HomeMy WebLinkAbout1995-006965 pool equip building , PERMIT
CITY OF ORONO � '
2750 Kelley Parkway- P.O. Box 66 � PERMIT TYPE: _
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Crystal Bay, Minnesota 55323 ` Permit Number:
(612) 473-7357 : Date Issued: , - -. -
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SITE ADDRESS: �
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DESCRIPTION:
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FEE SUMMARY:
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CONTRACTOR: �- , - _. _ � . . _ — _ . ... :=: OWNER:
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APPLICANUPERMITEE SIGNATURE iSSUED BY:SIGNATURE
�R �''' CITY OF ORONO - BDII,DI.,NG PERMIT APPI,ICATION
Total Fee: $ � � ` � ` Date Received:
Date P.pproved:
Entered By: � � :�- :.�� Permit Q: j�% '�� �.� :, _
ALL INFORMATION MIIST B$ SIIBMITTSD IN FIILL BEFORE PI,AN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: �-� ! D �c� C�F��/L-�.J�c�o `'� '�1� . ZIP:
(work) �y�" g�U O
NAMI: OF OWNER: 1`O T_�;����E e � PHONE: (home)
x(ATI�ING ADDR.ESS: 7 � 1 U �i� caA/Z (�E�o� CITY:1')L� C7 t�U ZIP:
CONTRACTOR: � A--�`,20 �,�U c���F��-l.� C f�;I�'�,� PHON$: -/Z�- 7 S � /
r�zzrrc ��x�ss: ��o /i�t�c��'i/�y �vE,�,cJ.cz�:�l��1� zzP: �5��.3
STATE LICENSE: � �{fJ i{Z
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ARCHITECT�ENGINE��Nl 1 /Yl �-�7��t//�U�-���.) �iJ s i- PHONE: ��`�� �'7 `�
MAILING ADDRSSS: ���J /ic/l�v�i/L`�l ��C ,br..,� CITY: {�il t ZIP: �S 3 v �
N�: RSGISTRATION A
TYPE OF WORR: New� Addition Accessory Structure Move
Demo Remo el/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : /��� � ,-��c�- �U x r v' i� r[L>► ►J , -�+�Z_ov��
YOE� Qc�1+� M �
--�
STORIES: t SQ. FEBT OF EACH FLOOR: �� -
�O. OF BSDROOMS: GARAGE STAI.LS: ATT. DET.
�STIHATED CONSTRIICTION VALIIATION (eacluding Ia.nd) : $ �� �v f
I hereby apply for a building permit and 2 acknowZedge that the information
above is complete and accurate; that the wor3c 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.
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APPLICANT'S SIGNATURE�/� / �1G� DATE: � 9 �I5
_ /
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
� FOR nFFIC� USE ONLY
ADDRESS OR LEGAL: zot(� ���oA2wooc9 102i� PID:
D$SCRIPTION OF WORR: /a c�es5o�'t 5 � (����-' � P�o< <'G`'� `p�"`* aC��'
-------------------- ---- -------------------
ZONING REVIEW BY: _ DATE APPROVED: �• �Z"�5
BIIII,DING REVIEW BY: � � DATE APPROVED: S • �2- 5.5
------------------- ------
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 SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------
ZONING CHECR LIST Zoning District: /2.-/✓�
Fire Department• �- Post Office: C_ School District: Q
Lot Area: No �i�J�v�.F Width: — Depth: —
Survey Submitted: Yes � No Date of Survey: o N i-i c..� -
Proposed Setbacks: , +
Front (Lake) : N �/9 Right Side: Sfl
Rear (Street) : �Oo` -E- Left Side: SZ�� "}
Adjacent Structures : 2� ` "1- Wetland: /(/�/�
Bui J�ding Height: Def . Hgt. c� •(� Peak Hgt.
Avg. Setback: Lot Coverag
E isting Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Vari ce Requ' red: Yes No Date of Co nci]. Approval:
Grading: Staf Approval Da By: Counci Approva� Date:
Septic: Staff Approval a BY=
Zoning FiJ.e: esolut on # : ResoJ�ut on Date:
REMARRS (in house) :
BIIILDZNG REVIEW CHECK LIST
QgC: (!- � CONSTRIICTION TYPE: �
Sq Footage . $ Per Sg Ftg
Basement X -
lst Floor X -
2nd Floor x -
Garage X -
X -
TOTAL
�oo�e
Estimated Construction Value: $ �"1
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/FilJ.ing
�Footing Mechanical Fire
�Framing Septic Water Connection
Insu�ation Fireplace Sewer Connection
WaJ�l Board (Masonry) Lawn Irrigation
p�-Fina 1 (Mf g.) Other
Other Well (State Permit)
�E�ectrical. ( State Permit)
----------------------------------------------
REMARRS (IN HOIISE) :
---------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approva�: Date BY�
---------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
• • ,
�
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
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 refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other �ocal, state or
federal agencies to the extent necessary to grocess the permit or
license.
