HomeMy WebLinkAbout1994-006238 - add/remodel PERMIT
� G�f r Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: =;�.:l I �;;��:�:;
Orono, Minnesota 55356-0815 - �=-=_= "�
(612) 473-7357 Date Issued: __'�_!�s__ _
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SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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CONTRACTOR: OWNER:
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� AP A ERMITEE SIGNATURE ISSUED BY:SIGNATURE
� ' CSTY OF ORONO - BIIII,DING PER�iIT APPI�IC�TION
� Dat� Received:
Total Fee: $ �
Date A��roved: �
Entered Bv: Fermit z: - __ -
TION MIIST B$ SUBMSTTF�D IN FffLL BEFORE PLAN RE�7IEW W�� BE ST�gR�
AT.T• INP�RM� (Se� Check-aff List EncZosed)
---- ------------(c�rcle ane)---��`�E� a CONTQACTOR�
TAE APPLIC�INT IS: ✓
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• ��ti.��cG�� 1/ ZIP: S � �S� �
S� �,�> > �'
JOB SSTE A�DRSSS: � � '
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(work)
' / PHONE: (home) ��s �9��
�IAME OF OWN�.�=
�.. f--��tii-2 ��-���G� P vc_,
7r S��e l�v cl�:����1 zzP: �5� 35,�
MAIZ,ING �D�ss: �'�s�� �u� y
CON�C`r -� �
o� �P % ...�._ � �,� pHorrE: 9'�� 7 6 7`3 —
,�Q� cz�: �?�/ zzP:,S� �3dS
ING ADDRESS� /�� � ""y"���-
ST��E LIGENSE: z �� l�" ,�'
PHONE=
ARCHI TE CT/�GINEF�t:
C=�.�,: ZIP_
MATLING ADDRESS:
gEGIS�RATZON z
NAME:
Accessory Structure Move •
TYPE OF Y�70RR: New
Addition Land Alteration
D�o Ft�*nodel/Alteration_� Renovate 1 ��
— �� ��x�o C�S�--
P�oPog� �7pRFC (describe in detail) = \ `
i �it/ � �� �
STORSES:�_ s4- �T aF EgCH FLOOR:
�,Rp,G� STAT,T,S: ATT. D ET.
NO. OF BEDROOMSs �
ESTIMATF.D CANSZRIICTION VALI7AT20N (e�rcinding I.a.nd 1 - S /���
ermit and I ac?cnow l.edg e t h a t t h e informat=on
I hereby apply for a building p that T
lete and accurate; that the work wi7-1 be in conform� de,^'ith t e
above is comp an� with the State Building e�it; and
ordinances and codes of the City
understand this is not a permit and work is not to start without a P
that the work wi11 be in acco dasice with the approved pZ�- . �
DATE:
APPLICANT'S SIGNATO�=
• ..
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�_- ��Y� C��� o� ����TO
Post Office Box 6&'Crystal Bay, Minnesota 5�323•Municipal O�ces
ea s .
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On the North Shore of Lake�tinneton a
• - • ' 0{
DATA PRSVACY ��SORY
"Ri htS Oi subjec`S OL
g
-rn accordance with M.S. Z3.Oa , Subd•our request for a permit or
-� � sae would I.ike to inforn you thof its departments nay require
�.ata , o= prono or any
I._cense from the City
�. cer�ain rivate or coniidential insormat�on-
vou �o s"urnish �` P
you are noti�ied that:
1, The information you fui nor i��ensebrequest�d. aetermine your
the e'--n-�
cual_f'-cation for P
2. vou may reruse to supply
data, but r�iusal may require that
,-•nit or Iicense.
the City deny the pe_. ,
be snareci with other .Ioca1 , s�a�e or
3 . The information may o to process the pe'-�ni�. oi
f ederal. agencies to the extent nec�ssary
�icense. ,
Iice*�se requ�res Counc�I a��'-°r
a, If your recuested pe�it or i
to aporove, some in=or:na.tion �ay become pubyic.
5 . You have certain rignts under M.S. 13.04 to rev�ew Br=v��e
data on yourself.
6 , your fu1l name is required to process this appZ�cation or
pe*-lnit.
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b � Last
r^i st
Middle
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Address �—
�� -S 3�3�
State Zip
City
-�/' ,� � 767 �
Phone
I understand my rights as stated above.
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Signature
�UILD�VG&ZONING—473-7357 • ADMIN1STFtATION&FINANCE—�i73-�358
• PUBLIC WORKS—4�3-�359
ASSESSIN G
�/
DATE T E
CITY OF ORONO cc,��Eo iN '� -��`� �'�'c�- /�
INSPECTION N TICE SCHEDULED '� /."�'c�
PERMIT NO.� COMPLETED � ��
ADDRESS � � � �--� �h-�� '�� �.
OWNER CO TR. � �
TELEPHONE NO. y 3�'�� 7 J r�`������
� I
� DESCRIPTION u �-���
� 47- 11 MECHANICAL RI 16 WELL TEST PUMP
FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 IN N 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� ���"�A�� R�— 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETRURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 27 COMPLAINT
Q
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBWG FINA� 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� C� CORRECT WORK 8 PROCEED r ISSUE CERTtFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,- pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '-' CITATION ISSUED
❑ INSPECTION REQU�RED.CALL TO ARRANGE ACCESS.
Call for the xt i spection 24 hours in advance.473-7357
OwnerlContractor it� :
Inspector.
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