HomeMy WebLinkAbout1991-004048-old PID# - tear-off/re-roof � PF RMIT
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1. � SOUth • P.O. B�x 66 " r Gi�'.t�.j{'1!�!v
Permit Number: •:�_�._����
Crysldi day, Minnesota 55323 Date Issued: i:_�!'_:Cfr`'=71
(612) 473-7357
SITE ADDRESS:
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APPLI�.t'�Iv! P ITEE SIGNATURE ISSUED BY:SIGNATURE �
� ' � CIT� OF ORONO - BIIILDING PERMIT APPLICATION `
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Total Fee: $ � �"" �' -� Date Received:
Date Approved: ` -
Entered By:
Permit#• �U ��� "`�
ALL INFORMATION MDST BS SIIBMITTED IN FDLL BEFORE PLP,N REVIEW WILL BE STARTED
-----------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRP,CTOR
JOB SITE ADDRESS: `�ST' C-= L v r�� L a�K _ �Z L� __ ZIP: � _S -� % /
(work)
Nl�ME OF OWNER: �j r;T� Y L� c� `�r,r /�� 1'rl rY� ra ,.. PHONE: (home)
MAILING ADDRESS: L/.S�` E-= L v-}-�� �-� ke�_ CITY: f;, u v� ��� ZIP: ,S'S3 `� /
CONTRACTOR: � L f�� C� --� ��� PHONE: �f l�3- � � �% -�
MAILING ADDRESS: / 7 � 2� {'3'►� h+`� t.z=�.�r,� (�� w'r) CITY: !'h7"�'� ZIP: �S -S -3 `f'��
TYPE OF WORR: New Addition� Accessory Structure Move
Demo Remodel/Alteration Renovate� Land Alteration
PR�POSED WORR (describe in detail) : Jt � ��C�°��)
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BBDROOMS: GARAG$ STALLS: ATT. DET.
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ESTIMATED CONSTRDCTION VALUATION (excluding 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 Building Code; that I
Lnderstand this is not a Fermit and work is not to start without a �ermit; and
that the work will be in accordance with the aFFroved p1an.
?�PPLICANT'S SIGNATQRE: . ,�' F� G� DATE: / U. > �- � /
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(Please fill out the verse side of this form)
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
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� _ � A � On the North Shore of Lake Minnetonka
DA�A_ PR�VACY 1_�DVI_SORY -
In accordance with M.S. 15.165, "Rights of subjects of data", we
wou3d like to inform you that your request for a permit or license
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 permit or Iicense 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 local, state or
f ederal agencies to the extent necessary to process the permit or
�icense.
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 fulZ name, and date of birth are required to process
this application or permit.
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First Middle Last
Address
-----. ....-----. .._..------ -.._ --- _ ......-.--State� --._.. ..__ _-___...ZiP
...__.
City ,
_.. ........ ..... .-�- --
Phone
I understand my rights as stated above.
Signature
BU[LDING&ZONING—473•7357 • ADMINISTRATION&FfNANCE—473-7358 • PUBLlC WORKS—473-7359
ASSESSI\G
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �U`�q-Q.� �_
PERMIT NO. cOMPLETED
ADDRESS �^� J��� � �e � �
OW(VER CONTR. I �G�
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16 WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 REE REMOVAL
Q 05 FINAL 13 METER SET(fURN ON 17 E INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PFOGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOWUP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTHACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED O PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
C CORRECT UNSAFE CONOITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
STOP ORDER POSTED.CALL INSPECTOR �1 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContra r�site:
Inspector.
White Copylinsp tor's File Canary Copy/Site Notice
�� ✓
DATE TIME
�iTY OF ORONO CALLED IN
INSPECTION NOTICE. SCHEDULED �C�``�d-�) ���
PERMIT NO. �`'� �" COMP ETED
ADDRESS �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q�INAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOWUP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
C'CORRECTUNSAFECONDITIONWITHIN HOURS. G 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.473-7357
Owner/Contractor o site:
Inspector. �
White Copyllnspect r's File Canary Copy/Site Notice