HomeMy WebLinkAbout1993-004972 - bathroom remodel �' PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 E`��T�.C}I��a
Permit Number: i�t��.=�7•�
Crystal Bay, Minnesota 55323 Date Issued: i�i f:��:.j:a::;
(612) 473-7357
SITE ADDRESS:
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REMARKS: ;;L�:"��—?�;�A' ;��''
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FEE SUMMARY:
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CONTRACTOR: O N�� — ������ �t=����� —
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APPL ANT/PERMITEE GNATUFE ISSUED BY:SIGNATURE
1
� " CITY OF ORONO - BIIILDING PFRM.ZT APPLICATION
Total Fee: $ /�G / , /� Date Received: ��a-�3
Date Approved: a'02 3 - �'/ "�'>
Entered By: ' � � '/
Permit#: 79 ��'
ALI. INFORMATION MIIST B$ SIIBMITT� IN FDLL BEFORE PLAN REVIEW WILI� B$ STAR�ED
(See Check-off List Enclosed)
T� APPLZCANT IS: (circle one) OWNER or CONTRACTOR
Jos si� �,nnRsss: i�go �NA�o�/w�b p 2� zzP: �S 3 g 1
(work) ��1 —Z��3
NAI� OF OWNER: R +�-�f�R'D � DtLa`2/� L. i y`"'r'L� PHONE: (home) �f�/ - �8`1�
2SAZI�ING ADDRESS: !S 9 0 5}4�}.��{ I,��aoo �D, ciz�: �v�4 Y`ZA-vri� ziP: S�'3 9 l
CONTR�CTOR: ��'N t� PHONS:
MAILING ADDRBSS: CITY: ZIP:
STATS LICEIJSS: �
ARCHITECT/ENGINEER: ONINE�Z PHONE:
MATLING ADDRBSS: CITY: ZIP:
NAML: RBGISTR�iTION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�� Renovate Land Alteration
PROPOSF.D WORK (describe in detail) : ��o��L Ma�Ep� '(3A�tH(�c�oNl (�St�
1��l��N�D s K-�7�-1��
��,��'Az.i!our�
sTOR.tss: 1 sQ. FE$T OF EACH FZOOR: N1A�a L,��E L° �2,��S� ��a .� l o oc�
NO. OF B�ROOMS: ,j GARAGB STALLS: ATT. X DET.�
ESTIMATED CONSTRIICTION VALIIATION (ezclndi.ng land) : $ �) �a�
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.
s � Ll
APPLICANT'S SIGNATORE: �"�`� ° e DATE: r Z Z �3
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
' � FOR OFFICE USE ONLY
Annx�ss OR LEGAL: '�� �� . n���.�_ , ,�:� Pzn: / 7 _ i��l — ,�3 � � �,,:, `I
DESCRIPTION OF WORR: ���z-t���-E-���-�-� ,��;,��'�,'<<:�-�.
----------------------- ------------------------------------------------------
ZONING REVIEW BY: DATE APPROVSD:
BIIILDING REVIEW BY: DATE APPROVED: � � Z� "� 3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓.No
PLAN REVIEW Yes�r No SEWER CONNECTION
STATE SURCHARGE Yes J No WATER CONNECTION
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No �^ SITE INSPECTION
Number of SAC Units OTHER (specif y)
----------------------------------------------------------------
ZONING CHECR LIST Zoning Distri t:
Fire Department: Post Office: SchooJ. Distri
Lot Area: Width: D pth:
Survey Submitted: Ye No Date �bf Survey:
Proposed Setbacks:
Front (Lake) Ri t Side:
Rear (Stree ) : L ft Side:
�
Adjacent S ructur s: / We land: r`/
Building Height�: Def. Hgt._7'� _ / Peak Hgt.
� �
Avg. Setback: ;� Lot verage:
Ex sting `! Pr posed
f J �% /
Hardcover: 0�75 ' �`
f r %
75J250 '
,•
25 -500 ' ;�
500 1000 ' ��
Hardcover 'Variance Req i ed: Yes % No Da e of Council App oval:
1
Grading: taff Approva ate: f� By: Council Approv 1 Date:
Septi c: taf f Approva]. ate: /r __ BY= �
�
Zoning File:# Reso�ution # : Resolution Date:
REMARKS (in house) :
BIIILDING REVIEW CHECR LIST
. �
IIgC: �'� (L ' �j' CONSTRIICTION TYPE: V N
Sq Footage $ Per Sq Ftg
Basement x -
lst Floor X -
2nd Fl.00r X -
Garage X -
x =
TOTAL
Gv
$stimated Construction Value: $ �,���
Inspections Required: Work Requiring Separate Permits:
Site � gPlumbing Grading/Fil7.ing
Footing Mechanical Fire
�Framing Septic Water Connection
Insulation Firep�ace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
Final (Mfg.) Other
Other WelJ. (State Permit)
�Electrical (State Permit)
--------------------------------------------------------------------
REMARRS (IN HOIISE) :
-------------------------------------------------------------------
REVIEW BY OTHEFZS: DATE:
Access: Existing New
Access Approval: Date BY=
---------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
. �
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Officea
�
• - � • On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike 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:
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 license requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva��
data on yourself.
