HomeMy WebLinkAbout1995-007092 - detached garageg .� PERMIT
� � CITY OF ORONO
2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE:
Crystal Bay, Minnesota 55323 Permit Number: -.
(612)473-7357 Date Issued: - - � _--
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: - : _. _ _._. _ --
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A I T/P M EE SIGNATURE ISSUED BY:SIGNATURE ���
� CITY OF ORONO - BIIILDING PER2LIT APPLICATION
:
Total Fee: $ ,�S �' J �1 _ Date Received: i� /� -ys
Date P_pproved:
Entered By: � ,�..�.� A. `�nY1"-
P ermi t,r.
ALL INFORMATION MIIST B$ SIIBMIZ'�� IN FOI�L BEFORE PI.AN REVIEW WILZ B$ STAR�ED
( See Check-off List Enclosed)
---------------------------------- --=�-----------------------------------------
Z'HE APPLICANT IS: (circle one) iOWNER' or CONTRACTOR
_, ,
� �- �,fi�(.-t ���� L��1��� ZIP: �� � �����"�i
Jos sz� x��x$ss: �����������. E_�����;��;�-ll ���� . �� �
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( �'CG�,� (work) -�i;�-,���♦;J.
N� OF OWNER: `,I��rl�'����� „���1 `yaY�� ����� ��' ;�.�'�� PHONE: (home) '=�-�W-����
7'-'_—_,
MATLING ADDRESS: ' --,� ���1����1,; ��C�' CITY: ��;��.��'�i� ZIP: ti^ ..,?I
CONTRACTOR: I� � PHONE:
MATZING ADDRESS: CIZ7: ZIP:
STATS LICENSE: �
ARCHITECT�ENGINEER: ���:I�Lll l,��� �.a G�I'C�C�C� � � PHONE:
MAIZING ADDR$SS: CITY: ZIP:
p�p�g: R.BGISTRATSON tt
i
TYPE OF WORK: New �I Addition Accessory Strncture Move
Demo Remodel/Alteration Renovate Land Alteration
PxoPos� wo�zx (aes�ribe in aetail) : ��11��ll"�� �� � � ���' ����t������-' �la����.1�'�
� �X ;;�� —
, % �� %
STORI$S: � SQ. FE$T OF EACH FZOOR: -� � -
. ' /
NO. OF BSDROOMS: ,;' GARAGB ST�LS: ATT. DET. '✓
ESTIMATED CONSTRIICTION VALIIATION (eacluding la.nd) : $ ,���`�-�-
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 wil 1 be in ac ordance with the approved plan. �
- � ;i i
APPLICANT'S SIGNA - __ _ �, '� -,,-..--��� / �� "� ' � ����� DATE: u ��� �L � ��
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i �: � .��4 .W�N �i��� O� �����
4F�- ,� ,
�'" �.'"t '�: Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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'� `� �'# �''" ��� On the North Shore of Lake Minnetonka
�-�►i- ;�. ;�:
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2, "Rights of subjects of
data", we would 3ike to inform you that your request for a permit or
Iicense from the City of Orono or any of its departments may require
you to furnish certain private or confidential information.
You are notified that:
l. 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 ar license.
3. The information may be shared with other Iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If 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 Lo review prica��
data on yourself.
6. Your full name is required to process this applica�iaa or
permit.
_ ��
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_ �a��, .�� .��,�
i ,'j�''��U�n,, ' �
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First Middle Last
� �,
- ����-;�.��'I�� �����
Address
1;'ti�,t�Z�;C��l I"��if� �_;,;_ I
City State Zip
���� .�'� �,��
Phone
I underst d my ri hts as stated above.
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S�1g�a�ure� � Y
BUILDING&ZONING-473-7357 � ADML�IISTRAT[ON&F[tiANCE -473-7358 • PUBLIC WORKS -473-7359
ASSESSING
�.p,� RIGHTS OF SIIBJF•CTS �F DATA
Subdivision L �`YPe
of data- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section. An.individuel asked to
to be given indivi�usl.
