HomeMy WebLinkAbout1990-002680 - tearing off/re-roof �'ERI�
` � ��� '��F �� ������ PERMIT TYPE: ;��SL������
;5 Brown Rd. South • P.O. Box 66 PermitNumber: �;;i;;T„_�;
;stal Bay, Minnesota 55323 Date Issued: �
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ISSUEG ; JRE
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CITY OF ORONO - BIIII,DING PERMIT APPLICATION
'�otal Fee: $
3Q' �� Date Received:
Date A��roved:
Entered By: �/'
Permit�: ���s �
�r•r• INFORMATION MIIST BE SIIBMITTID IN FIILI� BEFOR.E PLAN REVIEW WIZ,Z BE STARTED
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THE APPLICANT IS: (circle one) OWNER�r CONTRACTOR
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JOB SITE ADDRESS: �.-<'���,�, �' 1 z x ��� � = ��t�'� ZIP: J � -� �.
(work) j'��'� ���
.TAME OF OWNER: �� �.��� �}L �G"��i�' ��'� ;�� PHONE: (home ) '� � =� ��'�� ���
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• `), > >' � CITY: �� r_ �'_<- r��6�� ZIP:�.S � � �
1SAILING ADDRESS. ._ � ?�� �-�' � �. ' �
�ONTRACTOR: � , ���_� �1 '� �-= �: PHONE: �� � *- �����;
_�SAILING ADDRESS: ��'c�-3(fa -" ��c� r�c-t �;�u � . CITY:��'. � Z IP:�S^��c�,�
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
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?ROPOSED WORR (describe in detail) � �' �
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STORIES: SQ. FEBT OF EACH FLOOR:
�VO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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�STIMATED CONSTRIICTION VALIIATION (excludinq land) : $ i �-�-'�`-� '' ''-
T_ hereby apply for a building permit and I acknowledge that the informatior.
3bove is complete and accurate; that the work will be in conformance with thE
�rdinances and codes of the City and with the State Building Code; that I
snderstand this is not a Fermit and work is not to start without a permit; anc
Lhat the work will be in accordance with the approved plan.
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�PPLICANT'S SIGNATIIRE: ' � �1�✓"�? � ' DATE:
(Please fill out the reverse side of this form)
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` ' c 21> , �,_,: Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Qffices
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Y, � _ � ` �,., On the North Shore of Lake Minnetonka
`�"' DATA_PRIVACY ADVISORY
In accordance with M.S. 15.165, "Rights of subjects of data", we
wouZd like 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 will be used to determine your
qualification for the per•nit or Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
Iicense.
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.
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First Middle •
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I understand my rights as stated above.
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Signature
BUILIl[NG�ZONING—473-7357 • ADMQVISTRA'I'ION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSFSSiNG
DA TIME
CITY OF ORONO CALLED IN l�
INSPECTION O IC,� SCHEDULED - �
PERMIT NO. ��� g cPMPLETED �/ /-z = md
ADDRESS �� �C -�T -
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OWNER �Y S�II �G�f3f11.��f��t�CONTR.
TELEPHONE NO.
' FOOTING �1 PLUMBING RI ❑ FIRE PREV.
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� �RAMINGC��,��� Cl pLUMBINGFINAL ❑ FIRESUPRESSIONSYS.
� I- INSUTATION C MECHANICAL RI ❑ EXCAVIGRADINGIFILLING
y '�WALL BD. C MECHANICAL FINAL C LAKESHORFJWETLANDS
� C FINAL ❑ FIREPLACEIWOOD BURNER ❑TREE REMOVAL
Q C DEMO—SITE ❑WATER HOOK-UP ❑ KENNEL LICENSE
� C DEMO—FINAL C! METER SETITURN ON G SITE INSPECTION
� I� SEWER HOOK-UP ❑ PROGRESS
_ ❑ SEPTIC MAINT. ❑COMPLAINT
v C SEPTIC INSTALL. ❑ FOLLOW-UP
� l� SEPTIC FINAL
O ❑SITE WELL
� ❑WELLTESTP MP
� COMMENTS: (�� iJ� ►1.
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W �ORK SATISFACTORY:PROCEED rl PHOTO TAKEN
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WO C CORRECT WORK&PROCEED C! CITATION ISSUED
Q C CORRECT WORK,CALL FOR REINSPECTION C ISSUE CERTIFICATE OF OCCUPANCY
V BEFORE COVERING TEMPORARY
��CORRECTUNSAFECONDITIONWITHIN HOURS. PERMANENT
INSPECTOR WILL RETURN
Ci STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract on te:
Inspector.
White Copy/lnspector' File Canary Copy/Site Notice