HomeMy WebLinkAbout1992-004685 - re-roof/overlay �'� � ?��r�
F CI*'�= OF ORONO
1335 Bxowt�r RD s, Box 55 :�ERMIT TYPE: =��-•'�1��������
CRYSTAL BAY, MN 55323 t��_��t��=�!�
473-7357 'ermit Number: # ���.f;.���'i
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APP ;ANT PERMITEE SIG TURE ISSUED BY:SIGNATURE �'���
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CITY OF CRC270 - BJILDI�IG FER:�IT APPLICATIGN
^'otal Fee: $
�C/��� / �y Date Received:
Date F��nrocec:
cr nV:
��t�_e Pe�it�:
:I..L INFOKI�iATION MIIST BE SIIBMITTED IN FIILL BEFOR.E PI�N REVIEW WILI� BB STARTED
(See Chec?c-aff List Enclosed)
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BE APPI,ICANT IS: (circle one ) O�tl.IER or CONT�ACmOR
� .�r zzP: �S3 S�.
�oa sz� x��xBss: f/�D �o,� r/�i�'C� �0,�9,�
(work)
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.�ME OF OWNF.R: v� s��.�� /y������5�'^' PHONE: (home)
_�.AILING ADDRESS: ! �,�-Id /�'7� ,/�Id��/L� � CITY= (�'��.N G ZIP: S J 3.5 �
�ONTRACTCR: J (DO��TU� �'�-'v7r+��)�Y�)aaC PHONE: y%�J ��-%�3
ti:AII,ING �D�ss: ��v ;��Jzi�,���-�:c, cz�: �,til �,�ci� zzP: .S�r�S��
�TATE LIC�`7SE: �
�CHITECT/ENGINEER: P$��'
`AIZ.ING ADDRESS: CITY: ZIP:
;�: REGISTRATION T
,-vpE pg �ipRR- i7ew Additian Accessory St�ucture blove
Demo R�*nodel/Alteration Renovate Land Alteraticn
�soPos� wor�x (aescsibe in aetail) �����,J.�� /�,,�g,-�; ���,1�)v�,�� �v.�i �z--�-��^%�
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STORIES: SQ. FEET OF EACH FI,OOR:
�p_ pg gEDROOMS: G�RAGE STAI�I.S: ATT. DE'?'.
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'�T=Mp,TED CDNSTRIICTION VALIIATION (esc�uding Ia.nd) : S / 3 �
= here�y apoly for a building per1nit and I ac?cr_c�r?edge that the information
bove is comolete and accurate; that the work will be in conformance with the
�rdinances and codes of the City and with the S�.ate Building Code; that I
zderstand this is not a permit and work is not t� start without a permit; and
zat the work wi11 be in accorda�.R'ce with he aporoved plan. �
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// !�� � DATE: � '"/ � -�
':PPLICANT' S SIGNATDRE: !i; . v, j� �
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�� Post Office Box 66•Crystal Bay, Minnesota 5a323•hlunicipal Offices
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: � - a gr On the North Shore of Lake 11�iinnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2 , "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
Iicense 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 wil.l be used to determine your
qualiiication for the pe?-mit or Iicense recuested.
2. You raay refuse to supply data, but re=usal may reQuire that
the City deny the permit or I.icense.
3 . The information may be snared with o`�er iocal , s�a�e or
f ederal agencies to the extent necessary to process tne pe�-mit or
license.
4. If your requested per.^it or Iicense =ecuires Councii ac��o%
to a�Drove, some infor:Ttation may become pu��.ic.
5 . You have certain rights under M.S. ?? .C� to rev;ew pri-r��e
data on yourself.
6. Your full name is required to process this applicatior. or
pe�-mit.
(�1����'`z-- 4�� ��.�
F?rst Middle Las�
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Address
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City State Zip
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Phone
I unde;stan m ights stated above.
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Signature .
BUILDI�G& ZO�'i�'G - 473•73�7 • AD,`i(:VISTRATION& FIVANCE - 173-73:3 � PUBLIC WORKS -473•73�9
ASSESSiV G
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED
PERMIT N0. cOMPLETED
ADDRESS �
OWNER���s�o3 CONTR.
TELEPHONE NO.
� DESCRIPTION � 'E' L
� 01 FOOTING 11 MECHANICAL R 18 EXCAV/ ADING/FILLING
Q 02 FRAMING 13 MECHANICAL �AL 19 LAKES RE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL D. 12 WATER HOOK-UP 17 SITE INSPECTION
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14 SEWER HOOK-UP 06 PROGRESS
� DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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ORK SATISFACTORY:PROCEEO PROJECT COMPLETE
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� CORRECT WORK&PROCEED IS UE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN �' PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance.473-7357
Owner/Contr ct r on si .
Inspector.
White Copyllnspector's File Canary CopylSite Notice