HomeMy WebLinkAbout1993-005253 -re-roof/tear-off PEI�MIT
CITY OF ORO(�HO .� �
2750 Kelle Parkwa • P.O. Box 815 PEl�MIT TYPE: �;;f;;r,_t:,��;,
y y Permit Number: t��:'�-��
Orono, Minnesota 55356-0815 �y_,.;��;c,.;__i;^;
(612) 473-7357 Date issued:
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �,,Q��j)
�;�OF ORONO - BUII�DING PER�IIT APPLICATION
Total Fee: $ �� � �-5 Date Received:
Date Approved :
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Entered By: ,�--(� permit n: ���"-.-�
AT•T• INFORMATION MIIST B$ SDBMITTED IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
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TgE APpLICANT IS: ( circle one) OtiVNER�or CONTR.ACTOR
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JOB SITE ADDRSSS: l�%L �
(work)
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NAME OF OWNER: �-
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MAII,ING �D�SS: �� y��� �` �I�: y
CONTRACTOR: /� �'�" �� `" PH��
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: �
ARCHITECT/ENGINEER: pH���
MAII,ING ADDRESS: CITY: ZIP:
NAME: REGISTRATION n
TYPE OF WORR� New Addition Accessory Structure Mvve
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI�LS: ATT. DET.
ESTIIKATED CONSTRIICTION VALIIATION (ezcluding landl : $ �� UCU
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 wi�ha�hl
ordinances and codes of the City and with the State Building Code,
understand this is not a permit and wo�k is not to start without a permit; and
that the work will be in accordance w', the approved plan.
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APPLICANT'S SIGNATORE:- -�'" / - DATE: �
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��� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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• - • s On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of
data", we would Iike 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 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 , s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or 3icense requires Councis ac��or.
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 process this application or
permit.
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First _ Mid Ie Last
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Address �
.��;,v 9 L,q .�r� /1�� /l.� `� _'� .-���,
City State Zip
y7� "73y �
Phone
I understand my ri s as stated above.
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Signature
BUILDIVG&ZONING—473-7357 • ADMINISTRATION&FINANCE—173-7358 • PUBLIC WORKS —473-7359
ASSESSING
DATE TIME
CITY OF ORONO CALLED W �'"��/��3
INSPECTION NOTICE ���� SCHEDULED ' 3 r� _`�
PERMIT NO. COMPLETED
ADDRESS �G � �--'��'J
OWNER �-���`✓ CONTR. —
TELEPHONE NO. ��� �-� `��
� DESCRIPTION G�
ty� 01 FOOTING 1 ECHANICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWE7LANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q 5 FI A�� 13 METEF SET�fURN 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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W ❑CORRECT WORK R PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE COND�TION WITHIN HOURS. ,L pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTIONREQU�RED.CALLTOARFANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr or,p�site:
Inspector. U
White Copy/lnspector's File Canary CopylSite Notice