HomeMy WebLinkAbout1994-005938 - remodel interior PERIliIIT �
CITY OF ORONO ' � - -
PERMIT TYPE: '�� ����:��.�
2750 Kelley Parkway • P.O. Box 815 ' i ii:i�;'=::=�;;�V
Permit Number: �_j::;,jt°�;:;�°a�.
Orono, Minnesota 55356-0815 Date Issued:
(612) 473-7357
SITE ADDRESS: �;;__; °�;;i;i���v��1��i�;�? �:i#
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APPLICA /PERMITEE GNATURE ISSUED BY:SIGNATURE
. CITY OF ORONC� - BT]ILDING PERMIT APPLICATION
Date Received: �������
Total Fee: $ 7d'� � �/ �-
Date Approved•
Entered By: ' r",��
Permit�: � j��'
AI�L INFORMATION MIIST BE SIIBMITTBD IN FIILI� BEFORE PLAN REVIEW WILL B$ STAR�ED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: ; �C.� - `�'�'"��-l�� (1����1� �-C�✓ ZIP:
(work)
x� oF owri�x: �,�li..� ��''�'-1�,�,�� PsorrE: (home)4�1�-`t�=��
I�SAILING ADDRESS: �' , � `'���� � CITY: Cr%��-E�Ge�C_� ZIP:
� f s�s�-�..�--s
CONTRACTOR: �-����"��.,'� �l.'�'.=�� - ��1A�=i� psox$: �i ��-�,47`�`7
I�SAII.ING ADDR.ESS:I�i ,��/J� � � �CfG -�'�"��ITY: �lf�l' ZIP: GJ�`�-�`-�
STATS LICENSE: � ��C�� 7�
ARCHITECT/ENGINEER: PHONE:
MATI�ING ADDR.$SS: CITY: ZIP:
?7�ME: RBGISTRATION �
':'YPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORK (describe in detail) : ��N`���t� 1�7�".�'-���
STORIES: SQ. FE$T OF EAGH FZOOR:
NO. OF B$DROOMS: GARAGE STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �' �' '� �
_ ,�._ ,_ :.
T 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
inderstand this is not a permit and work is not to start without a permit; and
_hat the work will be in accordance with the approved plan.
,�..--�
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�PPI�ICANT'S SIGNATDRE: � - ,���� �.���� DATE: � ' �' � j �
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r �.��:���� ������ �ay� C ITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 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 Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other I.ocal , 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 to review pri�a��
data on yourself.
6. Yaur full name is required to process this applicatian or
permit.
�---
►-}��ti.���� ���� �-t�L�c'��.''1`i 1
First Middle Last
---��:� �.;,r_���.� -���- _"�-' .
Address
�'1 i��=-' Y`'r� `�=�'`��
City State Zlp
��77- �' 7���`
Phone
I understand my rights as stated above.
,
. ..—._____> � ,
- i F--��-�� z ,�� -L-L�
Signature
BUILD[NG&ZONING—473-7357 • ADMiN[STRATION&FINANCE—473-7358 • PUBLiC WORKS—473-7359
ASSESSING
� . .
513.0.4 RIGSTS OF 3IIB.7ECTS �F DATA � -
gubdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
. Subd. 2. Information r�d t� � �r� ����'1' An.individuel asked to
� ' su ply private or confidentisl data concernina �amWit�in�th collecting state agency,
P
purpose and intended use of the requeste
political subdivision, or statewide system; (b) whether he may refuse or is legal2y
required to supply
the requested date; (c) any known consequence arising from his
supplying or refusing to supply private or confidential date: and (d) the identity o
other persons or entities authorized by s Vadu� �e�kedlto supplyein�st g�ve da a
requirement shall not apply when an indi
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma rolert tgX re°una u structio uinsteadh�s
subdivision in the individuel income tax �r
on those orms. . - --- - - .
Subd. 3.
Access to data bY i�����' Up°n request to a responsible
authority, an individusl shall be inYormed whether h=VBteeor confident al.e UPon his
individuels, and whether it is classified as public, p ublic data on
further request, an individusl v�►he is the subject of st to�mri�de� he desires, shall
individuels shall be shown the data witho o f�hat dat�s. Af ter an individuel h�s been
6e informed of the content end meaning the data nesd not be �isclosed to
shown the privete date and informed of its u���aetion pursuant to this section is
him for six months thereafter unless a d�SP
t � pending or additional data on the individuh h� ate or publie datarupona equest by
responsible authority shall provide coples The res nsible authority may require the
the individual subjeet oft�e actual costs of ma�la'ng, certifying, and compiling the
requesting person to pay _
eopies. y ssible, with any request
The responsible authority shall comply immediatel o f� �te of the request,
made pursuant to this subdivision, or within five �YS1mmediate compliance is not
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot comply with the request �t�withintwhich toh mp1Y fwi h Lhe
individuel, and may have an additicnal five ys
request, exeluding Saturdays, Sundays end legal holideys•
Subd. 4. Procedm'e when data is not accurate or complete. An individual maY
himself. To
contest the accuracy or completeness�of public or private � the�responsible authority
exercise this right, an individusl shall notify in ����e authority shall within 30
describing the nature of the disagreement. The respe
days either. (a) correct the data found to be lete dataeincludingreec pients namedtby
notify past reaipients of inaecurate or incomp
the individusl; or (b) notify the individual that he believes the data to �ement is
Data in d i sp u t e s h a l l b e d i s c l o s e d e n 1 Y i f t h e i ndividual's statement of disagr
• i n c l u d e d w i t h t h e �i s c l o s e d d a t a. e�l e d p u r s u a n t to the
' The determination of the responsible authority Lo��tes ed cases.
