HomeMy WebLinkAbout1991-003647 - tree removal 1'F,lR1iiIIT
CITY OF ORONO � �� PERMIT TYPE:
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1335 Brown Rd. South • P.O. B�x 66 Permit Number: i_�'_}:;���:
Crystal Bay, Minnesota 55323 ;;�;y:�;,�__��
Date Issued:
(612) 473-7357 ��
SITE ADDRESS:
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DESCRIPTION: ��
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REMARKS:
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FEE SUMMARY: - -
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APPLICANT'PERMITEE SIGNATURE � ISSUED BY:SIGNATURE
CITY OF OROPO -��ING PERI�IIT APPLICATIOl�
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit#:
ALL INFORMATION MDST BB SQBMITTSD Il�i FIILL BSFORE PLAN RRVIEW WILL BE STARTED
--------------------------------------------------------------------------------
TH$ APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: � �� 6 �v ` ��, G� ZIP: �� ��
(work) G 73- �"��7 0
NAME OF OWNER: �c vv� ��n.�'� PHONE: (h ome) ��( '�/ �6
I�IAILING ADDRESS: �S�''"`'� CITY: �1NJ CW'¢''(Z•� ZIP: S�?� �
CONTRACTOR: !V`� PHONE:
MAILING ADDRESS: � � C.�-d.,.� CITY: ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : \�w�•:� C�.R�,(1ern11�� ��C'f-k��N� �'"
��1��-� i���,. C�uto�1�1[L' '�. _
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BBDROOMS: GARAGE STALLS: ATT. DET.
ESTIMAT$D CONSTRDCTION VALDATION (excluding land): $
I hereby apply for a building permit and I acknowledge that the information
above is comp lete and accurate; that the work wi 11 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 approved plan.
APPLICANT'S SIGNATDRE: �� �� DATE: L� ��
(Pleas ill out the reverse side of this form)
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CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal OfSces
•
� _ � � On the North Shore of Lake Minnetonka
D1�A ���C� �P����y ;,.
In accordance with M.S. 15.165, "Rights of subjects of data", we
would 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:
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 local , state or
federal agencies to the extent necessary to ,process the permit or
license.
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 Last
Address
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City State Zip
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Phone .
I understand my rights as stated above.
Signature
BUILDING 8c ZONING-473-7357 � ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
A3SESSING
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 9 -
PERMIT NO. COMPLETED �'i- 1 1 -� � 3= `I a
ADDRESS 3S ���v u P�-�-e--e.
OWN ER (�1µr� CONTR.
TELEPHONE NO.
j: ❑ FOOTING ❑ MECHANICAL RI ❑ SITE WELL
~ ❑ FRAMING ❑ MECHANICALFINAL G WELLTESTPUMP
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� C] INSULATION ❑ FIREPLACENVOOD BURNER u EXCAVIGRADINGIFILLING
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Q ❑WALL BD. ❑WATER HOOK-UP i 1 LAKESHOREM/ETLANDS
Z C 1 FINAL ❑ METER SET/TURN ON ❑TREE REMOVAL
Q C] DEMO—SITE ❑ SEWER HOOK-UP ❑ SITE INSPECTION
I
� Ci DEMO—FINAL ❑ SEPTIC MAINT. ❑ PROGRESS
J
lQ ❑ PLUMBING RI ❑ SEPTIC INSTALL. ❑COMPLAINT
_ ❑ PLUMBINC�FINAL ❑SEPTIC FINAL ❑ FOLLOW-UP
� COMMENTS: 7TlEE G� �_� .,A�I o�U-�)'9'�O� I�b�4�
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d i'WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
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� l l CORRECT WORK&PROCEED ❑ CITATION ISSUED
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O L; CORRECT WORK,CALL FOR REINSPECTION �PROJECT COMPLETE
� BEFORECOVERING ❑ ISSUECERTIFICATEOFOCCUPANCY
Cl CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
Cl STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
OwnerlContract r on ' e:
Inspector.
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