HomeMy WebLinkAbout1991-003731 - deck , .
PERMIT
C{ITY OF ORONO PERMIT TYPE: �:;t�I�CjIhdG
1335 Brown Rd. South • P.O. Box 66 Permit Number: ��E'������
• Crystal Bay, Minnesota 55323 Date Issued: � i �=�j`'��
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: -- ��,r�i i�a;�t. -- OWNER•
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APPLICANTiPERMITEE StGNATURE ISSUED BY:SIGNATURE ��i
�' 1�°��/�//�'/_
w1 fy ��2 �J�/
J �
CHECR OFF LIST FOR ISSIIANCE OF PSRMITS
� FOR OFFZCE USE ONLY `���"-�I `� �
ADDRESS OR I,EGAL: ��U � O/ �ID: ���� �� ��
DESCRIPTION OF WORR: � ��� -
�������_����_���_�_ �� �__�_���_�_�_����_��_��������_��L_��_�����������_�_
ZONING REVIEW BY: �;�, (�) ,�,�,,.. -- DATE APPROVED: � - 3 • `:' '
BUILDING REVIEW BY: .�.u...,.,.
DATE APPROVED: r}•� � `� ;
------------------
FEES TO BE CHARGSD: Misc. Fees Calculated By:
PERMIT Yes L' . No
PLAN REVIEW Yes� No 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 CHECK LIST Zoning District: L�-� �
Fire Department: M-t���✓.� Post Office: (.URy�-��� School District:
Lot Area: 1��000 so, � Width: (p b Depth: /4�G 2�t fl
Survey Submitted: Yes ✓ No Date of Survey: (�-IZ- ��( - 3 "1Z- 9 1
L = c�l�.e.s�rJ.e�Je�{c s = ��Ts-•r�.t ae c,�c
Proposed Setbacks :
...b'xe��(Lake) : L�tl0'-}- 5 N�� Right Side: L 12 5 NJjg,
��� � / //
�e�r (Street) : L,N�l� 5 �SD�f Left Side: L d�il S !� 3 �
Ad jacent Structures : p.T"�4-t�9 Wetland: /vl/}
Building Height: Def. Hgt. /Jr/� Peak Hgt. /l�j!'�
Avg. Setback: �� � Lot Coverage: /�{�
Existing Proposed
Hardcover: 0-75 ' A
75-250 ' ��� `�
250-500 '
500-1000 '
Hardcover Variance Required: Yes p� No Date of Council Approval: -y zZ-�t1
Grading: Staff Approval Date: N� By: Council Approval Date:
Septic: Staff Approval Date: /1/Ir BY=
Zoning Fi le:# t 63(o Resolution #: 25 SS Resolution Date: y�2Z.-�(
R$MARRS (in house) :
ri �w
BIIILDING REVIEW CHEQC LIST
QBC: S X (Z- � CONSTRIICTION TYPE: '�!!�_
Sq Footage $ Per Sq Ftg
Basement X =
lst Floor X -
2nd Floor X =
Garage X -
�Q.eG K. 3 0o x g,o U = � �-1 C90 °'
,:
TOTAL
Estimated Construction Value: $ 2, ti �� �J
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�CFooting Mechanical Fire
�Framing Septic Water Connection
nsulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
------------------_----------------------------------�--------------�-------
RI3MARRS (IN HOOSE) /�D��CAs'��'" � S�6N ��-� � 1 V/4C-�i �n U/S42�i
------------------------------------------------------------------------------�
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date By�
------------------------------------------------------------------------------
REMARRS (TO BS NOTED ON PERMIT) :
� sf,
CITY OF ORONO - BIIILDING PSRMIT APPLICATION
Total Fee s $ ��`�� �J� Date Received: �
_/ `-'" Date Approved:
Entered By: '
Permit#: � � 3 �
ALL INFORMATION MtJST BE SIIBMITTSD IN FOLL BEFORE PLAN REVI�W WILL B$ STARTED
(See Check-off List Enclosed)
T� APPLICANT IS: (circle one) OWNER CONTRACTOR
JOB SITE ADDRESS: g.l D � � ZIP: ��(, ,
(work) ���7�
NAI� OF OWNER: �� � PHONE: (home) �7�I"$�(�
MAILING ADDRESS: � d CITY: I ZIP:
�CONTRACTOR: S�V� 1 ���2�� PHONE: �.�Q- ���o Po
MAILING ADDRESS: � IN�U6� 1 D�� CITY: M�l.,e�1. �/1� ZIP:
� S
TYP$ OF WORR: New Addition Accessory S'�ructure,�_ Move
Demo Remo��/Alteration Renovate Land Alteration
PROPOSED WORR (aes�ribe in aetai�) : 5„b�;-� � �c I� D��Ws -���C i�,a5
�k�
STORIES: SQ. FEET OF EACH FIAOR:
NO. OF B$DROOI�IS: GARAGB STALI�S: ATT. DET.
