HomeMy WebLinkAbout1991-003884 - tear-off/re-roof �'ERMIT
���� OF ORONO PERMIT TYPE: � � :
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�335 Brown Rd. South • P.O. Box 66 Permit Number: �?��:;�_;:_�
Crystal Bay, Minnesota 55323 Date Issued: t����f�.i_=�1
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF ORONO - BIIILDING PERl�IIT APPLICATION
� / J Date Received• j� '���/
Total Fee: $ �7��.�/
Date Approved: ����-� � �
Entered By: - "�
Permit#: � U
AT•T• INFORMATION MDST B$ SIIBMITTED IN FDLL BLFORS PLAN REVIEW WILL BE STARTED
-------------
THE APPLICANT IS: (circle one) OWNER or CTOR
JOB SITE ADDRESS:r�"� � � w � ZIP:
(work)
. '/7
N1�ME OF OWNER: PHONE: (h ome)?/f'� �
MAILING ADDRESS:�oZ- � r ITY: ' ZIP:
�7-�� ��3 �'.
CONTRACTOR• � ` PH� � �7 Z Z
MAILING ADDRESS CITY. � ZIP�S� O
. , D 3� Z
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORK (describe in detail) : , ''
.
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF B$DROOMS: GARAG$ STALLS: ATT. DET.
� �
ESTIMATSD CONSTRIICTION VALIIATION (excludinq land) : $
�s'o v �
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 permit and work is not to start without a permit; and
that the work will be in accordance with the approved plan.
APPLICANT'S SIGNAT�RE: DATE: �
(Please fill out the reverse side of this form)
�
_ �
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_ _�... -� �iONO
�ITY of O
Posi Office Box 66•Crystal Bay,Minnesota 55323•Municipal O�ces
•:
� � _ � A �� On the North Shore of Lake Minnetonka
DATA_PRIVACY AD_V�SQRY
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 dep�rtments 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 Iocal, state or
. f ederal agencies to the extent necessary to process the• permit or
�icense.
4. If your requested permit or Iicense 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 Las ��
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Address
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._ ._._.___ __ _ ___ _ .__ ._ ._.__. __. __._. .._____._____ ____._....__
City State �iP
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Phone
I understand my rights as stated above.
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Signature
BUILfNNG&ZONING—473•7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSIti G
�
DATE TIME
CITY OF ORONO CALLED IN ��,,�'��
INSPECTION NOTI E SCHEDULED _� �
PERMIT NO. � COMPLETED 1( H
ADDRESS S�J ` �
OWNER �i�-�� ONTR. �m� � ,
TELEPHONE NO. � � � ^ �� 3 �
� DESCRIPTION �� —
� 01 FOOTING 11 MECHANI LRI 18WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 031NSULATION 24/�i WOOD BURNER/FIREPIACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD• 12 WATER HOOK-UP 34 TREE FiEMOVAL
Q FI�V 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ],t�WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W /O�CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 O CORRECT VYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOV�RING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN H�URS• ❑pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTtON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in adrance.473-7357
OwnedCon on ite:
Inspector: � _ -
White CopyAnspsctor's flk qnary Cop�rl8ite Notia