HomeMy WebLinkAbout1991-003549 - remodel bedroom � PERMIT
�CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: �����►����'��
Crystal Bay, Minnesota 55323 Date issued: "i''''� �
(612) 473-7357 i�1=%��i�'��
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: OWNER:
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nPPLICANT/PE EE SIGNATURE ISSUED BY:SIGNATURE � ����,....
� _G. _ . . .. . -... . ._ _. . .. _. ..' _-- "' '. _ .
� �1
t- CHECK OFF LIST FOR ISSIIANCE OF P�RMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � ���' S'�t,-��'���'r��� .[_.-�'�, PID:��� '� �I i " � �> - j �� " <"�t>ce j
DESCRIPTION OF WORS: � �yc c��c..�
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ZONING RLVIEW BY: /V��- DATE APPROVED:
BIIILDING REVIEW BY: DATE APPROVED: Z- � Z'CJ�
FEES TO BE CHARG$D: 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 Dist ict: '
Fire Department: Post Offi e: School istrict:
Lot Area: Width: Depth:
Survey Submitte : Yes No Da e of Su vey:
Proposed Setbac s :
Front (La e) : R ght Si
Rear ( Str et) : eft Si e:
Adjacent ��Structu s : Wetlan :
,� ,
i
�uilding Heig t: Def. gt. Pea � Hgt. j
avg. Setback�� �Lot Cover ge: �
I Exis ing 7 Propos
Hardcover: 0 � 75 ' � �
� �i� �
75 250 �
0
250 500 ' � �
,
�
a
500- 000 ' - �
''ardcover Variance Required: s N Date of Council pproval: -
Y
:�rading: Staff Approval Date: By: Council App oval Date:� a
:�eptic: Staff Approval Date: By: -
Zoning File:� Resolution #: Resolution Date: �
� � _
REM�fRRS (in honse) : a
�
,. - - - �
- - - - - - - - -- -
. -- - .. _. _ �_.__„ .
- - - --- - - . _ .__.�. _ _. _ _ _ ��. ,
BDILDING RLVIEW CHF?QC LIST s
IIBC: $�S `Z. '� CONSTRIICTION TYPE: ��—
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x = - :�
2nd Floor x = �
Garage X =
x =
TOTAL
Bstimated Construction Value: $ �S, 0 0'��- �
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_ _ =��
�,--,--�;_; ..;_ .
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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RBMARKS (IN HOIISE) :
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R�,'VIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date By�
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REMARRS (TO B$ NOTSD ON PERMIT) :
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�`, -� , CITY OF ORONO - BIIII�DI�IG PSRMIT APPLICATION
, ..
£ota' Fee: $ =�� i ��' Date Received:`-�i ,� �1 /
Date Approved:
�:�tered By: ���� �- ; ,>
Permit#: � -� � %
�LI, INFORMATION MIIST BE SIIBMITTED IN FiJLL BEFORE PLAN REVIgW i�iILL B$ STARTED
(See Check-off List Enclosed)
� APPLICANT IS: (circle one) OWNER or CONTRACTO
70B S IT$ ADDRES S: �700 S f!o r� �+ n� �r'. Z IP: .S..S 3 9�
(work)
� OF OWNER: .Zr w i� Jca c e b� PHONE: (home) 3.3 7- / 9 O/
+4�ILING ADDRESS: /700 S�j o r /��n� �►" CITY: Vf�aT�q ��t ZIP: .,�'.5 3 9/
:ONTRACTOR: ,.�e h��n �1 o m G s _,�,n� PHONE: ')�7S -D.Syp
iAILING ADDRESS : Go/ � Q /�ra 5�io rG P/�'�vyCIT`�� /���9 _ ZIP: �'S3�y3
1
'YPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�L Renovate Land Alteration
�ROPOSED WORR (describe in detail) :
�TORIES: SQ. FEET OF EACH FLOOR:
'O. OF B$DROOMS: GARAGE STALI�S: ATT. DET.
'STIMATED CONSTRQCTION VALIIATION (eaclnding land) : $ 7Sj�
hereby apply for a building permit and I acknowledge that the information
bove is complete and accurate; that the work will be in conformance with the
rdinances and codes of the City and with the State Building Code; that I
nderstand this is not a permit and work is not to start without a permit; and
hat the work wil 1 be in accordance with the approved plan.
