HomeMy WebLinkAbout1990-003316 - tear off PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �ii i�,���F�"
Permit Number:
Crystai Bay, Minnesota 55323 Date Issued: 1C�/�:x:�;/'��:y
(612) 473-7357
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: �������L�':� C:HET
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APPLICANT�PERMITEE SI E ISSUED BY:SIGNATURE
CITY OF ORONO - BOI7�DING PERMIT APPLICATION
�
Tota1 Fee: $ �?. ��_-� Date Received:
Date Approved:
Permit#: '� ��� % Project#:
Building Permit Application Requirements:
1. Building permit application - to be filled out completely and signed
2. 2 sets of construction plans to include the following:
a) Floor plans;
b) Footing and foundation plan;
c) Elevations (of all sides) ;
d) Wall sections and cross sections;
e) Details - stairs and any special connections.
3 . Certificate of survey with :location of existing and proposed
structures including hardcover calculations and grading and drainage
p lans as required.
4. Energy calculations - form provided.
5. Septic report and design if required.
ABOVE INFORMATION MOST BE SUBMITTED IN FULL BEFORS PLAN REVIEW WILL BE STARTED
THS APPLICANT IS: (circle one) WNE or CONTRACTOR
JOB SITE ADDRBSS: �y '� �;v�nq �-/p.-� �i/� ZIP: �,j 3 �l
�i� � � ��l (work) y7!-D6S�
NAI� OF OWNER: � �°r S Q � �5 PHONE: (home)�Tl- �/3 D
HAILING ADDRESS: 7 ;v;n ah L cz�: �a����a ziP: .�5'39 t
�- 33 -��53
CONTRACTOR: ��/Q s� ,�o-� �D. PHONE: /- ��3��q
MAILING ADDRESS: (o/ SS ;2.?S7L� .S7G �� CITY: �,-.n��e✓� ZIP: ��0.3 /
ARCHITECT: PHONE:
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORRs New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED DS$ (describe in detail) : �en�d Uc° O /r� Sh��nG`e5�, l'��O(1� O�c�
_�oa�c�s �� �.••�c��c� or c�r� ro�, o,�c� �es�i%rn�� roo
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BSDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRQCTION VALDATION (excluding land) : $ ��f�0 D• � �
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 a��ordance with approved p lan.
APPLICANT'S SIGNATQRE: '�� DATE: /O 'J`' "QD
(Please fill out t ;=�'everse side of this form)
C ITY of OR01�T0
Post Office Box 66•Cryatal Bay,Minneeota 55323•Municipal Officee
•
� . � � On the North Shore of Lake Minnetonka
� . ��q����_C�.�iDVISORY �
In accordance with M.S. 15.165, "Rights of subjects of data", we
would Iike 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 confidentia�� information.
You are notif ied 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 refusaZ 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
. Zicense. �
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
Phone
I understand my rights as stated above.
gnature
BUILDING dE ZONING—473-7357 • ADMINISTRATION�FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
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CERT =F = CATE OF SURVEY
F'OR CHET VERSAILLES
3472 Livingston Ave. I ,���'/' � �
� rono, MN — /0000 - E,45T-*
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50 So
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TimaCR �7EtA�N�y� N+A�� Le dl Description I ' ,
?Sy��N Lo 14 and 15, Block 2, "NA RRE HEIGHTS."
LoT /�- � LOT /S %- �'�` '!'
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p IJv. 3472 9�`�.7 2o xy7�8 �
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Scales `.� �� _, 2 ' _ � .�. � : �
o Denotes � iro monumen� `��"��� � _��«-�< • m� . _ �
x000.o = exis ing elevation ��., � �
Bearings are ssumed ; � � : �' , � a
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9�y,5 ��� L/l/�it/G'STON _ A(/E/VGC�" _ %���3
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Benchmark: North Rim of manhole 20 ' + East of intersection
Livingston Ave with Narvarre Ave.
N.G.V.D. 1929 adjusted elevation = 975. 30 feet.
� •,
' I hereby certify that this is a true and correct representation
of a survey of the boundaries of the above described land and of
the location of all buildings, if any, thereon, an al v�'jsib _
encroachments, if any, from or on said land. �,
As surveyed by me this 14th day of July, 1999. � y `
4416 Abbott Ave. ' N � • Herb F. Lemire RLS
Robbinsdale, MN 55422 Minnesota Reg. No. 13349
Phone: 612/537-0497
DATE TIME
CITY OF ARONO CALLED IN �f� ' p�
INSPECTION NOTIC SCHEDULED �i� ��-J 15 : 32��.,
PERMIT NO. � ��' CQMPLETED � � ' �/
ADDRESS ���.�� ��'��Z-'���'
OWNER.��i� ��-E-�c��-l�-�?-� CONTR. � �
TELEPHONE NO. ���"' �����
j� ❑ FOOTING ❑ MECHANICAL RI ❑SITE WELL
~ RAMING ❑ MECHANICALFINAL ❑WELLTESTPUMP
�
Q INSULATION ❑ FIREPLACFJWOOD BURNER ❑ EXCAVIGRADINGIFiLLING
y ❑WALL BD. ❑WATER HOOK-UP ❑ LAKESHORFJWETLANDS
O
Z ❑ FINAL ❑ METER SET/TURN ON ❑TREE REMOVAL
Q ❑ DEMO—SITE �SEWER HOOK-UP ❑SITE INSPECTION
I
� ❑ DEMO—FINAL ❑SEPTIC MAINT. ❑ PROGRESS
J
W ❑ PLUMBING RI ❑ SEPTIC INSTALL. ❑COMPLAINT
Z 0 PLUMBING FINA ❑SEPTIC FINAL / ❑ FOLLOW-UP
� COMMENTS� � �-O`` LU�G`�12st�� D�t -Q-���--
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W� 4�WORKSATISFACTORY:PROCEED ❑ PHOTOTAKEN
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O CORRECT WORK&PROCEED ❑ CITATION ISSUED
� ❑ CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
� BEFORE COVERING ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECTUNSAFECONDITIONWITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
❑STOP ORDER POSTED.CALL INSPECTOR
� INSPECTION REOUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor n site:
Inspector.
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