HomeMy WebLinkAbout1995-006958 - tear off PERMIT
"CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number: r.,CQ C
Crystal Bay, Minnesota 55323
(612) 473-7357 Date Issued:
SITE ADDRESS:
1101—PER-I'd A,-'-'-
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DESCRIPTION:
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REMARKS: V
FEE SUMMARY:
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CONTRACTOR: P I . T. - OWNER:
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APPLICANTPERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received: _
Date Approved :
Entered By: Permit it:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
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THE
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THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS:
(work)
NAME OF OWNER: i t'/� �/� PHONE: (home)
MAILING ADDRESS: �O /IL�O�TI'7l'/r+ dP CITY: / Z�/ZG#fn ZIP: SS39 _
CONTRACTOR: E',Of ��� •�r' PHONE:
MAILING ADDRESS:�//%7 �G^ �Y���O �r CITY: GtT� ZIP:
STATE LICENSE: # �ZJ�
ARCHITECT/ENGINEER: PHONE
MAILING ADDRESS: CITY: ZIP: _
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure_ Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) :
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (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
understand this is not a permit and work is not to start without a permit; and
that the work will be in accordance with e approved plan.
DATE:-
APPLICANT'S
ATE:APPLICANT'S SIGNATURE:
W.
CITY of
ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
D .O On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2 , "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 local ,
cal , state the permit or
federal agencies to the extent necessary to process
license.
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. 13.04 to review private
data on yourself.
6 . Your full name is required to process this application or
permit.
First
Middle Last
Address
City State Zip
Phone
I understand my rights s stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE— 473-7358
• PUBLIC WORKS —473-7359
ASSESSING
DATE TI
CITY OF ORONO CALLED IN ✓�� g'
INSPECTION NOTICE ,o SCHEDULED
PERMIT NO. COMPLETED _ �-
ADDRESS ��� "�
OWNECONTR. t �✓ C�
TELEPHONE NO. q71— 7®®(o
DESCRIPTION
0101 F0� / 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 F ING ./ 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
--d-Em-6-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
v0, COMMENTS:
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®RNSATISFACTORY PROCEED OOJECTCOMPLETE
W
QC ❑CORRECT WORK A PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO RRANGEACCESS.
Call fo a ne i s tion 24 hours in advance.473-7357
Owner/Contract on ftj
Inspector.
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