' Subd, 2. Information re9uited �mself sha]1 be informed of: (a) the
� � supply private or confidential data concerning
b whether he ma� refuse or is legally
ur ose and intended use of the requested �j a within the collecting state agen�
P P tem, from
political subdivision, or s t a t e w i d e s y s , }�own conseq u e n c e a r i s i n g
1 the requested data, (�) �Y �d (d) the identity of
required to supp y 1 rivate or con fidentiel data;
supplying or refusing to supp Y P State or federal lav�► to receive the data. This_
other persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an indi�via lg en orcementuofflcer.
pursuant to section 13.82, subdivision 5,
Th
e commissioner of revenue ma lace taX re°und l�tructions insteadhos
subdivision in the individuel income tax or ro ert
on those orms. � -
Subd. 3. Access to data bY
����, Upon request to a responsible
orit an individuel shall be informed whet�ec h r�teeor confident al.e Upon his
auth y� ified as pub � P ublic data on
individuels, and whether it is class�
e to him and, if he desires, shall
further request, an individuel �L8 w t out any chargtored private orndu� � been
individuels shall be shown the of that data• After an indi
�e informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its u���action pursuant to this sectioThe
him for six months thereafter unless a �p n request by
� ndin or additionel data on the individuel h� ate or pu lic datarupoeated.
+ pe g• rovide copies of the p require the
responsible authority shall p The res nsible authority may �in the
� certifying, and comp g
the individual subjeet oftrie actual•costs of maklnB,
requesting person to pay -
y if ssible, with any request
coQies. 1 immediatel , P�
The responsible authority shall comp y of the date of the request,
made pursuant to this subdivision, or withinlaa e ��immediate compliance is not
excluding Saturdays, SundaYs and legal Ys+
• e, If he cannot comply with the request within that time, he shall so inforth the
possibl ��e � 8dditiona1 five daYs Within which to comply
individual, and R►gY 8nd le al holidays•
request, excluding Saturdays, SundaYS g lete. An individ�� may
Subd. 4. Prxed�e �►hen data is not acccu'a ivate data conces�ning himself. To
contest the accuracy or comQleteness of public or p the responsible authority
exercise this right, an individuel sha11 notify in writing
eement. The respcnsible authoritq shall within 30
describing the nature of the disagr lete and attempt to
days either: (a) correct the data found to be inaccurate or incomPeci ients named by
notify past recipients of inacc��ae��V d�Q�t he t�e esathe data to be correct.
the individuel; or (b} no y eement is
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the �isclosed data• � 8ppe81ed pursuant to the
' The determination of the responsible authority mo contested cases•
provisions of the administrative procedure act relating
t CHECR OFF LIST FOR ISSDANCE OF PERMITS
• FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 53� R u SS�--�- �v e PID:
�
DSSCRIPTION OF WORR: � ����'
-------------
-----------------
------------------- .
ZONING REVIEW BY� DATE APPROVED' (j- ��--I"�1 .
-
DATE APPROVED: 6 - Z 1-cJ S
BIIILDING REVIEW BY:_ _ -----------
--------
-------------
FEES TO BE CHARGED• Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes � No SEWER CONNECTION
�/ I,Ja WATER CONNECTION
STATE SURCHARGE `�eS No p�tK FEE
INVESTIGATION FEE Yes SITE INSPECTION
SAC Yes No
OTHER ( specify)
Number of SAC Units --------------------------
--------
--------------------- 2�1,�
ZONING CHECR LIST Zoning District:
r Po Of ' c . `'SchooJ. Di stri ct:
Fire Department: �
Lot Area:
Wi th:
Survey Submitted: Yes/� N°
Date of Survey: 6 - J "� 3
Proposed Setbacks : S o ` Right Side• /V��
F r o n t (L-zr�c�e) :
Rear (Street) : ZS � Left Side: !C? `
Adjacent Structures : Z1 �
Wetland: N��
Building Height: Def . Hgt. C�, K- _ Peak Hgt• C� •<<
Avg. Setback: Lot Cove ge:
Existing Propos d
Hardcover: 0-75 '
75-250
250-500
500-1000
Hardcover Varia ce Requ red: Yes No
Date of ouncil Approva�:__
Grading: Staff pproval te: Y�
Coun il Approval Date:
Septic: Staff prova� Dat : By�
Zoning File: # Re o u ' on # • Resol tion Date:
REMARRS (in ho se) :
� � � �-- � l �- � �, ( i���'� �-z� `�
;y-�
--w10 �ec� � � � 1����. -
.