PPLICANT'S SIGNATORE: DATE: a7- 8 -9/
i
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CITY o� ORONO
Post Office Box 66•Crystal Bay,Minneeota 55323•Municipal Officea
•
� - � a 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
license 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 inf ormation 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 privat�
data on yourself.
6. Your full name is required to process this appl.ication or
permit.
JO/!'!G3 N O/`/�An VG Y1,SG i7
First Middl.e Last
�I� 8 ,S/ WG/�i r1 w fo n �c�
Address
/�l� �YI� .s-s.3 9/
Cit - , . . State Zip
y7.s-o 9p � -. �
� Phone � �
I understand my rights as stated above. .
S nature . . „ � . = .
� �
BUILDING&ZONING-473-7357 • ADMINISTRATION�FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING , _
_... .r �
- , ,' , �
' �
. 513.0.4 RIGII15 OF SIIBJECIS OF DATA � �
S
ubdivision L Tppe oi dats- _ The rights of individuals on whom the data is :
stored or to be stored sha]1 be as set forth in this section.
to be givea in�viduaL An.individusl esked to
- gubd. Z. Information r�� �ms� S� be informed of: (a) the
� �• supply private or .confidentisl data concerning State a ency, .
purpose and intended use of the requested data within the coV eT� or is egeuY
tem; (b) whether he ma„ from his
political subdivision, or statewide sys . �o� consequence arising _
required to supply the requested dats, <-(c) anY �d (d) the identity of_ _
supplying or refusing to supply private or confidentiel data;
ons or entities authorized by state or federal law to receive the date. This_
other pen 1 when an individual is asked to supply investigative date,
requirement shall not app y to a law enforesment officer.
pursua�t to section 13.82, subdi�►fsion 5, .
The commissioner of revenue ma iert tax re°und u�structio�nsteadho5
subdivision in the individuel income tax or r�
on those orms. . - � -- -� " .
Subd. 3. � Access to data bY
����, Upon request to e responsible
authority, an indindusl shall be infarmed whe��ec Pr'vateeor eonfidential.e QPon his
individuels; and v�►hether it is classified es p � ublic data on
turther request, an indieidusl who is the subject of e tr�e�mri�v�s�if he desires� shall
individuels shall be shown the data withou�f��t �a �ter an ino���ed to
6e informed of the content and meaning � �� n�d n
shown the private dete and informed of its meanin8, un�t to this section is
him for six months thereafter unless a disPute or action p
� endin or additional data on the individuel h�8te or public datarupongrequest by
� responsible authority shall provide copies of the p require the
the individusl subject of the data. The respensible authority may � the
requesting person to pay the actual costs of making, certifying, and �°mp g
copies. imme�ately, if pessible, with anY request
The responsible authority sha1T comQly af the date of the request,
made pursuant to this subdivision, or within five ��immediate compliance is not
excluding Saturdays, Sundays and legal holidays,
ossible. If he cannot complY H►ith the request within that time, he shall so inf�� the
have en additienal five days. within which to comply
individuel, and mey �d Ie holidays•
request, excluding Saturdays, SundaYs �
te or complete. An in���. To
Subd. 4. � Procedia�e when data is not accura
contest the accuracy or completeness�of public oripriwva�t��eon���e��a��
exereise this right, en individuel st�all�notify =i sha]l within 30
describing the nature of the disagreemeaL"� The resP°�ible authority
ete and attempt to
days either. (a) eorrect the data found to be inae��ei°�u�g�cipients named by ,
notify past recipients of inaccurate or incomP
i ,
the individusl; or (b) notify the individual tha.t�hdu���tem��� t��eem nt is - �
Data in disp d the indi ;
ute shall be �sclosed only '
• included with the disclosed data. � 8ppe8ied pursuant to the � �
' The deLermination of the responsible authoritp to contested cases• __:.
provisions oi the sdministrative procedure aci relatinB , ,
• _. . . �._: _ - - ._ - -- __ . .
l� DATE TIME
CITY OF ORONO CALLED IN I� 9
INSPECTION NOTICE� SCHEDULED .�/y-9/ `��
PERMIT N0. 3-S`� COMPLETED %l� G�
ADDRESS ���
OWNER ��-�� CONTR.
TELEPHONE NO.
� DESCRIPTION �/f'1/L.0-�.�-•^�- -�/n�� ��-�_
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 LL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 UEMO—SITE 14 SEWER HOOK•UP 06 PROGRESS
v 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 MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WOAK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra r site:
Inspector.
White CopyllnspectoPs File Canary Copy/Site Notice
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