HomeMy WebLinkAbout1993-005349 - re-roof/tearoff � _ . PEI�MIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 `�:j}=:�;�-�t�
Orono, Minnesota 55356-0815 Permit Number: ;:.,;_;�::a�=�
(612) 473-7357 Date Issued: ,_�-,;::; :�;:;_�_;
SITE ADDRESS:
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APPLICANT'PERMIT ESIGNATURE ISSUEDBY:SIGNATURE .C1i .
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' CITY OF ORONO - BIIILDING PERP+IIT APPLICATION
Total Fee: $ a��-�� Date Received:
Date Approved:
Entered By:P� permit#: `�35�5'
AT•T• INFORMATION MIIST BS SIIBMITTED IN FIILL BEF'ORE PLAN REVIL�'fd WILI� B$ STARTED
(See Check-aff List Enclosed) �
---------------------
TSE APPLICANT IS: (circle one) O�+TNER r CONTR.ACTOR
JOB SITE ADDRESS: �-�oO 1�J�� ����-� �� ZIP: �� � �
(work) ��� - ��1d
NAME OF OWNER: N���S ` -I�r�C [��.� ���� _ _ PHONE: (home) ' � DS
M�iII,ING ADDRESS: � ��I'<��-1 8 �'-� ITY: �� 1J� ZIP: `���� �
cox�,c�roR: �d���S ��-r��5 o ti1 s(� psorr�:q�S - �(�g�
1KAILING ADDRESS: �c��"1 � �l'P � �`t� CITY: ��-TC�l�� ZIP: �J`�.�g �
STATE I,ICLNSE: # 1 �IJ e���7 `� �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
�: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move �
D�a Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in.detail)�p��o�l E. '��`�- �l�e�' af q-S A�.a�t ��l�l���°S �
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STORIES:__ SQ• � OF EACH FLOOR:
NO. OF BEDROOMS: G�GE STALI�S: ATT. DET.
EST7.IKATED CONSTRIICTION DALIIATION (egclnding Iand� : $ ����` 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 cordance w'th the approned plan. •
APPI�ICANT'S SIGNATURE:
� DATE: � � �
� • �
0 4
(�I'I'Y o� O�►�I�T�
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipai Office.s
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• ' • o On the 1Vorth Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
3.icense 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 i.nformation 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, szate or
federal agencies to the extent necessary to process the permit ar
I.icense.
4. ff your requested permit or Iicense requires Councii action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to process this application or
permit.
�A� fV� 1 _f �• �V�.��
First Middle Last
� �� ����� � �
Address
��1A' D ��l ��(Q�
Ci� ` State Zip
7� � � 5�
Phone
I understand my ri hts as stated above.
t
ign tu e
BUILDING&ZONING—473-7357 • ADMINISTRATIOtY&FINANCE—473-7358 • PUBLIC WORKS—473 7359
ASSESSING
��E � TIME
CITY OF ORONO CALLED IN
INSPECTION N�T�C�E/ SCHEDULED � ,3 �
PERMIT NO. -� �"� OMPLETED _U �
ADDRESS �
OWNER CONTR.
TELEPHONE NO. �7� - S�C7 s
� DESCRIPTION �����
Ly 01 FOOTING 1 ECHANICALRI 16WELLTESTPUMP
02 FRA 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREMIETLANDS
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
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� �CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O �CORRECT WORK,CALL FOR REINSPECTION� TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
IPISPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
�INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr or n site:
Ins�ctor.
YYhRe Copyllns or's Flle Cenary CopylSite Notice