BDII�DING REVIEW CHECR I�IST - - � ,
- ..
IIBC: (J - 1 CONSTRIICTION TYPE: `��� - - -
- Sq Footage $ Per Sq Ftg ------ ' ..
- - - --- -.-.
-Basement -- - -� -__ ._ . ._x � __ - -- - - --- ---
lst Floor X - . ____ �_.. _---- . .
� 2nd Floor X � � _ � . . .__ _ . _- . .F ::...�
Garage S7�• x r5.'�3 = � '..
x = -.- - - - . _ _- _
TOTAL
$stimated Construction Value: $ `�,(���
--r
Inspections Rem�ired: Work Requiring Separate Permi.ts:
Site Plumbing Grading/FiI.ling
DC Footing Mechanical. Fire
pCFraming . _ Septic Water Connection
Insulation Fireplace Sewer Connection
Wal.l Board (Masonry) Lawn Irrigation
D�Final (Mfg.� Other
Other Wel.l (State Permit)
�Electrical (State Permit)
------------------------------------------------------------------------------
�2F.MARRS (IN HOIISE) :
------------------------------------------------------------------------------
REVIEW BY OTHF�2S: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------
REHARRS (TO BE NOTED ON PERMIT) :
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Scale : �'� - 4� Gc_aon R. Cof.i �
Date : �-i-�3 Nzrk S. Gror,berg Re�. ^���.1<755
o ,�f . I:-cn .rr�er L.�nd �ur�e�rors and Planners . .
. {�^d . I,an� L3ke, N.innesota
DAT/E TIME,
CITY OF ORONO CALLED IN �% -Y E_' ' � '�� C � �I
INSPECTION NOTICE, SCHEDULED /- �'- �! � ��x��
PERMIT NO. ���/�� ' JCOMPLETED �� �I
ADDRESS `7 �_��c ��. � �� � � �___
, �
OWNER �'.,�� �� ��:; CONTR. �L-�L.c�.�r���
TELEPHONE NO. ^ , �' '-' ,!`'` :�: �
� D TION ' t��z=�-�=.-��_ >,r' " _
� 1 FOOTING\ 11 MECHANICACRI � ` v, 18 EXCAV/GRAD�NG/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL� 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
0. 1�C�E' \v� � •
�
�
0
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0
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� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPEC70R WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CA�L TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor sit
inspector. -
White Copyllnspector's File Canary Copy/Site Notice
D TE TIME
CITY OF ORONO CALLED IN � �5y
INSPECTION N TICE SCHEDULED '�.�=i J
PERMIT NO. COMPLETED � �_
ADDRESS S3� o�_��C� �„r
OWNER �,>L2�� CONTR. u� �
TELEPHONE NO. ���3 -- vZ �-> >
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
QAMIN � 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y ULATION 24/25 WOOD BURNER/FiREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
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0.
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O
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d �INORKSATISFACTORY:PROCEED �_� PROJECTCOMPLETE
W s—
� ❑ CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. C pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDERPOSTED.CALLINSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next i pection 24 hours in advance.473-7357
OwnerlContr r i :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
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