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Home My WebLink About2012-01217 - shed � CITY OF ORONO * 2 0 1 2 - 0 1 z 1 7 * 2750 KELLEY PARKWAY DATE ISSUED: 12/12/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3675 JACOBS MILL RD P[N : 32-118-23-24-0012 LEGAL DESC : JACOBS MILL : LOT 002 BLOCK 002 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SHED> 120 SQ FT ACTIVITY : 649-ALL OTHER BUILDING & STRUCTURES VALUATION : $ 5,000.00 NOTE: SEPERATE PERMITS REQUIRED:ELECTR[CAL(STATG) WARMING HOUSE * ESCROW WILL f3E REFUNDED AFTER ALL DISTURBED AREAS ARE ESTABLISHED WITH VEGETA"I'ION AND FINAL INSPECTION HAS BEEN PERFOF�h9�.___r__�_(INITIAL) APPLICANT pERMIT FEE SCHEDULE 118.00 AMENT,JEFFREY& KARI STATE SURCHARGE(VALUATION) 2.50 3675 JACOBS MILL RD LONG LAKE, MN 55356 TOTAL 120.50 OWNER AMENT,JEFFREY & KAR[ 3675 JACOBS MILL RD LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this pennit is issued shall be performed according to the approved plans and speciYications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permi[s. All provisions of laws and ordinances governing this type of work shall be compicd with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time aCter work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.�I�his permit may bc revoked at any time for due cause. _ _ ____�j � Z/ t Z/ �Z C{� ��- / �2 / JZ- Applicant Permitee Signature Date Iss e 3y S�gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I. , . City of Orono Building Permit Appiicati � ��a�� for New Structures or Additions Mailing Address: Permit number: Gt��-bf oz�7 /O.�D,�.O PO Box 66 IL Crystal Bay, MN 55323-0066 Date received: Z—7�� "*'�� Received by: � ,a '�� ` �, � StreetAddress:' '�, ' �.��;,�j„ ��' 2750 Kelley Parkway Plan review fee: .7d \lR��`og*Y Orono, MN 55356 aG/�—U/ �/ \:,Esx,� � ---- Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: ��"S—��C e��j � � �� . Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will b required unless appficant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMA I N: � ' � Name: `��'t v dJ�V� a C t� ��' �! � �- State License# Expiratio Date: Phone: � - - office (cell Mailing Address: 22. I fzV' Ov Cit : +V : "S"S Contact Person: AppJicant is: Contractor / omeow r (Circle One) Email and/or F�c!--� � 01li1l� ° y C i2Q �C � F��'}-�Qlz . (c� T PROPERTY OWNER INFOR�M fTJON: �� Name: - '�' Phone (day): 2- - - ;�n Address: �" f' i Cit : l�t��i/� ZIP: ��3 Email and/or Fax ` —�c F -(- �i . c� ARCNITECT/ENGINEER �O�R�MATIO O�� a C�� S'�� Name: Phone (day): - �� d,�� Address: 2 4' �✓ Cit : ZIP: �� Email and!or Fax: j : �� t, ,d C + ✓ � PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑Addition attached garage �arage/Accessory Bldg. ❑ Public Sewer �Accessory Building ❑ Single Family with ❑ eck elocation detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) �O r SpeCify) A,��..i.,�p 18202 Minnetonka Blvd �'� V � r K Deephaven, MN 55391 q �� ^f� \ Phone: 952-471-0590 v'�/¢� q ' `� v C�� Fax: 952-471-0682 �--{��f� � www.minnehahacreek.or � �� Estimated Construction Valuation (excluding land) $ �i �� . STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= (� Number of bedrooms= � `� � �� Q[Wood/Frame , b.Width (ft.)= YJ Number of garage stalls: ❑ Masonry � �� '-T Areas in square feet Attached =� ❑ Metal ❑ Pole Bldg. c. Basement= Detached =�A ❑ ICF d. 1 S�Story = �� ❑ On-site Prefab e. 2"d Story= ❑ Off-site Prefab f. 'h Story = ❑ Other(please specify): g.Total Area= _�� REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements ❑ ❑ Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation s ❑ ❑ Se tic S stem Site Evaluation Re ort ❑ ❑ Access Permit ❑ ❑ Wetland Buffer Im rovement Plan ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other: APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for su'amitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. Applicant's Signature: � Date: !