ESTIMATED CONSTROCTION VALIIATION (ezcludinq 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 I
understand this is not a permit and work is not to start without a permit; and
that the work will be in accordance with the approved plan.
�pr.ic�r�s sicr��: nA�s: �-3 a`� �--
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M..�.��*� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
' .�.:;.
• - � � On the North Shore of Lake Minneto�
DATA PRIVACY ADVISORY � ` I
�
��In accordance with M.S. 13.04, Subd. 2, "Righ �/��� J
data , we would I.ike to inform you that your reque , �
license from the City of Orono or any of its depart ,��U,, /
you to furnish certain private or confidential info: _ /
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 license.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or I.icense requires Council. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
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 as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&F[NANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
.. , r
�.� �Gg� �g g�gJgCTS OF DATA .
Subdivision 1. Type oi date- The rights of individusls on whom the data is
stored or to be stored shall be es set forth in this section.
gubd. Z, Information required
to be given indi��' An.individusl asked to
� su 1 private or confidentiel data concernina tBmWi�in the collecting state gency,
purpose and intended use of the req t med �b� Whether he may refuse or is legally
po li tical subdivision, or statewide sys �oWn conse quence arising from his
re quired to supply the requested date; (�� �Y �d (d) the identity of
supplying or refusing to supply private or con fidentiel data;
ersons or entities authorized by state or federal law to receive the data. This.
other p 1 when an individuel is asked to supply investigative data,
requirement shall not app y to a�W enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lace the notice re uired under this
subdivision in the individuel income tax or ro ert tax re und u�structions instead o
on those orms. . - --- - " .
Subd. 3.
Access to dets by indivi�• UPon request to a responsible
authority, an indiyiduel shall be informed Wh ublic pr va eeor confidential.e �Pon �
individuels; and whether it is classified as p + ublic data on
further request, an individuel who is the subject of e to�mrl���he desires, sha11
individuels sha�. be sh°wn the data witho of�hat data. After an ino��c�ed to
�e informed of the content end meaning t� �ta need n
shown the private data snd iniormed of its u��action pursuant to this sectioT��s
him for six months thereafter unless e �SP
� ending or additional data on the individuh h� a eeor Publi��d�atgruP�narequest by
• p require the
responsible authority shall provide cepies e g o�ible authority maY
the individual subject oft�e actual�cos h of malcinB, certifying, and compiling the
requesting person to pay -
copies. li ssible, with any request
The responsible authority sha]l comply immediately, Po
made pursuant to this subdivision, or withia five days of the date of the request,
excluding Saturdays, Sur►dsYs and legal holidays, if immediate compliance is not '
ossible. If he cannot comply with the reQuest within that time, he shaIl sp inf�orth the
hsve an additional five daYs Within which to com ly
iadividuel, and maY S�� �d Iegal holidays-
request, exeluding Saturdays, YS
te or complete. An indi�idual may
Subd. 4. Procedure when data ss not acc�a himself. To
contest the accuracy or completeness�of public or pM�ate � the�respoaslble authority
exercise thi.s righL, en individusl shall notify in writing
describing the nature of the disagreemenL The r��sible authority shall within 30
days either. (a) correct the data found to be inae��ei°��ngQee�ipi��name tby
notify pas� recipients of inaccurate or incomp
the individual3 or (b) notify the individual that he believes the data to beem nt is
Data in dispute shall be disclosed only if the individual s statement of disagr
• included with the �isclosed data• � 8ppe�e� p�suant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED Z.-��1 � `�
PERMIT NO. COMPLETED Z Z��'J( �D%�S
ADDRESS ���U S�`��1 UJ���
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET(fURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES NO
c� CO MENTS: �(� ss b .S
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a - i ` �fP.�.�Ja�� `i'� -hf�4NOk•4,� 6�f/t.4 2 s7x1��S
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMP�ETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
O
�� PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. �
�—(1'��^C�1N e��'��CJuS C�vvO(T'c�� � I�
al or the next inspection 24 hours in advance.473-7357 U���
OwnerlContract si •
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED y-2� I �
ADDRESS I&►O S�'h°�_
OWNER �'�Q/�7`� CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 18WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WAIL 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 08 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL .
? OWNER/CONTRACTOR TO MEET YOU:_YES_�,[d0
� COMMENTS: �� ��`(S -i�•s1- C�+
� —�IJ�c�s i 1-�t r��e 5 o K Fc IL��oc:�o R
,
0 � � RN Q ��� �1�C�u A LIr
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� ... 2ES��uT c9NS N e�
d " '✓fX_v�S ��.Ib J v Il�"GW �W IV"�t
W� ❑WO KSATISFACTORIP:PROCEED ❑PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED �ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION �TEMPORARY
V BEFORE CONERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor on ite:
Inspector.
White CopyAnspsctor's Fik Canary Copy/Site Notke
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