6. Your full name is required to process this applicatian or
permit.
�i c i-�tti�7 ��� � �i T"T'C_�
First Middle Last
�8 g0 S f�f�`Dy��4o� ��,
Address
�.e�4�z,q-� �'1 n� 5"s3 q �
City State Zip
( (,} ��� �-1-�1 ( -�87 S`
Phone
I understand my rights as stated above.
/ }� `
.� r�
Signature
BUILDING 8c ZONING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBL[C WORKS—473-7359
ASSESSING
,- .
�.04 RIGII15 OF SIIBJECIS OF DATA ' '
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
-- . Subd. 2. Information required to be givea individuel. An.individual asked to
� • ivate or confidentisl data concerning himself shsll collecting state agency,
supply pr
purpose and intended use of the requested data within t e � refuse or is legally
political subdivision, or stetewide system; (b) whether he me,
required to supply the requested date; (c) any known consequence arising from his
rivate or confidentiel data; and (d) the identity of
supplying or refusing to supplp p
other persons or entities authorized by stsau��e�kedito supplyeinvest gave da a•
requirement shall not apply when an indivi
pursua;►t tc section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace t8X re°una�nstructioris insteadhos
subdivision in the individual income tax or ro ert
on those orms. . - - ---- - � .
Ac� to �� � ����, Upon request to a responsible
Subd. 3. �
authority, an individusl shall be informeda h b�� hpr vateeor confidential.e UPcn his
individuels; and whether it is classified p • ublic data on
turther request, en individual who is the subject of se tr�e�mri�v�e�if he desires, shall
individuels s1�au be shown the dat8 W��O of�hat data• After an individuel hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private data ar►d iniormed of its u�e�Ba��pn pursuant to this section is
him for six months thereafter unless e d�sp .
� ending or additional data on the individu e h�8teeor public datarupcnarequest by
' P rovide copies of th p require the
responsible authority shall p nsible authority maY
the individual subject of the data• The �P� �rtif n and compiling the
requesting person to pay the actual costs of malcing, Yi g�
copies. lmmediately, if possible, with any request
The responsible authority shall comply ' of the date of the request,
made pursuant to this subdivision, or with���'��mmediate compliance is not
excluding Saturdays, Sundays and legal
ossible. If he cannot comply with the requ et �t�wit�ntlW ch toh mply w�h the
P heve an additional fi YS
individuel, and m S turdays, Sundays and legal holidays•
request, excluding
Subd. 4. Proced�u'e when dnta is not aecurate or complete. An individuel may
- ublic or private data concerning himself. To
contest the accuracy or completeness�of p in �i� the responsible authority
exercise this right, en indiNduel s� notify nsible authority shall within 30
describing the nature of the disagreemenL The respo
days either: (s) correct the data f ound to be i�e datae including reee pients namedt by
notify past recipients of inaceurate or incomp
the individuel; or (b) notify the individual ind�v dualb s�state entdof disagreement is�
Data in dispute shall be disclosed only if the
• included with the disclosed dats. � BQpe�led pursuant to the
' The determination of the responsible authority to contested cases.
provisions of the administrative procedure act relating
oRo� r
oc
OPY
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;����vY��� ��o�bE�c�`ous
FOR ENTIRE Bil�II.DING
DAT�E TIME /
CI fY OF ORONO CALLED IN � -7" (3 �• � ���
INSPECTION NOTICE SCHEDULED � - ` .3 %/: o���' �
PERMIT NO. � � ��' COMPLETED ��
ADDRESS l - �-'�'�
OWNER � � �G� CONTR.
TELEPHONE NO. � �� �b� ��
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
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Z 04 WALL BD. 12 WATER HOOK-UP 34
Q 05 F1NAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP
J 07 DEMO—FINAL 27 SEPTIC MAIfvT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
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W� WORKSATISFACTORY:PROCEED J PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. CpHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
❑ INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContra ite: _
Inspector. t-' --
White Copylinspector' File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN Z
INSPECTION NOTICE SCHEDULED Z �'3 �� �3 D
PERMIT NO. �� � COMPLETED � •�
ADDRESS
OWNER C�� CONTR. ��
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 2 FR IN 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREMIETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
h 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
v�, COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDiTION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContra r o site:
inspector.
White Copyllns s File Canary CopylSite Notice
�.
DA E TIME
CITY OF ORONO CALLED IN 9'.5
INSPECTION NOTI E SCHEDULED � � �
PERMIT NO. `7Z COMPLETED
ADDRESS
OWNER CONTR. L2%o��I
TELEPHONE NO. '�7�- rI�7 S
� DESCRIPTION�,�'.¢���
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WA L BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 5 FIN 13 METER SETITURN ON 17 SITE INSPECTION
� EMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedCon r o site:
Inspector:
White Copyllns tor's File Ca�ary Copy/Site Notke