��Z— Owner's Signature: ,�� Date: ��1� 2� �� e��e� �� foc° �ew �c��s / �c�e�i��s r� r Address/ PID/LegaL• �� C � � � Description of work: �d�/!.i f� ' � Septic review bY: _ � � Date Approved: � Zoning review t�y: Da#e Approved: Builc6ing review bY: "�M--- Date Appr�ved: 2` 1• �O l� , _�_ Grading review bY� f{� Date Approved: � �� Zoning File#: Resolution#: Resolution Date: Zon�n District Fire De artt�rtent �osf Office Schoo!Dist�rict t� �'- 1 � dV� �/}�� M �f� .S�T'3'S'(o 28I�d'O'. Zoning: Lot Area:��0�2•� f�,.� SF/AC �dth: ` �I O d•`� 4 Depth: 'r 3 0 qv� Survey Subrnitted: �Yes C7'No Date of Survey:__�t- i�- i 4 Pro osed Setbacks: Front(L�kt} Raar(S�watr) ( N S�(� �' f ( N �ide � ) Other BuElciings Wetland i^�0' `�13d ' '}' �"�.� � 4�0' 7 5'; ; �'� ' } Building Defined Height: �'�' Building Peak Height: lS' #of Stories Ok?: �YES , FOR A BUILDING WITH A BASEME�IT OR CRJ4WL SPACE: FOR A BUILDING ON A SLAB FOUNDATtOW� START WITH the distance between the basement floor!crawl START the tlistance.between the stab�nd the laighe: space floor and the highest roof peak,the top of WITH roaf peak,the top af the comire of a flat roof; the corn►ce af a flat roof,the dedc line of a the dedc line of a mansard roof,or.the rnansard rflof,flr:tlle uppermost point on a round upperm�st point on:a round or other arch-t�p or Mher arch-. e roof : raof '- SUBTRAC`t" half the di5tance between the higFiest window and : SUBTRAC'f half the distance taetween-the higt�est win�ov hi�hest roof ak of a itched roof � and hi hest r+�of ak f a itChed roof SUBTRACT the distance b�ivveen the�basernent floor/crawl�� DD�� the��tlistant�befween the��lab and=�he highe: space floor and the highest e�tisting gracle wifhin existin rade vuithin# e founda#ib� the foundation or'f0 feet,whichever is less. EQUALS Definec�buildin hei t � EQUALS ' Defined buildi hei h# : Lot Coverage: N'!f} �F A//�1 % '; , : Sharefand District ' 1ViCWD Permit Received Avera e Lakeshore Setb.a�k Biuff � Yes �No � N/A � Yes �o 0 Yes . �o t] Yes CI No ;. �N/A P'ermit Nurnber. ��baok: � Harcicover Zon�es ' Existir� Prv osed Variance Re ui� CUP Re 'uired • 0-75' Q Yes ' No � Ye� � No 75-250'' � TYp�(Sa� TyRe(s): 250-50D' . 5Q0-10D0' _ REMARKS(in-house): Updated: 09/11f2009 z:lformslplan review checkfist.docx Fees to be Char ed YES !�O Remtit Plan R��iewr State Sw��t°�e Investigation Fee SA��-�ktr�be�o#SAC tPnits Sewer Connection 1d�latsr Connec#ion Park'Fee S1te-Enspect3on Other(specify) 11�isc�ilaneous-F'ees Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1�Floor X = � 2nd FIoO� X - � Garage X = $ Estimated Construction Value: �,dD d � Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading J Filling � Well CI Hardcover Removal � MecManical G Fire �Elec#rical Footing � Septic C! WaterConnection C! Poured Wall t3 Fireplace ` C! Sewer Connection O Foundat�on Survey � Masonry G Lawn Irrigation 0 Radon Rock Bed � Mfg. Framing � Other(specify) Q Insutation O As-Buil#Survey �ina1 O Other(specify) REMARKS (in-house): Other Review: Reviewec�-by: Date Approved: - Access:Existing: G YES t] NO New: � YES � NO EMARKS TO BE NOTED Of�! PfR T AND INITlALt D BY FEl�SON PULLING P R tT .