HomeMy WebLinkAbout1995-006753 - kitchen remodel PERMIT
�1TY OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 �;�::t :::' ;°�t�
Crysial Bay, Minnesota 55323 Permit Number: ;;:_;�,=�:��.�L;
(612)473-7357 Date Issued: ;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: _ ;:;�:- � ;.;_ -.:.;-:;.. .....
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APPLICANT/PERMITE IGNATURE ISSUED BY:SIGNATURE ��
� � � CITY OF ORONO - BIIILDING PERMIT APPLICATION
�otal Fee: $ �� � J �' Date Received:
Date Approved :
Entered sy: � ,l'�i,� -�
Permittt. ,�-�=�
ALL INFORMATION MIIST B$ SDBMITTED IN FIILL BEFORE PI�N REVIEW WILI� BB STARTED
(See Check-off List Enclosed)
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----------------- .,
THE APPLICANT IS: (circle one) OWNER 9x' CONTRACTOR
JOB SITE ADDRSSS: /��l � � `--� l 1 �"l'�� i�� � �( �r� ZIP:•��S ��
�w�o rk) ,5�� _/� �Ci
NAME OF OWNER:��yV l ��- `�- � t I���C�X�' ��� y PHONE: (horcte) 7��!/ ��"�i,
r�ziNc ��x�ss- ����� 1-(����.e��� �� cz�:�'��L� JG�� zzP:_��� �� I
CONTRACTOR: PHONE:
?�iAIZING ADDRESS: CIZ'Y: ZIP:
STATB LIC:ENSE: �
(' � � � - � y=���_ , PHo�: y ��� "��� .�
ARCHITECT/E�7GIN�ER: k'-����' C�{ti� 1 ��
MATr.zN� ��Fzass: ���' ��1��?U! 1-c-�`3}� ��- cz�: f���-���� zzP: � 5�� ���
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NAME: �`7 U�' � �� �'� �ti�� � R.BGISTRATION tt
TYPE OF WORR: New Addition Accessory Struczure Move
Demo Remodel/Alteration_�- Renovate Land Alteration
PROPOSED WORR (describe in detail) : t,�� �,U i �I �%U� �� � I ���1�'1'z-- �''^�TJ �-
� ��� � -. �l ,�i y�,V Q� �,7�<�y�_ " i �-� U��� �� � �t ���y�;'�}'1
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STORISS: ! SQ. FEBT OF EACH FLOORs � �G Ci
� � DET.
NO. OF BHDROOMS: `� GARAGB STALLS: ATT.
. � � �' '
ESTIMATED CONSTRQCTION VAI,IIATION (eacluding Ia.nd) : $ � J L����
I hereby appl.y 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 wiI 1 be in accordance with the approved plan. •
..,, � 1
APPLICANT`S SIGNATIIRE:��, � 1�5�� ����-` DA�E: �' ��_���/
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CITY of ORONU
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Mennetonka
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
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:
l. 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 refusa]. may require that
the City deny the permit or license.
3. The information may be shared with other �ocal , state or
federal agencies to the extent necessary to grocess the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�at�
data on yourself.
6. Y�ur full name is required to process this app3.ication or
permit.
����'� �J ��t�v �: C�qs���f,
First � Middle � Last
�1�� �. ��.�1� la� �'�"i�
Address
�
�X���� �� ���� l
City State Zip
�t7��� �� �
Phone
I understand my rights as stated above.
Signature
�
BUILDING&ZONING—473-7357 • ADMINISTRATION dt FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
• ' .
�
�.p� RIGHTS OF SOBJF.cTS �F DATA
gubdivision L Type of data- The rights of individusls on whom the data is
stored or to be stored shall be as set forth in this section. An.individual asked to
gubd, Z, Information r�d
to be given indivi�uaL
' su 1 rivate or confidential data concernin g amwithf in the collect g state gency,
PP y P v refuse or is legally
purpose and intended use of the requ em;d �b� Whether he ma„
political subdivision, or statewide sys �o`,yn consequence arising from his
required to supply the requested date; (c) g�y
u 1 in or refusing to supply private or confi federal law to receive he data.1tTti'Ls.
s PP Y g state or �vesti ative data,
other persons or entities suthorized by
requirement shall not apply when an individuel is asked to supply g
pursuant to section 13.B2, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace the notice re uired under this
subdivision in the individual income tax or ro ert tax re und instructions instead o
on those orms. � --- " .
Subd. 3. Access tc data by
����. Upon request to a responsible
authority, an individusl shall be informed wh uti c hp vateeor confident al.e Upon his
individuels; and whether �t is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individuel who is the subject of stored private or
individuals shall be shown the data v�►itho of�hat da a• After an individual hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private dats and informed of its meaning, u�uant to this section is
him fvr six months thereafter unless a dispute or action p
� rivate or public data upon request by
ending or additional data on Lhe individ�h hss been collected or created. Q
� p require the
responsible authority shall provide copies o P �iin the
The responsible authority may
the individuel subject of the data• certif n and comp g
the actual costs of makinB, Yi g'
requesting person to pay -
copies. y ssible, with any request
The responsible authority shall comply immediatel , if po
made pursuant to this subdivision, or withinlaa e �f Simmediategtcompliance eisu not
excluding Saturdays, Sundays and legal hol ys,
within which to comply with the
ossible. If he cannot comply with the request �thin that time, he shall so inform t e
p have an additional five y5
individual, and m S turdays, Sundays and legel holidays-
request, excluding
Subd. 4. Procefiu'e �►hen data fs not acc�ate or cocnplete. An individuel maY
- ublic or private data concerning himseLf. To
contest the accuracy or completeness�of p the responsible authority
exercise this right, an individuel shall notify in ���e authority shall within 30
describing the nature of the disagreement. The respo lete and attempt to
days either: (a) correct the data found to be inaccurate or incomp
notify past recigients of inaccurate or incomplete�e belie esdthe datalto be correct
the individuel; or (b) notify the individuel tha eement is
Data in dispute shall be disclosed only if the individuel's statement of �a�' to the
• included with the disclosed data. � 8 e�1ed pursuant
' The determination of the responsible authority may PP
provisions of the administrative procedure act relating to contested cases.
CHECK OFF LIST FOR ISSIIANCE OF PERMITS
" , . FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z1�SS 5 H a�y�fl d� � PID:
DESCRIPTION OF WORR: �-7VlAO' -' �Av � � tTG�^� ► �� /Go
o-�`�� G1►�-�- -c��p,�i- -- ------------
------------------------------------- -
ZONING REVIEW BY: N l� DATE APPR0�7F•D:
BIIILDING REVIEW BY. DATB APPROVED: I � IO ' �7� -
--------------------- ---------
FEES TO BE CHARGED• Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes ' No v" 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:
r^ire Department: Post Office: School District:
Lot Area: Width: Dept :
Survey Submitt d: Yes No D te of Survey:
Proposed Setb c s:
Front ( k ) : Right Side:
Rear ( S ree ) : Left Side:
Adjace t St uctures: We;�lan :
Building H ight: Def . Hgt. Pea Hgt.
Avg. Setb ck: Lot over ge :
Exist ng P pos d
�
Hardcove : 0-75 ' ` __
75-250 '
�`
250-500 ' �
�
500-1000 '
Hardc ver Varia ce equired: Yes No Date of Coun il Approva� :
Grad 'ng: Staff pp oval. Date: By: Counci]� Approva� Date:
Sep ic: Staff A roval Date: BY�
Zon ng File: � Resolution Resol tion Date:
S (in house) :
BIIII�DING REVIEW CHECR LIST
.
IIBC: � � CONSTRIICTION TYPE: �� �
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Bstimated Construction Value: $��c�0��
Inspections Required: Work Requiring Separate Permits:
Site p�Pl.umbing Grading/Filling
Footing Mechanical Fire
�Framing Septic Water Connection
�Insu�ation Fireplace Sewer Connection
�WaJ.I Board (Masonry) Lawn Irrigation
�Fina 1 (Mf g.) Other
Other Well (State Permit)
o� Electrical ( State Permit)
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REMARKS (IN HOIISE) :
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REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval : Date By:
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j2F.MARKS (TO BE NOTED ON PERMIT) :
�
D TE TIME
CITY OF ORONO ca��Eo iN �' !���
INSPECTION NQTICE SCHEDULED �? �Z_3 .�� //���7
PERMITNO. %�53 COMPLETEO �� �
ADDRESS � �5� � _-�fz���-'%
OWNER �2�'�� CONTR. G c-.�� �-<<.-L�
TELEPHONE NO. .�`�� ' `7>U D
� DESCRIPTION �_�i�-z�-��
� 01 F„=QTJ� 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
y�b2 FRAMING � 13 MECHANICAL FINAL 19 LAt�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
F` 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 09 PLUMBING RI 23 SEPTiC FINAL
35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
Z OWNERlCONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� CORRECT WORK 8 PROCEED ;- ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance.47�73�J7
OwnerlContra t on 't :
Inspector. � `
White Copyllnspector's File Canary CopylSite Notice