HomeMy WebLinkAbout1991-003525 (Remodel) PERMIT
CITY OF ORONO PERMIT TYPE: E;t;ILLiIl�u
1335 Etrown Rd. South • P.O. Box 66 Permit Number: t�t 3:�;�'�
�CrystaTBay, Minnesota55323 Datelssued: ��1i"��!'�1
(612) 473-7357
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: __ ��,�;,� �,��,j;t. -- OWNER:
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APPLICANT/PEFMITEE SIGNATURE ISSUED BY:SIGNATURE
: -� � CITY OF ORONO - BQILDING P$RMIT APPLICATION
�
rotal Fee: $ � ( o� �g5 Date Received:
r
° Date Approved:
3atered By:
Permit#: -��aS
�LL INFOI2MATION MIIST BE SIIBMITTED IN FQLL BEFORE PLAN RSVI�1 i�TILL BE STARTED
(See Check-off List Enclosed)� �
L'� APPLICANT IS: (circle one) OWNER o CONTRACTOR
TOB SITS ADDR$SS: � /� Q ZIP:
(work)
..-� >_ _ _
i�ii� OF OWiQER: �/ e PHOAE: (home)
�,ILING ADDRESS: � � p � CITY: IJ ZIP: �,�-�.��p
:ONTRACTOR: ����L[//p,�/P11y�i.!/�i �P PHONE: �9���//�
(AILING ADDRESS: U� � �J� CITY: ZIP: �d`�.�Sl�
RPE OF WORR: New Addition Accessory Structure Move
Demo Remoc�e�/Alteration� Renovate Land Alteration
�ROPOSED WORR (describe in detail) : e �
O /G�c�- /��G/P�l'l7 i/d� LJ,,��/lX�i.r�
TORIES: SQ. FEET OF EACH FI�OOR:
O. OF BSDROOMS: GARAGB ST�f,LLS: ATT. DET.
TIIKATBD CONSTRQCTI08 VALIIATI08 (eaclndin land) : $ � �� ��
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hereby apply for a building permit and I acknowledge that the information
bove is complete and accurate; that the work will be in conformance with the
rdinances and codes of the City and with the State Building Code; that I
nderstand this is not a permit and work is not to start without a permit; and
hat the work wil 1 be in accordance with the approved plan.
PPLICANT'S SIGNAI'ORS: ci��li�/ DATE: ��!� "�' 7�_
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CITY of ORONO
Post Office Box 66•Crystal Bay.Minneaota 55323•Municipal Offices
• _.
� - � � 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 I.icense 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 p=ocess 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. 13.04 to review private
data on yourself.
6. Your full name is required to process this application or
permit.
G . r
First Midd e Last
Address
�i1.t��.1I ��,d ��3���- - -
City State Zip
�9�- -���� �
Phone � �
I understand my rights as stated above. __
.�. _ _.
Signature _ ._: . - ' .
BUILDING&ZONING-473-7357 • ADMIIYISTRATION�FINANCE-473•7358 • PUBLIC WORKS-473-7359 �
ASSESSiNG _ `
I
- �• , •
' ,
513.0.4 RIGH15 OF SIIBJECIS OF DATd � _ .
' ion L Z`ppe oi data- The rights of individusls on whom the data is - '
Subdivss
stored or to be stored shall be as set forth in this section. An.individuel esked to
to be given in�ividuel.
S�d. 2. Information required �ms� s� �e �formed of: (s) the
• ' supply private or confidential data concerning state agency, ,
purpose and intended use of the req t med dat8 within the coV Te� or is legal2y
(b) whether he ma„ from his
political subdivision, or statewide sys . �oy� consequence arising
required to supply the requested dats, , ��� 8�Y= �d (a) the identity of;'
suppiyfng or refusing to supply private or confidentiel data; =
authorized by state or federal law to recei�e�e�ve dat8,
other penons or entities W�en � individusl is asked to supply in g
requirement shall not apply to a�W enforesment officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lacs t8X re°una�tructiocis�insteadh°s
subdivision in the individual income tax or ro ert
on those orms. . - � -�— � - � .
