HomeMy WebLinkAbout1990-003327 - pool PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: ��� f � ��� =� �
Cr stal Ba , Minnesota 55323 ����L����}��
Y Y Date Issued: i�i�:;_;�;�7
(612) 473-73�? _ -
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SITE ADDRES�
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CONTRACTOR: OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY: IGNATURE
�
CI'�'Y of ORONO
Post Office Box 66•Crystal Bay,Minneaota 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
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 license requested.
2. You may refuse to supply data, but refusa]. 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 Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�a�e
data on •yourself.
6. Your full name is required to process this application or
permit.
�� t ����c-z � .SL�J�_s�,f-- -
First Middle Last
o� 02� v� ( O� S'T'
Address
�jp/s �,��,� .sys�i y
City State Zlp
A'�/ -�� _ .,
Phone
I understand my rights as stated above.
�i �
r_ O�J/S�r-/'�.
Signature •
BUILDING&ZONING-473-7357 • ADMINISTRATION�FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING '
f
�13.04 RIGHTS OF SIIBJ'ECTS OF DATA �
gubdivision L Z`ype of ��- The rights of individu8ls on whom the data is
stored or to be stored sha]1 be es set forth in this section.
gubd. Z. Information re�quired to be g��+� ����1" An.individuel asked to
� � su ly private or confidentiel data concernin�g BmWit�h�in the collecting siate agency,
PP
purpose and intended use of the requested
olitical subdivision, or statewide system; (b) whether he ma� refuse or is legally
P the requested date; (c) any Irncwn consequence arising from his
required to supply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply p stete or federal law to receive the data. This.
other persons or entities authorized by 1 �vestigative data,
requirement shall not apply when an individual is. asked to supp y
pursuant to section I3.82, subdivision 5, to a law enforcement officer.
T
he commissioner of revenue ma plece the e��a�ti°,uctio uinsteadhos
subdivision in the individuel income tax or cro�ertv tax r
on those orms. . - -— - " .
Subd. 3.
Access to �ata by in�vi�- �Pon request to a responsible
authority, an individual shall be informed wh blic hpr vateeocuconfidential.e Pon his
individusls, and Whether it is clessified as p � ublic data on
further request, an individuel who is the subject of se to�mri�v�aae if he desires, shaIl
individu8ls shall be shown the data withou�fan�y ��ta, �ter an lndivi�u� � been
6e informed of the content end meaning the data need not be �isclosed to
shown the private data sr►d informed of its u���action pursuant to this section is
him for six months thereafter unless a d�SP
� ending or additienal data on the individusl h�8teeor public dataruponarequest by
p require the
responsible authority sha11 provide copiesThe responsible authority may
the individual subject of the ��- csrtif n and compiling the
erson to pay the actual costs of maldng, Yi g'
requesting p -
copies. ssible with any request
The responsible authority shall comply immediatelY, if po ,
made pursusnt to this subdivision, or within five days of the date of the request,
g�days and legal holidays, if immediate compliance is not
excluding Saturdays, `,yith the request within that time, he shall so in�orth Yhe
possible. If he cannot comply within which to comply
individuel, and may have er► additio� i���o days.
reqvest, exeluding Saturdays, Sur►daYs g
Subd. 4. Proced�e when data is not acc�ate or complete. An ind�ms�. To
contest the accuracy or completeness�of public or private data concerning
ht an individuel shall notify in writing the respcnsible authority
exercise this, rig , nsible authority shall within 3 0
describing the nature of the disagreemenL The respe
days either. (s) correct the data found to be inae��aei°�u�gpeec pients namedtby
notify past recipients of inaecurate er incomPl
the individual; or (b} notify the individual that he believes the data to �ement is
Data in dispute sha21 be disclosed only if the individuel's statement of disagi'
• included with the di�closed date• �ible authoritq may be apPealed pursuant t° the
' The determination of the respo to contested cases.
provisions of the administrative procedure act relating
Ca-�P� iv- �-Sc�
. . , •. _. _ .. -�-- --- ... _ _.
y CH$CR OFF I,IST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
AnnRsss oR �cAr.: �(�-�C:-� �1X'� � "�=-'� �� ' PID: Z7- 11�3 - �.� � � �C�l�
DESCRIPTION OF WORR: � �� L- v f i�''�-'ti1�!-"-��(�`---
� ."
-------------------�----- --------------------------_----�-----�-------------�
ZONING REVIEW BY: t/�� DATE APPROVED �C� `''� - : O
BIIILDING REVIEW BY: � DATE APPROVED: /(, • $" ' G'L�
---------------------- ---------------_------------------y�-- - ---�
-�/-� - -------
FEES TO BE CHARGSD: Misc Fees Calculated B • ( °
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)
----------------------------------------g---------�--�-f-------------------�
ZONING CHECR LIST Zonin District � ,�
Fire DepartT,ent- �i �-- Post Office: _ �-- School District: �f� �'�f � � j
.
� � ,
�-� �..