provisions of the administrative procedure act relating
� � CHECR OFF LIST FOR ISSIIANCE OF PERMITS
�OR �FFICE USE ONLY
ADDRESS OR LEGAL: /7�U S/fr4/JyG�Od/7 20� PID:
- ,
DESCRIPTION OF WORR: �CNI.c/��C- - S���a2 c���-y ��Q-y C..�cN�o�.�5 Non+ i�cz.o�vcL.vr�.--�5�
� ----------------------------------------------------- -----------
ZONING REVIEW BY: ���- DATE APPROVED:
BUILDING REVIEW BY: �} �--- DATE APPROVED: Z-2 S-`'7�
FEES TO BE CHARGED: Misc. Fees Calculated By•
PERMIT Yes � No
PLAN REVIEW Yes f No SEWER CONNECTION
STATE SURCHARGE YeS �-NO �- pARKRFEENNECTION
INVESTIGATION FEE Yes No
SAC Yes No � SITE INSPECTION
Vumber of SAC Units OTHER (specify)
-----------------------------------------
ZONING CHECR LIST Z ning District:
?ire Depart � nt• Post Off ' ce: chool District:
Lot Area: Width: Dept :
3urvey Su itte : Yes No Da e of Survey:
Proposed etback :
Fron (Lake) : Ri ht Side:
Rear (Street) • Le t Side:
Adja ent Struc ures : Wetland:
3uilding eight: De . Hgt. Peak Hgt.
�vg. Setb ck: Lot Coverage:
I E isting Proposed
'ardcover• 0-75 '
', 5-250 '
2 0-500 '
50 -1000 '
ardcover ariance Requir d: Yes No Date of Council A proval:
rading: S aff Approval D te: By: Council Appro al Date:
eptic: St ff Approval Dat : BY�
�ning Fil :# Re lutio # : ' Resol.ution Date:
@�I�iRKS i house) : � ..
(
BIIILDING REVIEW CHECR LIST • .
r. . �
IIgC: �_ 3 CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement x -
lst Fl.00r X -
2nd Floor X -
Garage X -
x =
TOTAI,
Estimated Construction Value: $ z Z ,o o�
Inspections Required: Work Requiring Separate Permi.ts:
Site � �Plumbing Grading/Fill�ing
' Footing �( MechanicaZ Fire
�_Framing Septic Water Connection
� Insulation Fireplace Sewer Connection
�Wa�I. Board (Masonry) Lawn Irrigation
pC Final (Mfg.) Other
Other Well (State Permit)
�E�ectrical (State Permit)
REMARRS (IN HOIISE) :
----------------_-------------------DATE:------------------ I
REVIEW BY OTHERS.
Access: Existing New
Access Approval: Date BY=
RF.IKARRS (TO BE NOTED ON PERMIT) :
DATE TIME
CITY OF ORONO CALLED IN ���-9
INSPECTIONNOTICE SCHEDULED �'�' 9� ' °�
PERMIT NO. Sp3� COMPLETED t� _.l,! '
ADDRESS / 7� � /e�
OWN ER Ly�a� CONTR. ,����'��t��a 9�
TELEPHONE NO. 9 3� —� �.�7
�
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y TION 2M25 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z04 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 O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
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� �RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WIIL RETURN
❑STOP OHDER POSTED.CALL INSPECTOR
❑CITATION ISSUEO
�INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the n xt inspection 24 hours in advanoe.473-7357
OwnerlCont r site:
Inspector.
White CopyAnspsct s Fik Canary CopylSita Not�e
ATE TIME
CITY OF ORONO CALLED IN �l����SF
INSPECTION NOTICF� SCHEDULED �� �'d�
PERMIT NO. � `�✓� COMPLETED �_ �_
ADDR ��O
OWNER CONTR.
TELEPHONE N0. 1��� - 3/8 6
� DESCRIPTION mtro�-�—��
� 01 F ING 11 MECHANICAL RI 16 WELI TEST PUMP
Q 2 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SEffTURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBiNG RI 15 SEPTIC INSTALL. 22 FOLL�IV-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W O CORRECT VYORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail fa�t ext inspection 24 hours in advance.473-7357
Owner/Con r site:
Inspector:
WhNe CopyAnsp�ct Flls Cenary Copy/Site Nhbtkx