HomeMy WebLinkAbout1994-006401 (Reside) PERIVIIT �/
CITY OF ORONO PERMIT TYPE:
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27.. Kelley Parkway • P.O. Box 815 Permit Number. ;-;;=;,_;`:i,_;�
• Jrono, Minnesota 55356-0815 - - �
(612) 473-7357 Date Issued: ;;��;f:-;r.,;���,�
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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APPLICANT/P R TE IGNATURE ISSUED BY:SIGNATURE � �
; CITY pF ORONO - BQILDING PER�iIT APPZ,IC�TION
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�, � � Date Rece?ved:
' Total Fee: S -
Date A��rove�: �
Entered Bv: ��(°.�� Permit� �`��� � - - _-
=NgOR2�iATION MIIST BS SIIBMITTED IN FIILL BEFORE PI�AN RE�TIEW WI7�L BE SgARTED
AT,T• (See Check-off List Enclosed)
� APPI,IC�NT I5_ �
circle one) OjdNER or C�NT_�ACTOR
� �� ��',' (ZC� i�/O ZIP:
Jos sz� a�nx$ss: �� �� l�� ��t2
(wor}c)
/ PHONE: (horne)`�73 ����
NAME: OF OWNP.R: ��� �. i �� �� C Lf�-.�.4-7��<�v �
CITY: ZIP:
MATI�ING ADDRESS:
lYl N S.D, ��-Z a 1 � �F
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CONZ'RACTOR- I V J
CITY:�p i' i.�•� ��'�G�� ��t�ZZP: S S 3 ��
MATI,ING ADDRESS� 7 `�7 `� ��L��`o
STA2'E LICENSE_ �
PHONE:
ARCHZTECT/ENGINEER=
CITY: ZIP:
MATI,ING ADDR.ESS_
REGIS�RATION �
NAME:
Accessory Structure riove
T`�PE OF WORK- New Addition Land Alteration _
D�o Re.*nodel/Alteration
Rer.ovate /���
.� __ � � �, S� p;�i�
PROPOSLD WORR (describe in detail) : " �S � n�
STORZESs� S4- ��T OF E�CH FLOORs
NO. OF BF•DROOMS:
�GE STAI.I�S- ATT. DET.
c,w
EST3MATED CDNSTRQC'rION VALIIATION (eacludin4 land) - $ 1 �b U, -
hereb apply for a building permit ae wo � wili be ia conf rmancef withtthe
I y Code; that T_
� above is complete and accurate; thaa ahwi�h the State Building e�it; and
� ordinances and codes of the City
� understand this is not a perntit and work is not to start without a p
that the work will be i ccordance with the approved plan- s - '
� � Gv��� DATE s �-"�� �
€ APP�ICANT'S SIGIIATURE=
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Post Office Boz 66•Crystal Bay, Minnesota 5a323•Mun.icipai Offices
♦1!
� On the North Shore of Lake Minnetonka _
� - • •
DATA PRIVACY AD�SORY
Subd. 2, "Rights af subjects of
In accordance with M.S. 13•ou`that your request for a pe="�it or
data" , we would like �o inform y o f its departments may rea_uire
license from the City of Orono or any
you to furnish certain private or conridential iniormation.
you are notified that:
1, The inTormation you furnish wil.l beeQuea�Pd, determine your
cuali�icatiorl for the pe='ln=-� �r license
Z data, but res"usal may require that
2. You may refuse to supp y
tne City deny tne permit or license.
be snared with other local , s�a�e or
3 . The information may to process the permit oi
f ederal. agencies to the extent necessary
Iicense. •
q. 1i your recuested permit or
Iice*:se requ�res Councis a��'-dr
ation may become public.
to aporove, some insorm . • Vz�e
J �
You have certain rights uncier M.S. 13. 04 to rev�ew pr=
data on yourself.
L ' or
6 . Your full name
is rec-uired to p,-oc=ss t�is apolica �-on
pe�i�.
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biiddle
Las�
r irst �
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Address
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— State Zip
City
� 7 � �� ��
Phone
= unde sta�id my rights s stated above.
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Signature
� pDMINISTRATIOiV&FINANCE--�73-�358
• PUBLIC WORKS-473-7359
SUILDING&ZONING-473-7357
ASSESSIN G
D TE TIME
CITY OF ORONO CALLED IN ��-S �
INSPECTION NOTIC SCHEDULED / � ;'-_�
PERMIT NO. � � COMPLETED �v
ADDRESS 1��J( �h-f�r�;�` '
OWNE CONTR.��`2��J ��.H�
TELEPHONE N0. ���� 'C��'`�C.�
� DESCRIPTION�/`r�_2�..�'F��
� 01 FOOTINCa 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z pq yy 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 5 FINA 14 SEWER HOOK-UO O6 PROGRESS
� EMQ—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBINCa FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY PROCEED PROJECT COMPLETE
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� '' CORRECT WORK 8 PROCEED : ISSUE CERTIFICATE OF OCCUPANCY
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Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORAFY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor it :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice