HomeMy WebLinkAbout1995-006850 - office partitions PERMIT
CITY OF OR013+0 , '` PERMIT TYPE: -
2750 Kelley,Parkway- P.O. Bo�c'�66 � �-=�'' --
Crystal Bay, Minnesota 55323 PermitNumber: �w:�::t.:=;_��=`i`y'�
(612)473-7357 Date Issued: _ .., . _. _ - �.
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPUCANT%PERMITE IGNATURE ISSUED BY:SIGNATURE
.CITX OF ORONO - BIIILDING PER�LIT APPLICATION
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Total Fee: � $ Date Received:
Date Approved:
Entered By: �
Perntit�: �t'��
ALL INFORMATION MIIST BB SIIBMITT� IN FIILL BEFORE PLAN REVIEW WILL Bg STARTED
(See Check-off List Enclosed)
---------------------------------------------- �-------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR f
JOB SITE ADDR$SS: r � ! � � .. ZIP:
(work)
N1�' OF OWNEfZ: t �'�' �. ��� PHONE: (home)
MAILING ADDR.ESS: CITY: ZIP:
CONTRACTOR: 7� ti� i �i/ (,r r `, PHONS: �,i1C r�,J``� �
MAIZ�ING ADDRESS: j�l� r r�� � �.�> ` a CITY:�1,1r►�� �1'��/�j S�.�IP: � G ,
� -
STATS LICENSE: �
ARCHIZ'ECT/ENGINEER: PHONE-
MAILING ADDRBSS: CITY: ZIP:
1,J�,r. RSGISTRATION ,�
TYPE OF WORRs New Addition Accessory Structure Move
Demo Remodel/Alteration�� Renovate Land Alteration
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PROPOSED WORK (describe in detail) :���C� tL�c�,S � � )��� �� �����>� ���"
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�r�j; ,��� ;�-������l , �r����� ��� �� �= <E�r �,��t-�� �i�,�
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STORI$S: SQ. FE$T OF EACH FLOOR: _
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
. `'X'� '
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ ����� �
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 wil 1 be in accordance with the approved plan.
APPI,ICANT'S SIG'IJATDREs � DATE:�� � / �� J
� ' ' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
' . FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ZY�� S��Y �o � PID:
DESCRIPTION OF WORR: G��<<-c= ��n�'�^`-� A�� G�'�i"�2
------------------------�---
ZONING REVIEW BY: N /4 DATE APPROVED:
BIIILDING REVIEW BY: DATB APPROVED: �'J3-5 5
-------------------- -----
FEES TO BE CHARGED• Misc. Fees Calculated By:
PERMIT Yes ✓No
PLAN REVIEW Yes �o � 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 is rict:
Lot Area: Width: Depth:
Survey Submitted: Y s No Da e of Sur ey:
Proposed Setback :
Front (Lak ) : ight Sid :
Rear (Str et) : Left Sid :
Adjacent Structu es : Wetl d:
BuiJ:ding Hei ht: Def Hgt. P ak Hgt.
Avg. Setbac : ot Co� rage:
isti g Prop sed __�.
Hardcover 0-75 '
75-250 '
250-500 '
500-1000 '
Hardc ver Variance quired: Ye No Date of Counci Approva]. :
Grad 'ng: Staff App al Date: By: Council A provaZ Date:
Sep ic: Staff Appr a� Date: By:
Zon ng Fil.e: # Resol tio # : ResoJ.ution Date:
REMARKS (in house) :
= /Sa
BIIILDING REVIEW CHECK LIST .
IIgC: �- Z CONSTRIICTION TYPE: vN
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor X -
Garage X -
x =
TOTAL
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Lstimated Construction Value: $ z� n���
Inspections Required: Work Requiring Separate Permits:
Site � p`Plumbing Grading/Fil�ing
Footing Mechanica� Fire
_�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
v�Wa�l. Board (Masonry) Lawn Irrigation
p�-Final (Mfg.) Other
Other Wel 1 (State Permit)
p Electrical (State Permit)
-------------------------------------------------
RF.I�fARR$ (IN HOIISE) :
-------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
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gi�1ARRS (TO BE NOTED ON PERMIT) :
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`�"`'7'"�+1� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� - � � 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 like 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 license requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit ar license.
3. The information may be shared with other Iocal, state or
federal agencies to the extent necessary to grocess the permit or
Iicense.
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 Lo review pri�a��
data on yourself.
6. Yaur full name is required to process this apt•licaticn or
p�rmit.
�� c�►�� �x'� --� -
First Middle Last
� L/� � l��..-�� 1(�l>�`�C��l � �
Address
.�� ► ,�r�-�-�2��,+-.�4 � 2 �1 , �5 3�1
City State Zip
l���-.'� J `/ ,,f% �
Phone
I understand my rights as stated above.
Si ature
BUILDING&ZONING—473-7357 • ADMINISTRATION& FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
. � .
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513.04 RIGH15 OF SIIBJF•CTS OF DATA �
S
ubdivision L Z�pe of da�e- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section. An.individusl asked to
Subd. 2. Information r�d
to be given in�ivi�uel.
� � rivate or confidentiel data concerning �mW hin the collect g state agency,
supply p v refuse or is lega]ly
purpose and intended use of the requested �b�whether he ma„ from his
political subdivision, or statewide system;
1 the requested date; (c) any known consequence arising
required to supp y 1 rivate or confidentiel date; and (d) the identity of
supplying or ref using to supp Y P State or f ederal le.w to receive the data. This.
o t her persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an individu a l is asked to supp y
pursuant to sec tio r i 1 3.8 2, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace t he n o t i c e r e u i r e d under this
bdivision in the individuel income tax or ro ert tax re und instructions instead o
su _ .
on those orms. • - --- .
t� �� b� ����, Upon request to a responsible
Subd. 3. Access
thorit an individuel sha]1 be inYormed Wh ublic h r vateeor confidentiel.e Upon his
e u y' u b l i c d a t a o n
individuels; and w he t her i t i s e l a s s i f i e d a s p �
turther request, an individual who is the subject of se to�mri�ae if he desires, shall
individuals shall be shown the data witho of�that da a• After an indiviaual has been
�e informed of the content and meaning the data need not be �isclosed to
shown the private date and informed of its meanin8� �uant to this section is
him for six months thereafter unless a diSPute or action P �ta u n request by
'n or additional data on the individuel h� ateeor p buc ed or �egted. The
� pendi g rovide cepies of the pri require the
responsible authority shall p The respcnsible authority may �in the
the individuel subjeet of the de�ta• certif n and comp g
requesting person to pay the actual costs of malcing, Yi g'
copies. immediately, if pessible, with any request
The responsible authority shall comply uest,
made pursuant to this subdivision, or With lidays, if Simmediateatcomplian�e e� the
excluding Saturdays, Sundays and legal
ossible. If he cannot comply with the request within that time, he shall so in�orth the
P have an additional fi�e daS'S Within which to comply
individu8l, and may �d le al holidays•
request, excluding Saturdays, Sun�eYs g
te or complete. An individuel To
Subd. 4. Procedia'e when data is not accara ivate data concerning himself.
contest the accuracy or completeness of public or p the respensible suthority
exercise this right, ar� individusl shell notify in writing
describing the nature of the disagreement.
The respcnsible authority shall within 30
�, either: (a? correct the data found to be in�e a�ae��a°g Pee�ipients namedt by
YS
notify past recipients of inaccurate or incomple �
the individuel; or (b) notify the individual that he believes the data to �ement is
Data in dispute s h a]1 b e d i s c l o s e d o n i y i f t h e i n d ividual's statement of �8�' t to the
• included with the �isclosed data. � 8ppe�ed pursuan
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
.
.
'� �"5��-�.i �� ��V�� `
�iL'DiMt� P�R1I�IIT PLAN RE�1/'i�
2l�ffiPEC'TOR
E'�ATE _ ' �� PERMtT Nt7. �,,,,�.,,,,..
�- APP"�'U'����7 AS SUBMI7TED
r� APPR�VE4D WITH CORRECTtON3 AS NOT.ED
NQT APPROVED — CURRECT & RESUBMI'F
t�r�e commertts ars tor your IMormatlon. A(I work sheN ha dMi/
«'r n�i� t�ompt}ence wlth a1i applic.et�ib buiW}rK 8 teK1Ny r04/I�
,a!ioemanis inciuc!ang itams.not spaclfksaliy not�d In MI� reMl�
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DATE G TIME
CITY OF ORONO CALLED IN �"��S� 7 S
INSPECTION NOTIC �/ b SCHEDULED 3""� �% �d
PERMIT NO. �v'� COMPLETED �_ `�J
ADDRESS 7 7 � �
OWNER �b�l� CONTR. � ��
TELEPHONE NO. �7 :? —(� � '��
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FR ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 0 TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMB�NG FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED �l PROJECT COMPLETE
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� � CORRECT WORK 8�PROCEED C;, ISSUE CERTIFICATE OF OCCUPANCY
W
OCl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ��' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
I
Call e ne t i(�pection 24 hours in advance.473-7357
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OwnerlContra n si :
Inspector. ^
White Copyllnspector's File Canary CopylSite Notice