HomeMy WebLinkAbout1993-005541 - land alteration 1 i
�ITY OF ORONO � ��� ���,� _����;Y�.
`750 Kelley Parkway • P.O. Box 815 Permit Number: ,r;
,�rono, Minnesota 55356-0815 Date Issued: ;"5°=�,��:�;::��`:
(E>12) 473-7357 _ _. . __.. _. _.
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REMARKS:
FEE SUMMARY:
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APPLICAN RMI EE SIGNATURE ISSUEU BY.SIGNATURE (JQ��
DATE TIME
CITY OF ORONO CALLED IN
INSPECTIAN NOTICE� Q, SCHEDULED
PERMIT NO. �7 COMP�ETED�
ADDRESS � -' �t:�f�
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION ��SG 5,- �� t ' v� � V�C! �tJQ!�
� Ot FOOTING 11 MECHANICAL RI 16 WELLTEST PU
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
�
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOILOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORK SATISFACTORY:PROCEED �7 PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED r'; ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINfiPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. - pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnedContract�{i�e:
Inspector U Q�
White Copyllnspector's File Canary CopylSite Notice
CITY OF ORONO - i��JIL�DiNG PERMIT A.PPI,ICATION
Total Fee: $ Date Received:
Date Aoprove�' :
Entered By: � ` y r�i��
Permitr:
AT•T• INgpRMATION MIIST BS SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILI. BB STARTED
(See Check-off List Encl.osed) �
TgE APPLICANT IS: ( circle one) O��TNER or CONTRP.CTOR
JOB SITE ADDRSSS: � ZIP' v`� `3 /
W4 y Z� � ' � � � (work)
NAME OF OWNER: -,�. 1/� I�? �D �-� � PHONE: (home) � '9 �
MATI�ING ADDRESS: �� I'Y) P _ CI�'�': ZIP:
CONTRACTOR: �p �"
� e. r ��.��h � /Vt��rs� r � Psorr�: �L73 ' �� �f
MATLING ADDRESS: � I,L �U�' t Q� �0 � aCITY:�f�, ZIP: �'�,3�
v
STATE LICENSE: � 7 d� 1� S� � �
PHONE-
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITY: ZIP:
NAMF- REGISTRATION �
TYPE OF WORR- New Addition Accessory Structure Move ✓
Demo Remodei/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :
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STORIES: SQ. FEET OF E.ACH FI�OOR=
NO. OF BLDROOMS• GARAGE STAI�LSc ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the
ordinances and codes of the City and with the State Buiiding Code; that I
understand this is not a permit and work is not to start without a permit; and
that the work will be in accordanc with � a pro ed lan-
� DATE s I/ �� N
APPZICANT'S SIGNATDRE: --7.._
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„�y� Post Office Box 6Fi•Crystal Bay,Minnesota 55323•Municipal Offices
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� _ � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADVIS�RY
In accardance with .M.S. 13.04 , Subd. 2, "Rights of sub e��t or
data"; we would like to .info�m you. tha.t your request for a p
license from the City of Orono or any of its d�epartments may require
you to furnish certain private or confidential information.
You are notified that: _ �
l. The information you furnish wil.l be used to determine your
qual.ification for the permit or Iicense requested.
2. You� may refuse to supply data, bu� refusal may ,require that
� the City deny the permit or Ii.cense.
3. The information may be snared with other Iocal , s`ate or
federal. agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii. ac�io%
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yoursel.f.
6, Your full name is required to process this application or
permit.
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Middle Last
First . .
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Address �
�a� 7- ��• 3� i
City State Zip
�7�3 �3� �I '
Phone �
I understand my rights as stated above.
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Signa ure
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BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—�73-7358
• PUBLIC WORKS—473-7359
ASSESSING !