HomeMy WebLinkAbout1991-003992 - re-roof/tear off .j
PERMIT
` CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �'�}1��'i:�'��' '
Permit Number: sjc_�:�_ �
Crystal Bay, Minnesota 55323 Date Issued: �`-j'�-�'_'�_�j
(612) 473-7357
SITE ADDRESS: :;�;;� �i�!I idr,�=:�T��ti'•J �1�'�
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REMARKS:
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APPLICANT%PERMIT SI ATURE ISSUED BY:SIGNATURE
� • CITY OF ORONO - BIIILDING PERMIT APPLICATION "
� , C�'�� Date Received:
'^otal Fee: $ � �,, _
Date Approved: � --
Entered By:
Permit#:
ALL INFORMATION MUST BE SIIBMITTED IN FDLL BEFORE PLAN REVIEW WILL BE STARTED
------------------------------------------------------
�HE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: ; S� �.5� �-�c � i �� � ���-G�.. ZIP:
(work)
Nl� OF OWNER: � i w, �C� h v� r ,. ��-� PHONE: (h ome) J 1 `( � -<i�� "� _-
MAILING ADDRESS: 3C�� �1�Y�'�L�ti. � �- V[- CITY: �'"r (�i:��� � ZIP: :✓5� � 0,�
CONTRACTOR: � L � �`� � VL t' PHONE: �( 7 � � I ��3
MAILING ADDRESS: I� �}',� ;Z 1'�'1 ���e�c�.�A �S�V�TY: V►'l��►�
z z P: �����3 �.S`�
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) : r� � �� � -'r=
STORIES:_�__SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
C�C>
ESTIMATED CONSTRDCTION VALUATION (excluding land) : $ �C'C,'C� "
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 Fermit and work is not to start without a permit; and
that the work will be in accordance with the aF�roved plan.
. �� ' .J(��� DATE: I'G?-" � ' y�
APPLICANT S SIGNATURE: � , '���
(Please ill out the reverse s ' of this form)
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.
_ .'� �
CITY of ORON
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•.
� _ � A ` On the North Shore of Lake Minnetonka
DAT�1_PRIVACY A._�VISORY -
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
� 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 Ioca1 , state or -
f ederal agencies to the extent necessary to process the permit or
�icense.
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.
C� ��C _ _..l`1___��- -- ---Ic�._.(�1 � �-� -- ------ - -
First Middle Last
��S 3`� �Q Q�. � C<< �c.�. �-� . _ ._.___ . .- - -- ---
Address
. P'`J.ec,�._.-- s�- ._-+�.... ..._._..12�.-�--.w_�-_.. .. _-------5--�--.`1.�.. -------�-----..._
City State ZiP
�3 S-` 1 �S' � SC ---- --
Phone
I understand my rights as stated above.
Signature
BUILII[NG&ZONING—473-7357 • ADMINIS7RATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSI\G
✓
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED PD-g '°l c .�'t��
PERMIT NO. -3�92' COMPLETED �l( '�I,
ADDRESS N ' N
OWNER CONTR.
TELEPHONE N0.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/CaRADINGI�ILLING
y 03 INSULATION 2M25 WO00 BURNER/FIREPLACE 19 LAKESHORFJWEfLANDS
Z 04 WALL BD. n�,, _ 12 WATER HOOK-UP 34 TREE REMOVAL
Q INAL (LC(GGO�13 METER SET/TURN ON 17 SITE INSPECTION
� 07 D MO—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
J 10 PLUMBING FINAL 23 SEPTIC FINAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W� �1NORKSATISFACTORY`.PROCEED PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED �SSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT Y1fORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
own • e:
Inspector: �
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