�,� � �' �� ' � ` ' � , Updated: 09/11/2009 z:�fortns�plan review checklist.docx Christine Mattson From: Ament, Jeffrey R [Jeff.Ament@morganstanley.com] Sent: Wednesday, December 05, 2012 1:22 PM To: Christine Mattson; Melanie Curtis Subject: Your Help- Permit Application for The Ament Residence Christine and Melanie— As I mentioned to Christine earlier today, I would appreciate anything you can do on your end to fast-track our recently submitted permit application for a 160SF shed/warming house. As you can imagine, we're racing against mother nature to get the project started before the ground freezes so that we can use the warming house this winter. If there is anything additional that you need from me, please let me know. Thanks! Sincerely, 1eff Ament 3675 Jacobs Mill Road Orono, MN 55356 952-239-9300 Important Notice to Recipients: Please do not use e-mail to request, authorize or effect the purchase or sale of any security or commodity. Unfortunately, we cannot execute such instructions provided in e-mail. Thank you. The sender of this e-mail is an employee of Morgan Stanley Smith Barney LLC ("Morgan Stanley"). If you have received this communication in error, please destroy all electronic and paper copies and notify the sender immediately. Erroneous transmission is not intended to waive confidentiality or privilege. Morgan Stanley reserves the right, to the extent permitted under applicable law, to monitor electronic communications. This message is subject to terms available at the following link: http://www.morQanstanley.com/disclaimers/mssbemail.html. If you cannot access this link, please notify us by reply message and we will send the contents to you. By messaging with Morgan Stanley you consent to the foregoing. 1 T a � � a a z ¢ �w m w� wW ¢� vi� az 6 �I 3 a^ � � � N O N � 3 � 3 ' � Y o � o m y Z a 4 4 II 3 � �' v � � � � 5 � 5 � �� 8 �y _5 W �� ' FRONT ELEYAtION RICzI-IT �LEV.4tION � a�° 9C4LE:I/4".I'-O" 9CALE.VI•i 0 _ � �LEvATION iGEY NOTES � o a Z >- g>$M Q �'¢wu", O Stending steam metal rooflru� � �Z� U w� O9-I/4"HerdlePlank Select Cedarmtll I � • O3 l-i/4"4/4 HardleTrlm NT3 Boerde Smooth � � 3 Oq 3-I/2"4/4 HardieTrim NT3 Boarde Smooth • 5 � OHa�diePanel vertical Slding Board�Batten Nadi Betten Boerde e 12"O.G. 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[[�� oae eEc ��'E ....��.._.�e� ___ „lE�� :...�.._ _"_. � � � �� ..`,�"�.'.:��.:�`�.`.:' �;: � G � � DA TIME (/ CITY OF ORONO CALLED IN ��'—�� INSPECTION NOT�CaE10/ai7 SCHEDULED I2,'l 3-I 2- � PERMIT NO. � COMPLEfED ADDRESS ��P7S �V� L�- �1��- OWNE TELEPHONE NO 95a- o�s�9-3� CONTRAC �� -/ d �S � >; DESCRIPTION ��- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADIN LLIN Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOILOW-UP ? ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � a � Q/L-''�' 0 '� � '� l � 0 � W aC Q � Z W � W � � � d W ❑'WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETl1RN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. ,�.�. . (c White CopyllnspectoPs File Canary CopylSite Notice DATE TIME � CITY OF ORONO CALIED IN INSPECTION TICE SCHEDULED 12� PERMIT NO. �IZ��I?-I� COMPLEfED " � ADDRESS �� <<� � OWNER TELEPHONE NO. CONTRACTOR a DESCRIPTION v� �`" `� �� 4~j ❑ FOOTING ❑ PLUMBING FINAL 0 EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS h O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v � DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PIUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: � a � � � O �. � O � W � Q � 2 W � W � � d W ❑WORKSATISFACTORY:PROCEED OJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContracto si . Inspector. �7 White Copyllnspector's File Canary CopylSite Notice � � . • • . • • � • . emo To: Finance Department Frorr�: Christine Mattson, Planning Assistant CC: Street File � Date: June 9, 2014 G/L: 101-22205 Re: Escrow Refund Building Permit Application #2012-01217 pertaining to 3675 Jacobs Mill Road is complete. Please refund the � to the applicant, Jeff Ament. