HomeMy WebLinkAbout1993-005153 - att screen porch , � PEIZMIT �
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C+�Y OF ORONO PE�MIT TYPE:
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2750 Kelley Parkway • P.O. Box 815 Permit Number: r yr_����;�;
Orono, Minnesota 55356-0815
(612) 473-7357 Date Issued: E_;e;�;w;���:�;
SITE ADDRESS:
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CONTRACTOR: — ��_��i i���-��� — OWNER:
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APPLICAN ERMITEE SIGNATURE ISSUED BY:SIGNATURE ,�'„/) .
' ��'" CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ '.�';/ °�� Date Received:
Date Approved:
Entered By: � %'/
PermitR. 'i��
AIaL INFORMATION MIIST BS SIIBMITT� IN FIII�L BEFORE PLAN REVIEW WI7�L B$ STAR�F,D
(See Check-off List Enclosed)
---------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: ' �4b L-r���-�c /�� ZIP:
(work)
N�ME OF OWNER: i �ue y ����ea PHONE: (home) 41�"( -��f��
�SAILING ADDR.ESS: {Z�G�.S ���/��-+�. /Uc CITY: ��p,�,.a�, _ ZIP:
CONTRACTOR: �r'�ILQ�J �,�S+�vU-r�o-v Ca�P,t,.s:I PHONS: 6�!-�G�- -S3�
�IAILING ADDRESS: �-r- .'�"' 4-���.c 38S CITY: � 5.�,.r�-� _ ZIP: SSG4G
STATS LICENSE: � U a�a 24GGG.
ARCHITECT/ENGINEER: -rHa ����L.. �2G�[�7"<:G?�J,�J` PHONE: GZS -3 �9 �
MAILING ADDRBSS: CITY: �f'L5. ZIP:
N�: /r/��-,-/-� � � �.,�cJz RBGISTRATION �
TYPE OF WORR: New Addition K Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSF.D WORR (describe in detail) : � � S c; �r-� �o�c�r Q�A-GNc�E� "T�'
1-I ouS t= C�F'�fi �!3 P_.,,�fe. v N C�rs'T/1 G '�A--t!o
STORIES: � SQ. FEBT OF EACH FLOOR: ?U S� -
NO. OF B$DROOMS: GARAGE STAI.LS: ATT. DET.
_ �
�STIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ ►4�aQ .
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
�hat the work will be in ance with the approved plan. �
APPI�ICANT'S SIGNATDRE: _/� DATE: �llZ1`j�
. �.�..
�
CITY of OR4N�
Post Office Box 66•Crystal Bay,Minnesota 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 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 wi3.l be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to suppZy data, but refusal may require that
the City deny the permit or Iicense.
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 publ.ic.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Yaur full name is required to process this apFl.icatian or
permit.
��.vn��5 �7aP o�fi..J '�.�F���+S t�
First Middle Last
'�--r. � 4 �3 au ��s
Addr�
�.� �-r r ��v, 550 4 a
City State Zip
Q.4-q.�-53 s'3
Phone
I unders my ri hts as stated above.
Signature ,
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
...,, ,
513.04 RIGHTS OF SIIB.TECTS OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section. An.individuel asked to
Subd. 2. Information required
to be given individuaL
� ' su 1 rivate or confidential data concerning BmWi�in the collect g state agencY, .
PP y P v refuse or is legally
purpose and intended use of the requested �ti� Whether he ma, from his
political subdivision, or statewide system;
1 the requested data; (c) any kncwn consequence arising
required to supp y and (d) the identity of
supplying or refusing to supply private or confidentiel data; 1 �vestigative data,
er ersons or entities authorized by state or federal law to receive the data. This.
oth P 1 when an individuel is asked to supp y
requirement shall not app y to a law enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lace taX re°una�tructionsuinste8dh°s
subdivision in the individual income tax or ro ert
on those orms. • - --- - .
Subd. 3. �
Access to data bY i����' �p°n request to a responsible
authorit , an individuel shall be informed wh b� h r vateeor confidentia.l•e �P°n �
y ified as p � P ublic data on
individuels; and whether it is cless�
data without any cherge to him and, if he desires, shall
turther request, an individual who is the subject of stored private or�du� � �en
individuels sheu be ShO� t of that data. After an ind�
�e informed of the content end meaning the data need not be disclosed to
� shown the private data end inf ormed of its meaning+ u��t to this section is
him for six months thereafter unless a diSPute or action P �� u n request by
din or additionel data on the individuel h�8te or publ�c ed or �eated. The
� pen g require the
responsible authority shall provide copies of the p �d compiling the
The respos�sible authority may
the individual subject oft�e aetual�costs of making, certifying,
requesting person to pay -
copies. y ssible, with any request
onsible authority shall comply immediatel , it po
The resp of the date of the request,
made pursuant to this subdivisionnd legal thoudaYs� ��immediate compliance �s not
excluding Saturdays, Sundays
ossible. If he cannot comply with the request �thin that time, he shall so infort the
p have an additionel five Y'S N►ithin which to comply
individual, and may S�� �d le al holidays.