Subd. 3. �
Access to data bY ����• tiPon request to a responsible
authorit , an individuel shall be informed whe��ec h��ateeQr eonfidentiaLe UPon his
y ublic data on
individuals; and whether it is classified as p � P
data without eny chat'Se to him and, if he desires, shell
further request, an inaividuel who is the subject of stored private or�du� � been
individuels shall be shown th of that data. Aiter an indi
6e informed of the content and meaning � �� need not be �sclosed Lo
shown t1�e private date and informed of its ute��BC�on puMu�t to this section is
him for six months thereafter unless a �p n request by
� ndin or additicnal data on the individuel h�8te or public datarupoeated. The
' Pe g shall provide copies of the p require the
responsible authority The respcnsible authority may � the
the individusl subject of the �� cartif n and comp g
requesting person to pay the actual costs of making, Yi g�
copies. 1 immediatelY, if pessible, with any request
The responsible authority sha]T comp y of the date of the request,
made pursuant to this subdivision, or within five ��immediate complianae is not
excluding Saturdays, Sundays and legel holidays,
ssible. If he cannot comply with the request within that time, he shall so infM1onrth the
in° have en additional five days M►ithin which to comply
dividuel, and m Saturdays, Sundays and legal holidays•
request, excluding
te or aomplete. An individuel To
Subd. 4. Procedia'e when data is not accura'vate data eoncerning himself
contest the accuracY or completeness�of public or p �e ����e authority
exereise this right, an individusl shall�notify � ��e authority shall within 30
describing the nature of the disagreemeriL"� Th� r�P° ete and attempt to
days either. (s) cori'ect the data found te be inaccui'ate or incompl � i�� named by ;
notify past reaipients of inaccurate o�r���P�t�t�e���e �� to be correct. �
the individuel+ or (b) notify the in , eement is ;
ute shell be disclosed only if the individual s statement of disagr ;
Data in disP . i
• included with the disclosed da� � appealed pursuant to the
' The determinetion of the responsible authoritq to contested cases.
provisions of the sdministrative procedure ac! relatinB . , ,
- . I
V CHECR OFF LIST FOR ISSIIANCE OF P$RZiITS
.
. FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z 1 � �►v�flG�.s w,A-�� PID:
DESCRIPTION OF WOR'�: � C�►4 �/�5t�
-------------------------------------------------------------------------------
ZONING REVISW BY: � �/4 DATE APPROVED:
BIIILDING REVIEW BY: DATE APPROVED: /��/- �t /
FEES TO BE CHARG$D: Misc. Fees Calculated By:
PERMIT Yes v No
PLAN REVIEW Yes ��1.� SEWER CONNECTION
STATE SURCHARGE Yes �No� WATER CONNECTION
INVESTIGATION FEE Yes No �/� PARK FEE
SAC Yes No �/ SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------•
ZONING CHECR LIST Zoning District: �
Fire Department: Post Office: School District:
Lot Area: Width: Depth:
Survey Submitted: es No Date f Survey:
Proposed Setback :
Front (Lake Righ Side:
Rear ( Stre ) : Lef Side: �
Adjacent S uctu s : W land
�
Building Height Def. Hgt. Peak gt.
�,vg. Setback: f Lot verage
Existing � Pr posed
Hardcover: 0-75 ' �
<
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes � No Date of Council Approval: :
Grading: Staff Approval Date: By: Council Approval Date: a
Septic. Staff Approval Date: By: -
:oning File:# Resolution #: Resolution Date:
. t
�MPiRRS (in house) : _ �
�
�
_ . ..__.. _ .__ . __y-_._. _ _ - _ _ --- � �.. a
BQI?�DING RLjVIEW CHECR LIST
�----��`- •
QBC: g' -��' G�-3 CONSTRIICTION TYPE: _ �
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X - - -
2nd Floor X -
Garage X '
x =
TOTAL
si-r3— `
$stimated Construction Value: $ 2- �OOo _
„ � ��. �
. . _.�.:; .,--._ :.
Inspections Required: Work Reqniring Separate Permits:
Site �Plumbing Grading/Filling
Footing Mechanical Fire
raming Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
inal (Mfg. ) Well State Permit
Other Electrical (State Permit)
�MAR1iS (IN HOIISE) :
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REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY�
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FtF.MARRS (TO BE NOTSD ON PERMIT) :
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CITY OF ORONO ALLED IN p�' A� // 3•T�v
INSPECTION NOTICE�z����� SCHEDULED a - � = °�.��
PERMIT NO. �� MPLETED �_ �
ADDRESS � v
OWNER � /�.c.8d CO TR.
TELEPHONE NO. �cL� �' �,J 9' �CS
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 0 N 24125'WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANOS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK•UP 06 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMEN�
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d 0 WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContracto ✓�t�:
Inspector. (1/�-�.�
White Copyllnspector's File Canary Copy/Site Notice