HomeMy WebLinkAbout1991-003918 - re-roof/tear off � , . ,
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� 1'ERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �;���L�y�.���
Cr stal Ba , Minnesota 55323 Permit Number: c,ta:;�a�.c_:
Y Y Date Issued:
I (612) 473-7357 ��"�=`�-}�-��
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REMARKS:
FEE SUMIVIARY:
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APPLICA T� R ITEE SIGNAT E ISSUED BY:SIGNA UR
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ � �`�� ��� �� Date Received: ��` �- � `� �� ' �
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� � - - Date Approved: � ��'���' �`�
Entered By: �--- ��i� , �
�; Permit#: '� � � ��
,
AT,I• INFORMATION IKDST B$ SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
----------------------------------- - -------------------------------
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THE APPLICANT IS: (circle one) OWNE or CONTRACTOR
JOB SITE ADDRESS: ��� /V���-�6� �i�-�� ��. ZIP: ���G�
(work)���� Z ZS-�3��
Nl�ME OF OWNER: _� �7 �� PHONE: (h ome)���-r�� �
MAILING ADDRESS: � Q (v �Q�� ��'C ' _ CITY: Q�O�.�� ZIP: ��
CONTRACTOR: / V�v� PHONE:
MAILING ADDRESS: CITY: ZIp'
TYPE OF WORR: New Addition AccessorX, Structure Move
Demo Remodel/Alteration Renovate x Land Alteration
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PROPOSED WORR (describe in detail) : �����d� — ( ���- Grr
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAG$ STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALDATION (excluding land) : $
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 �ermit and work is not to start without a �ermit; and
that the work will be in accordance with the aF�rove� plan.
a���"" � -�a
APPLICANT'S SIGNATURE: DATE: 5 �
(Please fill o he rever e ide of this form)
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_�. � ^ - . NO
�ITY og ORO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•. _
� _ � A 4� On. the North Shore of Lake Minnetonka
DATA_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
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 Iocal , state or
federal agencies to the extent necessary to process the permit or
�icense.
4. If your requested permit or license requires Counci 1 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
�C�O N- �� 2� - - - - -
Address
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City State Zlp
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Phone
I understand my rights as stated above.
Signa ure
BUILIIING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSIIG
� , DATE p TIME
CITYOFORONO CALLEDIN � ��D'r� � ��_��
INSPECTION NOTICE G� SCHEDULED � �9 f ����
PERMIT NO. � ` �� COMPLETED n
ADDRESS 7� �°�� ��'"'� ��•
OWNER �'��2� CONTR.
TELEPHONE N0. �7 a ' ��� �
� DESCRIPTION 1�2- -l�-�
� 01 11 MEC NICAL RI 16 WELLTEST PUMP
02 FR,_AMIN�/ 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y ULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
O
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 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C'GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site: � �
Inspector.
White Copyllnspector's File Canary CopylSite Notice