HomeMy WebLinkAbout1991-003734 - interior remodel PERMIT
C11�Y OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 E;€1 I��:t I�,�U
Permit Number: tt��;;j;;;�
Crystal Bay, Minnesota 55323 Date Issued: �j�,�t�c;���;1
(612) 473-7357
SITE ADDRESS:
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REMARKS:
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ITRACTOR: OWNER:
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APP�ICAN iPERMITEE SIGNATURE ISSUED BY:SIGNATURE
. � • ' ' _ .
CHECR OFF LIST FOR ISSIIANCE OF P$RMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I 3ZS �S('�fl R.E�-i N�- PID:
DESCRIPTION OF WORK: �W(O�E L - '^'T�-�-��� ���-�t
-------------------------------------------- -
------•------------------------
ZONING REVIEW BY: /U�/4 DATE APPROVED
BIIILDING REVIEW BY: .r-- DATE APPROVED: 6- S-`V�
FEES TO BE CHARGED: 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 �/ SITE INSPECTION
Number of SAC Units OTHER (specify)
-----------------------------------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: � Width: epth:
Survey Submitted: Y s No Date;�'of Surv�y:
Proposed Setbacks : ' �
Front (Lake ) : Rig t Side: �� �
� i �
Rear (Street) : Lef�t Side:,
, �
Adjacent Structures : ,' Wetland:
Building Height: Def. Hgt. ; Peak Hjt. �
;
Avg. Setback: Lot Coverage;: '
Existing ' Proposed ; '
r �
Hardcover: 0-�5 ' � � �
: �,
,� � �
�-�.. __., - 3
75-�150 ' y, , _*-_
/ '\/ �
250-500 '
500-1000 '
Hardcover Variance Required: Yes ' No Date of Council'. Approval:
J
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: ' By:
Zoning File: # Resolution #: Resolution Date:
REMARKS (in house) :
, �
BUILDING REVIEW CHECX LIST
QBC: �Sg �-3 CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor X -
Garage x -
x =
TOTAL
$stimated Construction Value: $ ��00 �`—'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical Fire
�Framing Septic Water Connection
p Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
REMARRS (IN HOOS$) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
----------------------------------------------------------------------
R$MARRS (TO B$ NOTSD ON PERMIT) :
CITY OF ORONO - BIIILDING PERMIT APPLICATION
� �- �- �'1
Total Fee: $ r�r �G Date Received:
Date Approved:
Entered By: ;���
Permit#:
AI�L INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVI�tn1 WILI, BE STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
Z'HE APPZICANT IS: (circle one) OWNER or CONTRACTOR
JOB SIT$ ADDRESS: �%��Sr ���`�e'�.Ya(� ��` • ZIP:
(work)
NAML OF OWNER: � �OE� `� PHONE: (home )
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: S*�/�L��'Z ���V� PHONE: �I��'� `��-��
MAILING ADDRESS: 3� /� �° ��� rB I CITY:���Cr'�g/ ��1�, ZIP:
TYFE OF WORR: New Addition Accessory Structure Move
Demo Remod�/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) :
STORIES: SQ. FEET OF EACH FI�OOR: _
NO. OF BEDROOI�LS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRQCTION VALIIATION (egcluding 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.
APPLIC1�iNT'S SIGNATURE: DATE:
� . ,
�
CI'�Y o� ORONO
Post Office Box 66•Crystal Bay,Minneeota 55323•Municipal Offices
•
• - � • 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 wou3.d 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 wi3.1 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 or I.icense.
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 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 application or
permit.
D�o�v � 7"l¢�°�' ��'
First Middle Last _
_ 3��° sa � �y io �
Address
� �h��
Cit State Zip
�� 3�����
Phone
I understand my rights as stated above.
�
Sig ature ,
BUILDiNG&ZONING—473-7357 • ADMINISTRATIOIY&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING ,
, , ,
S13.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of data- The rights cf individuels on whom the data is
stored or to be stored shall be as set forth in this section.
gubd, 2, Information re9uir�d
to be given indi�duaL An.individual asked to
� su 1 rivate or confidentisl data concerning BmWit�h�in the collecting state agency,
pP y P
purpose and intended use of the req t med �b� Whether he may refuse or is legally
political subdivision, or statewide sys ' �o"yn consequence arising from his
required to supply the requested data; (�) �Y �d (d) the identity of
n or refusing tc supply private or confidentiel data;
supplyi g state or federal law to rece�e�e�ve� da a
other persons or entities authorized by
requirement shall not apply when an individuel is asked to supply g
pursuant to section 13.82, subdivfsion 5, to a law enforcement officer.
The commissioner of revenue ma lace the notice re uired under this
subdivision in the inciividual income tax or ro ert tax re und uLstruct�ons instead o
on those orms. . - -- - - .
Subd. 3.
Access to data bY ����- �Pon request to a responsible
authority, an individuel shall be informed wh ub�c hp=vateeor confidential.e Upon his
individusls, and whether it is classified as p � ublic data on
ta him and, if he desires, shall
further request, an individusl who is the subject of stored private orvidual hes been
individuels shall be shown the data witho of�hat data. After an indi
�e informed of the content end meaning t� �tg need not be disclosed to
shown the private data and informed of its u��action pursuant to this section is
him for six months thereafter unless s �SP n request by
� endin or additionel data on the individusl h�ate or public datarupoeated. The
� P g require the
responsible authority shall provide copies The hresponsible authority may
the individual subject of the data. certif n and compiling the
requesting person to pay the actual eosts of making, Yi g�
copies. 1mmediatelY, it possible, with any request
The responsible authority she]1 comply � of the date of the request,
mac3e pursuant to this subdivisi�nd legal th 1�daYs� if�immediate complianae is not
excluding Saturdays, SundaYs with the �
ossible. If he cannot comply with the request �t within which tohcomply f orm t e
individual, and may hsve an additio� leV al ho days.
request, exeluding Saturdays, Sundays g
te or complete. An individuel maY
Subd. 4. Proced�e �►hen data is not a�'8 ivate data concerning himself• TO
contest the accuracy or completeness�of public or p �ble authority
exercise this right, an individual shall notify in writing the resPo
describing the nature of the disagreemenL T'he resp��ible authoritq shall within 30
days either. (a) correct the data found to be inae��e��a,i°ngQee�ipi��ngmedt by
notify past recipients of inaccurate or incompl �
the individueli or (b) notify the individual that he believes the data to beement is
Data in dispute shall be disclosed only if the individual's statement of �g'I' to the
• included with the �isclosed data. � 8ppe81ed pursuant
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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� DATE TIME
CITY OF ORONO CALLED IN ����' �� -
INSPECTION NOTIC SCHEDULED � �i C'`�'
PERMIT NO. � �� � COMPLETED !� ��
ADDRESS C:��` � Lc���-�c-r.�-ic�-
OWNER �/_�/%�-� �.l��.t�0.� CONTR. .j�r'r�2;' �`��%��cJotin�;rL
TELEPHONE NO. `t� � "� : ��.S��i
� DESCRIPTION
� 01 FOOTI � 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING '� 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK•UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMP�AINT
i09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d WORK SATISFACTORY:PROCEED
W� ❑ PROJECTCOMPLETE
W CJ CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOA WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContra n si e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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