HomeMy WebLinkAbout1991-003623 - add/remodel � i PERMIT
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CITY OF ORONO PERMIT TYPE: '�
1335 Brown Rd. South • P.O. Box 66 �'����-�����
Permit Number: t�i�:;�,'�:_
Crystal Bay, Minnesota 55323 Date Issued:
i 2 L{.i'C3'�i r`i i
(612) 473-7357
SITE ADDRESS:
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FEE SUMMARY: '�'""�` �`
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�NTRACTOR: OWNER: -- �����I i c a��t. --
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PLICANT%PERMITEE SIGNATURE SSUED BY:SIGNATURE
� /-��- r,.='� c�'�. 9-�/
CITY OF ORONO - BIIILDING PERMIT APPLICATION �
Total Fee: $ � `-� �� �' � Date Received: - �� - �� �
r .
� Date Approved:
Entered By: � �� ' � " � i
Permit#: �, �U<- .`.
ALL INFORMATION MIIST BE SIIBMITTED IN FiJLL BEFORE PLAN REVIS'W WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPZIGANT IS: (circle one ) OWNER or CONTRACTOR
JOB SITE ADDR$SS: r� �-�l. �� \ � �
.�.: �,�,�r,r• ZIP: ���,S�i f
� (work) 3j:� -�/'���
NAME OF OWNER: ��, z . ,� 1 �, ��, ,�' PHONE: (home) �7t-C�4 z-J
MAILING ADDRESS: � oSfr� ��r� �- CITY: �r-� �,a �^+�,M•� ZIP: S-S��j J
CONTRACTOR: �T�1�►�_ PHONE: �,r�-yr�
�
MAILING ADDRESS: _.`�!'� � � CITY: ZIP:
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remode�/Alteration�� Renovate Land Alteration
PROPOSED WOF.R (describe in detail) : �Q�r�►r- ���
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI.LS: ATT. DET.
,,...�=
ESTIMATED CONSTRIICTION VALIIATION (ezcluding 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
iderstand this is not a permit and work is not to start without a permit; and
�at the work will be in accordance with the approved plan.
LICANT'S SIGNATQRE: - =- -�' �' DATE: �I-3 '� i -
,
r�
� _
�'� � CHECR OFF LIST FOR ISSIIANCE OF P$RMITS
FOR OFFICE USE ONLY
/� / /)�
ADDRBSS OR LEGAL: p, C O � � �� G �� 1 ��,Z�/PiD:\
�
DESCRIPTION OF WORK: ��r�'-�-
------------------------------------------------------------------------------
ZONING REVIEW BY: V1ti� DATE APPROVED: � - a S- �7/
BQILDING REVIEW BY: DATE APPROVED: '� `� -� '�'1 (
FEES TO BE CHARGSD: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes� No SEWER CONNECTION
STATE SURCHARGE Yes� No WATER CONNECTION
INVESTIGATION FEE Yes ✓No � PARK FEE
SAC Yes No c� SITE INSPECTION
Number of SAC Units OTHER (specify) , d,,A f,�
ZONING CHECR LIST Zoning District: �„ � - ( C_
Fire Department: �"� Post Office: /'`-School District: `�-
Lot Area: �Q , /„ �5,,� Width: Depth:
-T
Survey Submitted: Yes � No Date of Survey: �3- -/S-�y , ��l-�'7- �O
Proposed Setbacks: /
Front (Lake) : �y Right Side: 2 0 �
Rear ( Street) : Left Side:
l� �
Adjacent Structures : �� Wetland: --'—�
Building Height: Def. Hgt. ------ Peak Hgt. -��
/ �'�` 3,G1 Q.'7S�/ �'�. /S�
Avg. Setback: 't'(-�'"�`'��••�� Lot Coverage: 3 5 03,�.a,( �/�---�/6.f
�E ' s i g Proposed �
,��
Hardcover: 0-75 ' C.- `�-
75-250 ' 7 � O �f, �S� S'9'� ' . S�S.s�01. ��10
250-500 ' G- �-
500-1000 '
Hardcover Variance Required: Yes�No Date of Council Approvalr /z--l0 --9a
Grading: Staff Approval Date: �- By: �Council Approval Date:
Septic: Staff Approval Date: � By:
Zoning File: # �r��� Resolution #: o�, y/S Resolution Date:�L. -/6 - QO
(in hou e)
��c �� � ! �7 3 c? l,3 /}'-� Q. ..e-,�� ►�o�-�.a.�......!i���o,..c.r
~ ��-�-' ,�. ��2���-i - yi �
, _
BUILDING REVIEW CHECR LIST r ��'�
IIBC: $� �'j � CONSTRIICTION TYPE: °�ii �
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage X =
x =
TOTAL
00
$stimated Construction Value: $ Z��� `
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�Footing Mechanical Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
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RRMARxS (IN HODSE) :
-------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
-------------------------------------------------------------------------------
REMARRS (TO BS NOTED ON PERMIT) :
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�~P � ' Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal OfSces
•
s - � �r 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 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 Iocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Your full name is required to process this appl.ication or
permit.