request, exeluding Saturdays, YS g
te or complete. An ��mse�lf. To
Subd. 4. Proced�a'e when data is not eccura
contest the accuracy or completeness�of public orlpriv`Rai� the�nresponsible authority
ht, an individuel shall notify ri
exercise this rig eemen� The respensible authority shall within 30
describing the nature of the disagr lete and attempt to
days either: (a) correct the data found te be inaecurate or incom Teci ients named by
notify past recipients of inacethetindiv dcu�l p�t he tbe�e es the data to be correct.
the individuel; or (b) notify eement is
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the disclosed �ta• �ible authority may be aPPeeled pursue�t to the
' The determination of the respo to contested cases.
provisions ef the administrative procedure act relating
, , �. CHECK OFF LIST FOR ISSIIANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: /2 Y S �� A� N pID' �
DESCRIPTION OF WORK: S 'P�QG�'�
---------------,,n--_ -----------------------
ZONING REVIEW BY:_ �'P�. (�.- DATE APPROVED: S-/7- S�
BDILDING REVIEW BY: DAT$ APPROVED: S-/7- S �
-------------------- -----
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes J�. No �
PLAN REVIEW Yes � �No� SEWER CONNECTION
STATE SURCHARGE Yes� No WATER CONNECTION
INVESTIGATION FEE Yes No PARR FEE
SAC � Yes No� SITE INSPECTION
Number of SAC Units OTHER (specify)
---------------------------------------
ZONING CHECK LIST Zoning District: L/L-►/�
Fire Department: C.��CE Post Office: (.c�..�� C��cc� Schoo� District: D�Na
Lot Area: /VV C���3�'`�idt Depth:
Survey Submitted: Yes� No Date of Survey: S'"� L�� �►
� o� F�iC
Proposed Setbacks: � �
F�eat (Lake) : 1 y o Ri ght Side: !N Ig t ,
Bs�-r (Street) : /'11 (�A Lef t Side: 0 � w
Adjacent Structures: /¢-TT►AC.l�f-E�' Hletland: /v�/4
Building Height: Def. Hgt. (� . �G Peak Hgt. D•(G
Avg. Setback: C�•l� Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 ' d •�c
250-500 '
500-1000 '
Hardcover Variance Required: Yes No ?C Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval. Date:
Septi c: Staf f Approna]. Date: • BY=
Zoning File:# _ Resolution �: Resolution Date:
REMARRS (in house) :
BIIILDING REVIEW CHECK LIST ..� . _ �
DgC: g� �( .� CONSTRIICTION TYPE�'
-�.�---,
Sq Footage $ Per Sq Ftg
Basement X i . `
lst Floor X -
2nd Floor � X -
Garage X _
. , X _
TOTAL
Estimated Construction Value: $ ! `l,' g0o ��
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/FiI.]�ing
�Footing Mechanical Fire
�Framing Septic Water Connection
Insulation ' � ` � Firepl.ace Sewer Connection
Wa•ll.,Board (Masonry) Lawn Irrigation
_�Final (Mfg.) �Ot,her .
Other WeIJ. �(State Permit)
Electra.�al� (State Permit)
R�RS (IN HOIISE) c` `� � " � `
--------------------------�--;-------------------
REpIEW BY OTHffitS: - DATE:
Access: Existing New
Access Approval: Date BY=
-------------------------------------------------------,,
R�IARRS (TO BE NOTED ON PERMIT) :
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C�
ATE TIME
CITY OF ORONO CALLED IN J
INSPECTION N TICE SCHEDULED .� •'30
PERMIT NO. COMPIETED � -/� �G S ` = v
ADDRESS `�-5 - � • � '
OWNER CONTR. ,
TELEPHONE NO. �[-'�7' -535 3
� ON
01 FOOTIN 11 MECHANICAL RI 16 WELLTEST PUMP
Q AMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
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 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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�RKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W
W �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. G PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTION REQUIREO.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance.473-7357
OwnerlContractor ite:
Inspector.
White Copyllnspector's Flle Canary CopylSite Notice