HomeMy WebLinkAbout1991-003510 - remove/install bath PERMIT
CITY OF ORONO PERMIT TYPE: �,�;I� G���
1335 Brown Rd. South • P.O. Box 66 Permit Number: i�i�:.;;L i�
Crystal Bay, Minnesota 55323 Date Issued: �y� i�y;_;;_��
(612) 473-7357
SITE ADDRESS:
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REMARKS: `.1 "'-" `."''
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FEE SUMMARY: :`=:'V�f'��
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CONTRACTOR: OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATUflE
CITY OF ORONO - BDILDING PERMIT APPLICATION
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Total Fee: $ / _i�C . :� `� Date Received: / - �� `%1
I , Date Approved:
Entered .By: c:��-�
� Permit#: � S/ C-
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' ALL INFORMATION 1KDST BE SiTBMITTED IN FDLL BEFORE PLAN REVIEW WILL BE STARTED
' ------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: � � �� ��',��/��'�1��CU-z`�-��--�1 ZIP: �� ��l �
(work)
NAML OF OWNER: �,�,�� �j �� ��- PHONE: (home)y ' -C��'7
MAILING ADDRESS: �' �C�� ����.Y..e��c,C�-c�-o-z� CITY: C��.�y,.,��n;- ZIP:���`1 _
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CONTRACTOR: ��L.����-�-� a���� PHONE: � 7 3 ' �C� S 3
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MAILING ADDRESS: ��' ��( � I CITY:�;'�c��, _ ,� Z IP: ��:3�� �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate�� Land Alteration
PROPOSED WORR (describe in detail) : i( .�Q�cl�c a�<--�--�� ��-� ���
.�i 1���-�C�'`� r��_-�'�'-_` �`�/-�L-cx_-�l -f-tt:.�t c-�S--�-�rr-�t��' Y
STORIES:_�� SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTROCTION VALDATION (excluding land) : $ �,,� ;����� �
I hereby apply for a building permit and I acknowledge that the informatic
above is complete and accurate; that the work will be in conformance with ti
ordinances and codes of the City and with the State Building Code; that
understand this is not a Fermit and work is not to start without a permit; a
that the work will be in accordance with the approved plan.
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APPLICANT'S SIGNATIIRE: �� ;�%-��iZ�t.�� DATE: � �T
(Please i 1 out the reverse side of this form)
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._����:��� s���:� CITY of ORON�
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�' ���9 ,�s'��� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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,e� _ � ' � On the North Shore of Lake Minnetonka
DAT�_ PRIVACY ADVISORY
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
f rom 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 local , state or
federal agencies to the extent necessary to process the permit or
license.
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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Address
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Phone
I understand my rights as stated above.
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Si na ure
BUILBING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
� DATE TIME
CITY OF ORONO CALLED IN '� �y/
INSPECTION NOTICE SCHEDULED � � C� `9/ -,�
PERMIT NO. �-S�U COMPLETED �'6 �`�'i� Z,'�
ADDRESS �OU %y�4��-�•-��-�
OWNER _/`��c''�J��- CONTR. ����Z(-e- ��-��v
TELEPHONE NO. �7 3 �" -3 �'� 3
� DESCRIPTION
� <\�].� 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 I ATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 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
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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d ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O C7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �C�TATION ISSUED
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor o si :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice