HomeMy WebLinkAbout1991-003612 - kitchen remodel ���;���liilIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �'t���'�1�'���
Permit Number: ;,:):;t:,,�;_
Crystal Bay, Minnesota 55323 Date Issued: s_;�,;=t��:=;_���
(612) 473-7357 �'
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APP ANTiPERMITEE SIGNATURE ` ISSUED BY:SIGNATURE
ii�9 _ l�, .
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ / 3 oZU Date Received:
Date Approved:
Entered By: • 2 �
Permit#: ) � �
ALL INFORMATION MDST BE SUBMITTED IN FQLL BSFORE PLAN REVIEW WILL BE STARTED
------------------------------------- ------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: �--��� K���� � ���' ' ZIP=
Ss33 �
(work) �'��r� � �3
N1�ME OF OWNER: ��F� '�/1�'r r�'-'j� �'� ' J PHONE: (home) �J l - ��I$,j
MAILING ADDRESS: L� �� ��Cy ���s ' CITY: ��C<,��_S��Q� ZIP: -�.�33 j
CONTRACTOR: S��-� PHONE:
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration � Renovate Land Alteration
PROPOSED WORR (describe in detail) : �� M �'`��� ������r'',
STORIES: 2 SQ. FEET OF EACH FLOOR:
�,/o�p
NO. OF BEDROOMS: y GARAGE STALLS: ATT. � DET.
,�.; / ��U o�
ESTIMATED CONSTRIICTION VALIIATION (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
understand this is not a �ermit and work is not to start without a permit; and
that the work will be in accordance with the agproved plan.
, , ��.� � �- ��Z /
APPLICANT S SIGNATIIRE. DATE: � /
(Please fill ou the reverse side of this form)
.� ,
. �.
CITY of ORON4
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal OfFicee
Y
� _ � � On the North Shore of Lake Minneton.ka
D1�T��R�ITACY �pV�SQ�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
� quaiification 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.
G�,�y ���e����v. :M---._.---_ __.__..
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First Middle Last
z 6 q s ����y �o�'�. _._ _._ __. .. . ._ ___
Address
�,,rc��.S7o �1 rJ 5,�33 �
_ .____. ._-----_._ ._____.----�-- __--- -------..._
._.,_. ....----- -_._------__ _._ __.._._.._._._----.. _
City State Zip
S�7I� O c1''�3 ,
_.. .-.-- ..___._____. --
Phone
I understand my right�s as stated above.
Signature �
BUILIi[NG&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
� DATE TIME
CITY OF ORONO CALLED IN �f�i 0 � y°/
INSPECTION NOTICE, SCHEDULED z�"/� -9/ 9-".3�`
PERMIT NO. ��/ �l COMPLETED I,I ��=�
2� Q� �: �
ADDRESS ����- �%'�'-�-
OWNER �-���`�-«� CONTR. f
TELEPHONE NO. � �� `'���3
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 2 FRAMIN 11 MECHANICAL FINAL 18 EXCAVlGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r� pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTtONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contrac o ite:
Inspector.
White Copy/lnspector's,File Canary CopylSite Notice