HomeMy WebLinkAbout1993-005515 - tear-off/re-roof PEI�MIT
CITY OF ORONO "'� � ` ' PERMIT TYPE: "
2750 Kelley Parkway • P.O. Box 815 �;::;;i {-;;;:�r�
Orono, Minnesota 55356-0815 Permit Number: . t_� _
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Date Issued:
(612) 473-7357 i;-;;'��f-�;'_�:v:
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS: --
FEE SUMMARY:
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CONTRACTOR: �- ;�{:_-::.-:; � __.,;+. - OWNER:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF O�C37Q -- BUILDING PERMIT APPLICATION
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Total Fee: $ ��� � "� Date Received:
Date Approved:
Entered By: � / �
Permit n: y7 �.:�
AT,T• INFORMATION MIIST BE SDBMITTED IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
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TgE APPLICANT IS: (circle one) 0��7NER or Q�TR�ACTO_ R �,
JOB SITE ADDRBSS: �� '�- F . cr -E !/�-�� ZIP:
(work)
NAML OF OWNER: � r ,�: � PHONE: (home)
MAILING ADDRESS: / �� ��e� � ��: P LN CITY: (�� ZIP:�y����
CONTRACTOR: �c�r � c, �' �� � � � � PHONE: L/ 7/'- %/�"��-
MAII�ING ADDRESS: -5/� �, c�G�c�-� /�l`/ � F CITY: �-'�c u,J cI ZIP: �;�_,��v y
STATE LICENSE: � �-/�I��
ARCHITEC�'hC�NGINEER: PHONE:
MAILING ADDRESS-��``�--- CITY: ZIP:
NAME: ` REGISTRATION n
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration � Renovate Land Alteration
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PROPOSED WORR (describe in detail) : /<�.a-�o��� �-- �f-� -
STORIES: SQ. FEET OF EACH FLO�Rs
NO_ OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ �Cj%�?�� —
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 Building 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 accordance with the app r ed pl n. �
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APPLICANT'S SIGNATURE. �— DA�: i�'� - ��
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�-- - ' � Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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� _ e s On th.e North Sh.ore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of
data", we would 3ike 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:
1. The information you furnish will be used to determine your
qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or license.
3. The information may be shared with other Iocal . e�it or
federal agencies to the extent necessary to process the p
1.icense.
4. If your requested permit or license requires Councii ac�ior.
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6 , Your full name is required to proc�ss this application or
permit.
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Middle Last
First .-
S i �'� / �/, �� k6 rE� Y/'l l,� �
Address �
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City State Zip
L/ �/- ��� 7
Phone
I understand my rights as state ab�e.
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nature �
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS —473-7359
ASSESSING
DATE TIME
CITY OF ORONO CALLED IN .3 �j �G���
INSPECTION NOTICE � SCHEDULED " " -3 /�•�3G an-�
PERMIT NO. D 5��� COMPLETED I=�O
ADDRESS / C 3 S
OWNER l � �� CONTR.`��
TELEPHONE NO. `� � �— ��� ��
� DESCRIPTION
� 01 FOOT1t1G_ 11 MECHANICAL RI 16 WELLTEST PUMP
�02 FRAMING_.) 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
Q 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
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
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED [�; PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
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
OwnerlContrac o ite:
Inspector. �-
White Copyllnspector's File Canary CopylSite Notice