HomeMy WebLinkAbout1995-007036 - pool PERMIT
` CI�Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - _ - �-::-:
Crystal Bay, Minnesota 55323 Permit Number: ` : -Y y j 'a���
(612)473-7357 Date Issued: '�'��� _ _
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS: %;rifilc', '1 ;L• ��s�.��
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FEE SUMMARY:
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CONTRACTOR..:-: — r� _-� : -:
: _ .� - :. � _.._. QWN.�R:,
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF ORONO - BIIILDING PERMIT A.PPLICATION
J �
'�'otal Fee: $ '��` �- � � _ Date Received:
J
Da�e A�orovec:
Entered By: ' ��-ti" � .
Pe�znit�: 7� �I (=�
A7.T• INFORMATION MIIST B$ SIIBMITTED IN FULL BEFORE PI�AN RES7IEW WIIaI� BB STAR�P.D
( See Check-aff List Enclosed)
--------------------------------
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THE AppI,ICANT IS: ( ci�cle cne) OWN�R or CONTRACTOR
� 5 YS-- � , ��� �� zzP: S'��S!� �ci /
JOB SITE ADDRBSS:
�-. (work)
�`.� � � PHONE: (home)
NAME OF OWNER: /
MA=I�ING ADDRESS: � y� �j=--� �
�l /�( cz�: /t..c�-n--cl— zzP: S s 3�r
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PHor�: � E �' � /a�
CONTRAC.'TOR: ��/��`-('1 -S
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�zzxc �Dx�ss: �/'�, 2� b�S 'f?r /� .,/ cz�: /-� • � � zzP: 5 `(
STATS LIGENSE: �
PHONE:
ARCHSTECT/ENGINEER:
MAILING A.DDRSSS:
CITY: ZIP:
N�_ RBGISTRATION n
�Y�PE OF WORK: New Addition Accessory Structure
Move
Demo R�*nodel./Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :
��
STORIES: S4• FEBT OF F,ACH FLOOR:
HQ_ OF Bg�R�p�: C�RAG$ STAI.ZS: ATT. DET.�
� �
ESTSMATED CONSTRIICTION VALUATION (eaclnding Iand) : $ �� -S�'�
� hereby apply for a building permit and I acknowledge that the informatio:
above is complete and accurat ; that the work wil.1 be in conformance wit� t:��
ordinances and codes of the i y and with the State Building Co ee�1��aan�
understand this is not a perm ' d work is not to start without a p
�hat the work wil 1 be in acco e i h the approved plan. �
APPLICANT'S SIGNATQREs DATE:
� � � �
. C�� O� ORSOFFOCEIUSE ONLYOF p�MITS
, '""` F
,
ADDRESS OR I,EGAL: � S P��N fo' t�I�- PID:
D$SCRIPTION OF WORR: -----------------------------------
--------------DATE
------------------- -- (o- 5/(0
APPROVED: - -
ZONING REVIEW BY:
BY: DATS APPROVED: /e - G`�G
BIIII,DING REVIL�F7 ---------------------------
-- BE C�G�: Misc. Fees Cazcul.ated By:
FEES TO
PERMIT Yes� No
PLAN REVIEW Yes v'' No SEWER CONNECTION
WATER CONNECTION
STATE SURCHARGE YeS �No � pp,gg FEE
INVESTIGATION FEE YeS Na �� SITE INSPECTION
SAC YeS specif )
Number of SAC IInits ---------------
OTHER Y ___
---------- LIST -----------------Zoning District: �2'��
ZONING CHECK
Fire Department: �,(�_ -
Post Office: �N School District:1�tl
U G��6� Width: � Depth: '"'
Lot Area: N
Survey Submitted: Yesp�,
No Date of Survey: �rf �'�
Proposed Setbacks: � /�
Front (I�`) : ��tC�� '�' Right Side: �v � �/
Rear (st�-E�'f) = 3Z�
` -� Left Side: N�� �
Adjacent Structures: � O� � Wetland: 1� �'�"
Hei ht: Def �Hgt• 1 Peak Hgt-
Bui].ding g
Lot verage:
Avg. Setback: pr posed
Ex' sting
Hardcover: 0-75 '
75-250 '
250-500 '
500-100
Hardcover Var' nce Req ired: Yes o
D te of Council Approval:
Grading: Sta Approva Date By=
Council Ap roval Date:
Septic: Sta Approval Date y�----
Zoning
Fil :# R solution : Resolution Date:
gg,�ggg ( ' house) :
BIIILDING REVIEW CHECR LIST �-*-� . _
� lv � ,
IIgC: Jl��y� CONSTRIICTZON TYP$: .
