HomeMy WebLinkAbout1991-003961 - extend kitchen/addn r PERMIT
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' • GITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �i i T;�i����'
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: i t;��i)7/_=t�,
(612)473-7357
SITE ADDRESS: �,;���s:� ��TH A4'L td
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REMARKS:
:3T�TE F'ER�'1 I T REt:�!�I�iE� �iif�i CI.._��t::�i�i�:�i_
FEE SUMMARY: _
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CONTRACTOR: OW �� '�'�'�' �`'`"' . —�
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��
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� ' ' �CITY OF ORONO - BOILDING PERMIT APPLICATION ✓
Total Fee: $ �j j/, �5 Date Received:
. Date Approved:
, _ .
Entered By:�,�'�,l permit#: �7(�I
ALL INFORMATION MIIST BE SIIBMITTED IN FOLL BEFORE PLAN RSVIgW i�iILL B$ STARTED
(See Check-off List Enclosed )
---------------------------------- ------------------------------------------
THE APPLICANT IS: _ (circle one) OWNE r CONTRACTOR
JOB S ITS ADDRESS: �;1(�} l c7 :�r� �-c� ��� � Z IP: S � � S �
(work)
NAME OF OWNER: R 0 �, � ('�� �1 Yl � R�t PHONE: (home)�/���-3
MAILING ADDRESS: S�,rYl � CITY: L L ZIP: �' S 3 S (o
CONTRACTOR: R p b� i(^ � �R V�.I (14 PHONE: ���p - / 3 �..3
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORK: New Addition �C Accessory Structure Move
Demo� Remode�/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : (` P ,�y�� �� e cQ n�ra a P (`oa�„} P ��e rtc�
k �+c�e n �-�, m ak e P_�_ �-�n a � �e v�-� m u� r�o rr� r - c r n��l nt�r c��r,
STORIES: I SQ. FEET OF EACH FLOOR:
ivd. Ol� t��ROOMS: �ARA�� �fi16iLL�: �,TT. D�fi.
$STIMATED CONSTRDCTION VAI�IIATION (ezcluding land) : $ ���d O L� -
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.
APPLICANT'S SIGNATQRE: DATE: c� /
�
� CHECR OFF LIST FOR ISSDANCE OF PERMITS
FOR OFFICE USE ONLY .
ADDRESS OR I.EGAL: y ZZU Go c�nn'Y �0�4 0 � �'ID-
DESCRIPTI ON OF WORR: �rJ Q I'T�0 NS
------------------------------------------------------------------------------
ZONING REVIEW BY: �. DATE APPROVED: 9'-Z3'9'l
BIIILDING REVIEW BY: DATE APPROVED: S- 2 3'S(
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 v SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: P t ff' e: � c 1 ' s ri r_
/
Lot Area: id e t :
Survey Submitted: Ye No Date of Survey:
Proposed Setbacks: / �
Front (L,�ce�: /lJ l i4 Right Side: Y �jd t
Rear ( "�) : 3�0� �' Left Side: �/00 ��'�"
. �
Adjacent Structures : �S� Wetland: /�//�
Building Height: Def. Hgt. Jl��/�- Peak Hgt. /" ��
Avg. Setback: Lo Cov age:
Existi g Propo ed
H�r��ev�r: Q-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Varian e Requir d: es No ate of ouncil Approval:
Grading: Staff pproval D te• By: Co cil Approval Date:
Septic: Staff Approval D te. By:
Zoning File-# esolut'on #: _ esolution Date:
REMARRS (i house) :
- -- .._ � .:_ _._ -
. -
_.,,_ ._.
BDILDING REVIEW CHECR LIST _ ` � ,
QgC: �� R. '� CONSTRIICTION TYPE: �
Sq Footage $ Per S:� �Ftg
Basement X -
lst Floor X -
2nd Floor X =
Garage X -
x =
TOTAL
$sti_mated Construction Value: $ Z�,0 o v °tl
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)
REMARRS (IN HOIISE) :
-----=-------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
---------------------------------------------------------------------
R$MARRS (TO BE NOTSD ON PERMIT) :
, �
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� T
CITY of ORONO
� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� • � � 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
Zicense 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 wiZl 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 license.
3. The information 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 priva�E
data on yourself.
6. Your full name is required to process this application or
permit.
�ab�er�' *-��i � C. � n � nh .�r
First Middle Last
y a-�o C otA ,r.� �� R �1 c�
Address
L o n ae �-a��. dryl dl� S �3 S C�
City State Zip
�f7 � l � 8' 3
Phone
I understand my rights as stated above.
. . ►
Si ature
BUILDiNG&ZONlNG—473-7357 � ADMINISTRATIOIV 8c FINANCE—473-7358 • PUBLIC WORKS—473•7359
ASSESSING -
- — — -•-----�-...______ ---- - , ,
513.04 RIGSTS OF SIIBdECTS OF DATA • � �
gubdivision 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.
Subd. 2. Information required
to be given in�i��' An.individuel asked to
� ' su 1 private or confidentiel data concerning himself sha]1 be informes ate aaency,
purpose and intended use of the requested data within the collecting g
olitical subdivision, or statewide system; (b) whether he may refuse or is legally
p the requested date; (c) any known consequence arising from his
required to supply and (d) the identity of
supplying or refusing to supply private or confidential data;
other persons or entities authorized by state or�e�kedito supplyeinvest ga�ve da a
requirement shall not apply when an individuel
pursuant to section 13.82, subdivision 5, to e law enforcement officer.
