BEFORECOVERING ❑ ISSUECERTIFlCATEOFOCCUPANCY
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
C7 STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-7357
OwnerlContra r o�site:
Inspector. U
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