Sq Footage $ Per Sq Ftg
Basement X
lst Fl.00r X �
2nd Floor X
� _
Garage X _ .
x
TOTAL
$stimated Construction Value: $ 2 Z-� J���
Inspections Reqnired: Work Requiriaq Separate Permits:
Site � Plumbing Grading/FiJ.J.ing
�Footing Mechanica� Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa1.J. Board (Masonry) Lawn Irrigation
�,Fina 1 (Mf g.) Other
Other Wel 1 (State Permit)
E�ectrical. (State Permit)
---------------------------------------
�T�FiARTC$ (IN HOIISE) :
----------------------------------------
gEpIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
-------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
�
` 'Y'Y Of ORONO
CI
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offsces
•
� . � � On the North Shore of Lake Minnetonka
DATA PRNACY 1�DVISORY
��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 o r�ate or confidential e nfo ationmay require
you to furnish certain p
You are notified that:
1. The informa�ti�heY°e�itnor Iicensebreque ted. determine your
qualification f P
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 ��rocessCthe permit or
federal agencies to the extent necessary to p
license.
4. If your reque f�at on may be ome pubii�ires Council action
to approve, some i
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Yaur full name is required to process this applicatian o�
permit.
� qT �
• ��►1�
First Middle Last
� �� �.� � �
Address
'�l I�� S� (( J
City State Zip
? � 3�3 �� 3
P:�one
I understan ' g t as stated above.
Signature
BUILDING&ZONiNG—473-7357 � ADMINISTRATION�FINAIVCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
�.p� RIGHZS OF SIIB�TS OF DATA �
' 'on L Typa of ��- The rights of indi�idu� on whom the data is
Subdivisi
stored or to be stored shall be es set forth in this section. An.individuel esked to
Subd, 2. Information r�d
to be given in�vi�3s1.
� te or confidentisl data concerning �mW.�in the collect g s ate 8g n y�
supply priva v refuse or is lega11y
purpose and intended use of the req em;d �b� a`,yhether he ma„
political subdivision, or statewide sys }�own consequence arising from his
required to supply the requested date; ��� �y 8nd (d) the identity of
supplying or refusing to supply private or confidential �at8+ 1 �vestigative data,
or entiries authorized by state or f edeke le�w�to�P y 91ve the data. This.
other penons 1 W�e� � individual � �
requirement shall not app y to a law enforcement officer.
pursuant to section 13.82, subdivision �,
The cfl
mmissioner of revenue ma p1acQ tgX re°und i�tructions�nsteadh�S
subdivision in the individual income tax or pro�er V
on those orms. • -
�� by ����. IIpon request to a responsible
Subd. 3. A�� t°
an individusl shall be informed whetheC h=VBteeor ccnfident al.e UPon tus
authority, ified ss pubL � P ublic datg on
individuels� and whether it is class � he desires, sha11
turther request, an individuel who is the subject of se to�mrl�� °r p been
individuals shall be shown the data witho of�that da a• After an individual hes
�e informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its mesning� u�uant to this section is
him for six months thereafter unless a diSPute or action P �ta u n request by
gd�tionel data on the individual h� b e or c ubl�c ed or �eated. The
. pending or rovide copies of the priva P reQ�re the
responsible authority shall p onsible authority may �ln the
the individual subject oftrie actual.cos h o making, certifying, and comp g
requesting person to pay - re uest
copies. 1 immediatelY, if pcssible, with anY Q
The responsible authority shall comQ y of the date of the request:
made pursuant to this subdivision, or within �����lmmediate compliance is not
excluding Saturdays, Sundays and legal
If he cannct comP1Y With the request wit�i{�ntW�ch tohcomP1Y w�h the
possible. �Ve � gdditionsi fi�e day5
individual, and m8Y 5��� �d legal holidays•
request, excluding Sgtu�'davs,
te or complete. An individuel To
Subd. 4. Proced�e when data is not acec�a ivate data concerning himself.
contest the accuracy or completeness�of public orlp �i� the responsible authority
exercise this rig�t+ � individuel shall notify �ible autt►oritq shall within 30
describing the nature of the disagresment. The respe lete and attempt to
�ays either: ($) correct the data found to be inaccurate or incompe�i ients named by
notify past recipients of inacc�het n�v dcue�p�t he belie esdthe data to be correct.
the individusl; or (b) no y eement is
Data in dispute shall be disclosed only if the individual's statement of �a� t to the
• included with the �isc1osed data• � appealed p�u�
' The deLermination of the responsible authoritq to contested cases•
provisions of the administrative procedure act relating .
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DA E TIM
CITY OF ORONO CALLED IN '9S I�` U���
INSPECTION NOTICE SCHEDULED (�L,s- ,� 3:U��
PERMIT NO. 7�3� COMPLETED �k
ADDRESS �
OWNER v�`�-Q-��in�.a','`� NTR. ��'�o
TELEPHONE NO. S�� r U j� 3
� TION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W
� CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the nex inspection 24 hours in advance.473-7357
OwnerlCon a o s' :
Inspector. •
Wf�ite Copyllnspector's File Canary Copy/Slte Notice