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Jeff Ament 3675 Jacobs Mill Rd Long Lake, MN 55356 w:�,street filesyacobs mill yd�3675�escrow refund form 2012-01217.doac � ' BUILDING PERMIT ESCROW AGREEMENT Orono Building Permit#2012-01217 AGREEMENT made this�_day of �(� , 20 I Z by and befinreen the CITY OF ORONO, a Minnesota municipal corporation ("City") and Jeff Ament("Owners"). Recitals 1. A building permit application has been filed for an accessory structure located at 3675 Jacobs Mill Road the ("Subject Property"), legally described as Lot 2, Block 2, Jacobs Mill, Hennepin County Minnesota. 2. Owners request the City to review this application. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit $600 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or legal consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a building permit application. The escrow will also guarantee reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79. The financial security may also be used by the City to eliminate any hazardous conditions associated with the work and to repair any damage to public property or infrastructure that is caused by the work (including planning, engineering, or legal consultant review) associated with building permit #2012-01217 if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt of bill. 4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment to the City within the timeframe outlined in#3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the Owners when the review has been completed and written notification is received from the Owners requesting the funds. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the subject pr rty pursuant to Minn. Stat. §§415.01 and 366.012. CITY: CI 'O � OWNER: -- By: � � � � Its: ��a��r�i�;� ��:��"r��C�"�I�i�i�i��iPk - � ._ �x, � � �� i ' r_r: �I . i�z�'�. G¢';.. - ... .. aJ.- C��J�y� ' ��`��t� � �``�,;`tf _ � �'�ffhx4�. [`� �`' S �µ `�' �� N. . . �: `' `�� 'T�iC�� _ . �t' (-=:. f; 8y 4.� . .. . ��C . �'! tC..ij . t'�r'�<',�� t�..; �^ �.: 1� a �� '� i��l A 1`�� `'•' � ; �� £� !�1 ry f r�r L��$� `'c�% � . . ... . . ti,„f,n i7 ��,, , �'C/�; .u��. �.�i Y�` ��,� LM� ' �Ql v�� : �r�� `�r �AaJ+�:.�f4 S,'�;�+`, 3 f,;r. �yp� - �Lf��Fi'� ...��'Y`y - � . . .. . .. . �I��fYf•,�, . 1i f'� ��. � ��:n��,��f =''y,: :'iT �% Ff�fr� f� �y . . " ��fiS�� ' . ,.�` �r't.`(r .., . . . . . . .. 1= '�1 v`�f� �`` CITY OF ORONO * z 0 1 2 - P1 1 2 3 6 * � � 2750 KELLEY PARKWAY DATE ISSUED: 12/12/2012 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3675 JACOBS MILL RD PIN : 32-118-23-24-0012 LEGAL DESC : JACOBS MILL : LOT 002 BLOCK 002 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: THIS$600.00 ESCROW IS TIED TO BULIDNG PERM[T 2012-01217-PD CHECK#1919 BY JEFFREY AMENT APPLICANT ESCROW FEE-BUILDING 600.00 AMENT,JEFFREY&KARI ESCROW FEE-EROSION CONTROL 0.00 3675 JACOBS MILL RD ESCROW FEE-GRADING 0.00 LONG LAKE,MN 55356 TOTAL 600.00 OWNER AMENT,JEFFREY&KARI 3675 JACOBS MILL RD LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which[his pertnit is issued shall be perfortned according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at anv time for due cause. / / / / Applicant Permitee Signature Date Issued Bv Sienature Date SEPARATE PERMITS REQUIRED FOR WORIL OTHER THAN DESCR[BED ABOVE. i � 411 4/1 �/ � � �j V;' E a � � uk � � � =. } � r «.� t� -� � � � a � � � °�L � �" ,�'� G p��-..:� Qs ,� s+� � � �r`r.. . � -�j . t,C � �i a �r �, ��, � � t.�X'�,�"... �, t � 'r'%'= �ja��'T�:, . �.. �' Wt� � �, ..:�... � �� V `o-,F'j_'.. ...._. �� - j3f •� �_- �"' � �� I ��' � � d..l._ � ,�, Z � � �'# v = �'4 I�;. a — � i '� �'� �y � a� G ---r `� � N i f'�w C �( !�a.. � .� � s �. � � ; " ' � � C7 i , _ r a Q� � �.•. � � �i �" � . , � � ❑ � � �-- i--- _ �y Z p� i�; ; , �: I� � — y�i - r +� � �� ► +� � � - - ' e�- � a ' � � p � ^ � � ti�p � r N M � o : � � ; � C71. kt; �i �. 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