Lot Area: /� �" -` Width: ���d) '' Depth: -- -
d ', .,'° _
Survey Submitted: Yes� No Date of Survey: j> �" � ry �-�'
Proposed Setbacks :
Front (Lake ) : Right Side: r � � �,..�-�'�1�.-� -- S E�
..,� �-�� � ,l" � ,.���L-�'F'L..�l� �
Rear ( Street) : ' Left Side: l � �
Adjacent Structures : �— Wetland:
Building Height: Def. Hgt. -�-�-- Peak Hgt.
Avg. Setback: Lot Coverage: ��
Existing Proposed
Hardcover: 0-75 '
75-250 ' A
,
250-500 ' '�
� �
500-1000 '
- ,.
Hardcover Variance Required: Yes No�. Date of Council Approval: �
Grading: Staff Approval Date: � By: Council Approval Date: �
Septic: Staff Approval Date: '"`�� By: '
f
Zoning File: # "��' Resolution #: `�" Resolution Date: �'""�'" �
i
. . i
REMARRS (in house) :
BIIILDING REVIEW CHECR LIST ' ~'� ,~t .
IIBC: �� f1 -3 CONSTRUCTION TYPE:� ` D"�------
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage X —
x =
TOTAL
Sstimated Construction Value: $ cS,FS'�.��
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)
-------------------------------------------------------------------------------
RSMARRS (IN HOIISE) :
-------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Exi�ting New
Access Approval: Date BY�
-------------------------------------------------------------------------------
REMARRS (TO B$ NOTED ON PERMIT) :
�
I
I
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. �
• • �T CITY OF ORONO - BIII7�DING PSRMIT APPLICATION
Total Fee: $ � T��a_�Q� Date Received:
� Date Approved: � d A �` `�'�
Entered fy: � 3 a�
Permit#:
ALZ INFORMATION MIIST BE SDBMITTED IN FLJLL BEFORE P?�AN REVI�UI ieiILL BE STARTED �
(See Check-off List Enclosed)-
--------------------------------------------------------------------------------
T� APPLIGANT IS: (�ir�e one) OWNER or NTRACT
� ZIP:
JOB SITE ADDRESS: - � ��C N �
(work)
NAI� OF OWNER: �°�2.� �rK,f �aL/ ����/;.OS PHONB: (home)
MAILING ADDRESS: �A' CITY: ZIP:
CONTRACTOR: �OO�S � z- PHONE: $"6 /".,--� �d
MAILING ADDRESS :���j W 60� �T CITY: /+�P�S h^�^'�' Z IP: �S y/9
TYPE OF WORK: New k Addition Accessory Structure Move
Demo Remode�/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : Sl���r+��S �oa / /.�-x�-y 3�6��` �'�'
STORIES: SQ. FEET OF EACH FIAOR:
NO. OF B$DROOMS: GARAGE STALLS: ATT. DET.
�
BSTIMATED CONSTRIICTION VALIIATION (escludinq land) : $ $�g0 d -
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 w�rk is not to start without a permit; and
that the work wil 1 be in accordance with the approved plan.
APPLICANT'S SIGNATOItE� .�— � � RO� .yr��- DATB: ��Si l�v
DATE TIME
CITY OF ORONO CALLED IN ro-z�-�o
INSPECTION NOTICE SCHEDULED �o-.�S—Qa_ �
PERMIT NO. 3 3 a� COMPLETED �_
ADDRESS %���d � ��"'�` �'
OWNER 1'Q�cI�-�I��c..Q.�-�"' CONTR..��� ��i''`�- '
TELEPHONE NO. �� � — �'�'t �
j; ❑ FOOTING ❑MECHANICAL RI ❑SITE WELL
~ �FRAMING ❑MECHANICAL FINAL ❑WELLTEST PUMP
�
Q ❑ INSULATION ❑ FIREPLACENVOOD BURNER �EXCAV/GRADINGIFILLING
y ❑WALL BD. ❑WATER HOOK-UP ❑ LAKESHORENNETLANDS
Z ❑FINAL ❑ METER SEf/TURN ON ❑TREE REMOVAL
Q O DEMO—SITE ❑SEWER HOOK-UP ❑SITE INSPECTION
� ❑ DEMO—FINAL O SEPTIC MAINT. ❑ PROGRESS
J
W �PLUMBING RI ❑SEPTIC INSTALL. ❑COMPLAINT
_ � PLUMBING FINAL ❑SEPTIC FINAL ❑FOLLOW-UP
� COMMENTS: �4��`'� ��'��
0
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d �ORK SATISFACTORY:PROCEED ❑PHOTO TAKEN
W
� ❑CORRECT WORK 8�PROCEED ❑CITATION ISSUED
W
O ❑CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
V BEFORE COVERING ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR PERMANENT
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra s'e:
'nspector.
White Copyllnspector's File Canary Copy/Site Notice
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notes Proposed Elevation r � ✓ � ? �' �� $ ti� �q � 3o i
�otes Extstiny Elevacion • '' ;�>..;� �a • / / � � n �p[1- � �` A�"x��n`t- n
Ttyp of Foundation � ' +`� , "°w q ----d' 'M 4' � --_"- ' �' o �
'mp of Basement Floor • � t� 5 1B � / � �J1e� a ti�' a
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