4. If your requested permit or Zicense 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 applicatiaa or
permit.
First Middle Last
Address
City State Zip
Phone
I understand my rights as stated above.
Signature ,
BUILDING&ZONING—473-7357 • ADMINISTRATION&F[NANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING -
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�.04 RIGHTS OF SIIBJF.cTS OF DATA � �
Subdivision L Type of data- The righ sectio�viduels on whom the data is
stored or to be stored shell be as set forth m this
gubd. Z, Informatioa required
to be given in�v��' An.individuel asked to
� ' su 1 private or confidentiel data concernina �BmWi�n the collect g s ate ag n y�
PP y v refuse or is legally
purpose and intended use of the requested �b� Whether he ma„
political subdivision, or statewide system;
the requested date; (�) anY known consequence arising from his
required to supply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply P State or federal law to receive the data. This.
other persons or entities suthorized by 1 investigative data,
requirement shall not apply when an indt�via18 en orcementuofflcer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma la�t t8X re°und lnstructionsu nsteadhos
subdivision in the individuel income tax or r� er
on those orms. . --- - - .
Ac� to �� by �����y Upon request to e responsible
Subd. 3.
authority, an individuel shall be informed whether h r vateeor confidential.e Upon his
individuals, an d w he t h e r i t i s c l a s s i f i e d a s public, p u b l i c d a t a o n
turther request, an individual who �s the subject of e to himrlande if he desires, shall
individuels shall be shown the data witho of�hat da a• After an individual has b�en
�e informed of the content end meaning t� �ta need not be �sclosed to
shown the private data and iniormed of its meaning, u��t to this section is
him for six months thereafter unless a dispute or action p
� rivate or public data upon request by
e
pending or additional data on the individuel has been collected or create ' the
� responsible authority shall provide copies of the p require
the individuel subject ofthe actuel�cos h of making,i�ertl Yingy 8�d compiling the
requesting person to pay -
copies. ssible, with any request
The responsible authority sha]1 comply immediately, if po
made pursuant to this subdivision, or withinla8 e �f Simmediate8t omplianes eis not
excluding Saturdays, Sundays and legal hol ys,
ossible. If he cannot comply with the request within that time, he shall so inf�orth the
P have an additional fve daYs v►►ithin which to comply
individusl, and mflY �d le al holidays•
request, exeluding Saturdays, SundaYs g
Subd. 4. Proced�a'e when data is not accurste or complete. An individuel may
himself. To
contest the accuracy or completeness�of public or private data conce o�ble authority
exercise this right, an ind�v�du81 s� notify in writing the resp
describing the nature of the disagreement.
The respcnsible authority shall within 3 0
days either. (a) correct the data found to be inte dataeincludingrec pients namedt bY
notify past recipients of inaecurate or incomple �
the individual3 or (b) notify the individual that he believes the data to �ement is
Data in dispute s h a l l b e d i s c l o s e d o n l y i f t h e i n d ividusl's statement of �a�' to the
• included with the disclosed data. ealed pursuant
' The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases.
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P!p j A�FROVEt? — C�RRECT & RESUBMlT ;
'ihese comrnonts are for your in�ormntkin. AI! work shall � c��:/� i
m tdll cornpliance with alt ap��catrle bcr�klin� & zo++ing �r� :�� �Q
•uitea►ents including items not spectficeily noted �n this �.^ � � !
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DATE TIME
CITY OF ORONO CALLED IN � l L ��7.:� �`� 1 �����/
INSPECTION NOTICE � SCHEDULED 5 ' / '7-5.5 /L% .' e� �,;�
PERMIT NO. L� `J� J COMPLETED � �
ADDRESS �� /�: ���Ct 1�'�.c� � C� �l'�
OWNER !�i � `��� ��%k�, � '� � CONTR. I'. i ; � l � - � - _
TELEPHONE NO. �� I - �I � �l�
� DESCRIPTION _���. ��
� 01�FOOT_W� 11 MECHANIC I 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
� COMMENTS:
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d WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� CORRECT WORK&PROCEED C,: ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ins ction 24 hours in advance.473-73rJ7
Owner/Contr t site:
Inspector.
White Copyllnspector's File � Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �'�
INSPECTION NOTIC SCHEDULED �'i,�
PERMIT NO. � S COMPLETED d �
ADDRESS � �'���
OWNER � CONTR.�,����
TELEPHONE NO. ��C.� f -�--� `� 7 `
� DESCRIPTION
l� 01 FOOTING 11 ECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAM NI G" 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINA� 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
� OWNER/CONTRACTOR TO MEET YOU:_YES vN0
� COMMENTS:
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d �ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED C� ISSUE CERTIFICATE OF OCCUPANCY
W
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ;` 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.473-7357
OwnerlContracto it :
Inspector. ..
White Copyllnspector's File Canary CopylSite Notice
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