The commissioner of revenue m8 lgrt t8X re�und uistructio uinsteadhos
subdivision in the individuel ineome tax or r� e
on those orms. . - -— - " .
Ac� � �� � �����y Upon request to e responsible
Subd. 3.
authority, an individual shall be informed wheu�c h=vateeor eonfidential.e IIPon �
individuels; and whether it is classified as p � P ublic data on
further request, an individual who is the subject of se to�mri�v�a��he �res, shell
individuels shall be shown the data witho of�hat datga. After an individuel has been
6e informed of the content and meaning t� �� need not be disclosed to
shown the private date and informed of Its u��8ction pursuant to this section is
him for six months thereafter unless a �P n request by
ending or additional data on the individusl h8 V8 eeor puLlic datarupoe8ted. The
� p � require the
responsible authority shall previde copies The hres onsible authority may
the individuel subject of the data. � ��rtif n and compiling the
requesting person to pay the actual costs of malanB, Yi g'
copies. ' lmmed'iately, if pessible, with anY request
The responsible authority she]1 comply � of the date of the request,
made pursuant to ttiis subdivision, or within five ��lmmediate compliance is net �
excluding Saturdays, Sundays and legel holideys,
within which to comply with the
ossible. If he cannot comply with the requ et �thin that time, he shall so inform t e
individuel, and may have an additional fiv YS
request, excluding Saturdays, SundaYs a�d legal holidays-
Subd 4. Procedia'e when data is not accurate or complete. An indi�� may
himself. To
contest the accuracy or completeness��Pn t�y�rl�� the�responsi'Ule authority
exercise this right, an ���� nsible authoritq shall within 30
describing the nature of the disagreemen� Z'r►e resp° lete and attempt to
days either. (e) correct the data found to be inaccurate or incomp
notify past recipients of inaccurate or incomPle t��e esdthe datalto be correct
the individuel3 or (b) notify the individual tha eement is
Data in dispute shall be disclosed only if the indieidusl's statement of �� to the
• included with the disclosed data• � 8ppealed pursuant
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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. � �CITY OF ORONO - �. -�- y 1 , ;` .
_ -_..�r J." ''�"��,..
SITE� PLAN . GRADING PLAN ' � .. -�.
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� A�'PROVED � , 3 � .
❑ APPROVED WITH REVISIONS w , , , �� . .
. ❑ DISAPP VEQ� , �, -' .
' BY Cll�nr«_ .
� �DQ;TF_ � -23 -�i� � , ; .
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� DATE •1 TIME
CITY OF ORONO CALLED IN b� - ���'� ���
INSPECTION NOTICE SCHEDULED �l� ��-a-��/►'`
PERMIT NO. � COMPLETED _� �
ADDRESS �a�� ���� �
OWNER Q Y► ►7 r/�� CONTR. `�h/l � `�.��
TELEPHONE NO. �7 G�'" � 3R 3
� ION Q�lX-.
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� FOOTING 11 MECHANICAL RI 18 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24l25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETlTURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 08 PROGRESS
v 07 DEMO—FiNAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTAIL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
ti COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
W O CARRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL REfl1RN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspsction 24 faurs in advance.473-7357
OwnerlContra
Inspector.
�--�xnspector's File Canary Copy/SiM Notice
� DATE TIME
CITY OF ORONO CALLED IN ���
INSPECTION NOTICE SCHEDULED ��/s/qi �' 30
PERMIT NO. Q�J. �(� � COMPLETED � �_
ADDRESS ���O _r • � (�� �l�ut'• �I �
OWNER ,.�ls� � , CONTR.����it�r��u
TELEPHONE NO. '�7(0 ^/3��
� DESCRIPTION_�������„� G,�f �
� G 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125''WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
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 06 PROGRESS
� 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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� ❑ PROJECTCOMPLETE
W �ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALI INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContr on �te•
Inspector. � �
White Copyllnspector's File Canary Copy/Site Notice
11/
DATE TIME
CITY OF ORONO CALLED IN ���//
INSPECTION NOTICE G� / SCHEDULED %�.z�/�ii �—
PERMIT N0. � �/ � ` COMPLETED � ��
ADDRESS - -� •�
OWNER CONTR. ��
TELEPHONE NO. '�7(� -l3�3
� DESCRIPTION G��Q.
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
y �RA NCi� 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—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 SEP"T�IC FINAL
Q OWNERICONTRACTOR TO MEEf YOU:JC rES_NO
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� �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN � PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra ite:
Inspector.
White Copyllnspecto�'s File Canary Copy/Site Notice
�
i AT i Q� TIME
CITY OF ORONO CALLED IN i
INSPECTION NOTICE SCHEDULED � � � �
PERMIT N0. �L9C,cv COMPLETED p H
ADDRESS �a' a 6 (� /��Q. (p
OWNER CONTR.
TELEPHONE NO. 'Y ��— �3�3
� DESCRIPTION �� LC.Gt-�
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLiNG
y 03 INSULATION 2M25'WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINA 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLA�NT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SE IC FINAL
� OWNER/CONTRACTORTOMEETYOU:�YES_NO
y COMMENTS: Ct2 ��� ��-✓
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V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOH ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-7357
OwnerlContra ite•
Inspector:
White CopyA Flle Canary CopylSits Notla
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GUARDRAILS
36" MIN. i-9fE1Gf�1T
�' MAX. OPEN'1N(�v
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