�A� -�V tt:, � r.�,� (�11�r, e �x.�� �,�
First Middle Last �
�O�L � . d� :��C' �
Address
��'�._.}t�-y-�. '��� �f�l"��,�. ���R �
City � � State Zip
��� � - ���-fZ—�
Phone
I understand my rights as stated above.
S gn r �
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
573.04 RIGHTS OF SIIBJECZS OF DATA
gubdivision L Tppe of data- The rights of individusls on whom the data is
stored or to be stored shall be as set forth in this section
gubd. Z. Information re9uired t° be g�v� ����' An.individuel asked to
� � su 1 rivate or confidentiel data concerning �mwithin the collecting stgte ge�, .
PP Y P uested data
purpose and intended use of the req tem; (b) whether he may refuse or is legally
politicel subdivision, or statewide sys . �oWn consequence arising from his
required to supply the requested date, (c) any �d (d) the identity of
supplying or refusing to supplp private or confidential dats;
other penons or entities authorized by state or federal law to receive the data. This.
when an individual is asked to supply investigative data,
requirement shall not apply to 8�W enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lert tax re�und instructio uinsteadh�s
subdivision in the individual income tax or r•
on those orms. . � -— - � .
Ac� � �� � ����, Upon request to a responsible
Subd. 3.
authority, an individusl sha]1 be informed�h b��pr'vateeor ccnfidential.e UPon tus
individuals; and whether it is classified p ublic data on
further request, an individuei Wh° is the subject of � to himrland, if he des�res, shall
individuels shall be shown the data withou�f��t �� �ter an individuel has b�en
�e informed of the content and meaning t� �� need not be �'isclesed to
shown the private data and informed of its ut��8ction pursuant to this section is
him for six months thereafter unless a �SP �
� ending or additional data on the individuel � 8te or public ddataruponarequest by
, P
responsible authority shall provide cepies The respensible authority may require the
the individual subject of the data- certif n and comp�g the
requesting person to pay the actuel costs of making, Yi ��
copies. immediatelY, if possible, with any request
The responsible authority shall comP1Y of the date of the request,
made pursuant to this subdivision, or within five �Ys,mmediate compliance is not
excluding Saturdays, Sundays and legal holidays, -
ossible. If he cannot comply with the request w�it�it�n w�ch toh mply wi h the
P have an additional five y5
individual, and maY 5��� �d legal holideys•
request, exeluding Saturdays,
d�a�e when data is not accurate or complete. An individuel mgY
• Subd' 4' p� ublic or private data concerning h�ms�• To
contest the accuracy or completeness�ef P ln �i� the respensib�e authority
exercise this right, an indiv�� s� notify �ible authority shall within 30
describing the nature of the disagreemen� Z'1�e resp° leie and attempt to
days either. (a) correct the data found to be inae��ei°�u�gPecipienis named by
notify past recipients of inaceurate or incomP
• or (b) notif the indieidusl that he believes the data to �ement is
� Data in disput shall be discl°sed only if the indi�►idual's statement of disagr
• included with the disclosed data. ealed pursuant to the �
' The determinstion of the responsfble authority to conte.��ed cases.
provisions of the ad,-ninistrative procedure act relating
lD�I�TIFICAT�ON Of PRE�lISES R�QU�RED
' C��proved Addresses Shall Be Dis la ed �
p y � �
�
Flamly Visible And Legibie From The �
� Streex Fronting The Property SPECIAL NOTE
SEE ATTACt—�ED S�'EET
� ��f�"�� FC3R '��/Jkk�C-
REQUtR�N�El�STS
---- =�._�i2,J�-r��("t-: 'j'i1��'J'_i')
STA6RS _ ,�;�=-�� -.... ��, G :f�,
--_
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8" MAX. RISER 9" MIN. TREAD
6'-6 ' M,{N. HEADR�(3!eA 2v�v'�
AT LE;AST OP�E HA!���i�.�;6L �2�:�UIRED ,
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DECK �-z�� �--�-�-r ,
S, STAIRS & PO�CHES � f �
All Structural Members Must Be Approved ; � '
Wood Of Natural Resistance To Decay Or � \ � ' �
Treated Wo�.t: �
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�% DATE � TIME
CITY OF ORONO CALLED IN '���-� '��/
INSPECTION NOTICE � -�- scHeou�Eo �� "� f L '���.�
PERMIT N0. �,�i ��'�-�' COMPLETED L1 �
ADDRESS :�,G r _ �l%, ,;t�� �t -c-t�
OWNER ' ' '`�� ���` CONTR. -"` "
TELEPHONE NO. ` �� �%�� � f �� �
� DESCRIPTION ,��.'L-c�` -�`� %�" -<< c��._�,�5'--<--�`
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04.WA_�� 12 WATER HOOK-UP 34 TREE REMOVAL
�'05 FINAL � 13 METER SETITURN ON 17 SITE INSPECTION
� D7 DEMO—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
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� �WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
Owner/Contractor on s�te:
Inspector. -V
£ White Copylinspector's File Canary Copy/Site Notice
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