HomeMy WebLinkAbout1992-004162 - remodel 2nd floor PERMIT
CITY OF ORONO PERMIT TYPE: &UILDING
1335 Brown Rd. South • P.O. Box 66 Permit Number: 00416-2
Cryctal Bay, Minnesota 55323 Date Issued: 01I31I92
(612) 473-7357
SITE ADDRESS:
3675 TOGO RD
CH
P. I . N. 17-117-23-'.1-0035
DESCRIPTION:
REM00m, Fl.l.�OR
Building Per,r11,67"T�yt�iF-ADDIREM+3DEL
Bu i I+�i t-t�,,�: wo- T fi },, j M NCIVAT�%REM�iDEL
VBC
13C C,t4o#
Construc
'7 1 TY C Drd WD
REMARKS: fIy1/�IA/NCE Offllf
1.31 J144444 A
SEPARATE PERMIT REQUIRED ��t � t��� � 01 LEN 184.4
FEE SUMMARY: 41 �f�'� 11'.4
VAL T + , 700 1t�'t
r - 41 CEN �.3�
2-ase Fee $180 .00
Plan Review $117 . 00
Surcharge --------
Total Fee -$30S.35
CONTRACTOR: OWNER: -- Applicant -
KEMPF RALPH
=:675 TOGO RD
O RONi i MN 55:391
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APPLICANT/PERMI E GNATURE J, ISSUED BY:SIGNATURE �J
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ j(�5 - � Date Received:
Date Approved:
Entered By:
Permit#: q/(, L
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
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THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: 30S Ir�co�� �T J W AYZRTR ZIP: SE 1
U NT1 L (tel)
V?,q
NAME OF OWNER ��P�{ �c ��� PHONE: (home) y"I 1- Zq
MAILING ADDRESS: S0. CITY: ZIP:
CONTRACTOR: ( PHONE:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovated Land Alteration
PROPOSED WORK (describe in detail) : Sg ¢. C.c cc�uti�r,ww i K c Ir�ea�S :(� ►-� .� �'��o r
hlnni-K 0-1
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS:_1LLL0(Ls> GARAGE STALLS: ATT. DET. Q o A-s-
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 800.00
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 SIGNATURE: ( DATE: I- L2-
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL DESCRIPTION:
PID: _ " - 3
rP
DESCRIPTION OF WORK: 1'I'YLG�sCP /N� ��Z O�C�VI
------------------------
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: .DATE APPROVED:
PERMIT ISSUED BY: DATE:
------------------------------ ------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes V No SEWER UNIT $
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
PENALTY Yes No PARK FEE
SAC
Yes No v SITE INSPECTION
OTHER (specify)
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ZONING CHECK LIST Zoning Di rict:
Fire Department: Post O fice: Sch41icstrict:
Lot Area: Width: Depth
Survey Submitted: Y s No Date of S rvey:
Proposed Setbacks:
Front (Lake) : Right S 'de:
Rear (Street): Left S'de: —
Adjacent St tures Wet 'and:
Exis in Propos d
Hardcover: 0-75
75-25 '
Hardcover Vari ce Required: Yes No Date of Co ncil Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution # : Resolution Date:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC: $� �j CONSTRUCTION TYPE: l
BLDG SIZE: H. L. W.
Sq Footage $ Per Sq Ftg
Basement x _
1st Floor x -
2nd Floor x =
Garage x =
�I�;nwoe� �3 2g x Y 25 = /Z U5
TOTAL
Estimated Construction Value:
Inspections Required: Work Requiring Separate Permits:
Site DC Plumbing Grading/Filling
Footing Mechanical Fire
pFraming Well Water Connection
Insulation Septic Sewer Connection
all Board Fireplace Lawn Irrigation
Oinal
(Masonry) Other
Other (Manufactured)
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REMARKS (IN HOUSE) :
---------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT) :
CITYof ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
0 RONO-ONOOn 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 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 private
data on yourself.
6. Your full name is required to process this application or
permit.
First Middle Last
3(0`15 0 0 QR -
Address
�S�, S S351
City State Zip
x'11 -
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —47 3-7 35 9
ASSESSING -
513.04 BIGUM OF SUBJEMS OF DATA
pe of data. The rights of individuals on whom the data is
Subdivision L Ty
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required
to be given individual. An.individual asked to
nformed of: (a) the
supply private or confidential data concerning himself
mw hin the collecting state agency,
purpose and intended use of the requested
(b)
political subdivision, or statewide system; whether he may refuse or is legally
required to supply the requested data; (c) any known consequence arising from his
supplying or refusing to supply private or confidential ederal law to race receive the identityof This.
other persons or entities authorized by state p thdata data,
requirement shall not apply when an individual is asked to Supplyinvestigative
pursuant to section 13.62, subdivision 52 to a law enforcement officer.
The commissioner of revenue ma illlace the reound I requiredctio under iof
nstead
subdivision in the individual income tax or ro ert tax
on those fS. - - -—
Subd. 3.
Access to data by individual. Upon request to a responsible
subject of stored data on
authority, an individual shall be informed whether h Vateeor confidential. Upon his
individuals; and whether it is classified as public, p public data on
further request, an individual who is the subject of stored to him and, if hvate or desires, shall
individuals shall be shown the data without thyat datBa• After an individual has been
Se informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its ate Boor action pursuant to this section is
him for six months thereafter unless a disp
• pending or additional data on the individual hes�ateeor public data n collected rupon arequest by
responsible authority shall provide copies of p nsie o authority may require the
the individual subject oftthe he actual•cos h of masking, certifying, and compiling the
requesting person to pay
copies. Immediately, if possible, with any request
The responsible authority shall comply ' theuest,
made pursuant to this subdivision, le ntal h holidays,five days
immediate compliance is not
excluding Satreq
urdays, Sundays and
possible. If he cannot comply with the request wit within which to comply mply wi h the
individual, and may have an additional legal holidays•
request, excluding Saturdays, Sundays
when data is not accurate or complete. An individual may
Subd. 4. Procedureublie or private data concerning himself. To
contest the accuracy or completeness-of p ng the responsible authority
exercise this right, an individual shall note in id a authority shall within 30
describing the nature of the disagreement. te to
days either: (a) correct the data found to be inaccurate��u�g recipientsename
by
notify past recipients of inaccurate or incomethe
the individual; or (b) notify the individual i at he be sStatement atadisagreem nt is
to be correct.
Data in dispute shall be disclosed only if the
• included with the disclosed data. appealed pursuant to the
The determination of the responsible authority to maybe
cases.
provisions of the administrative procedure act relating ,
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' APPROiVCD As.SUG 'tiTTCD
t�RS�' { APPE�t�'JCQ WITH CORiZEECTIQIi, AS NOTED
i j 1 �z�' I ;T �,Fta>y InteN COEiRE(, E RESUBMIT
3� + NOTAPPRO,
t :�" . I .l• i 1 I U ' Z� re for 'ownfcdr'ltion AliI wurk shall be done
—�._' I' '�•, + + i r i � �, ., ail a2)�,.Ic iwe
zoning 0048 I`8'
1 bo W
.�„ ted in this revl@1�.
SL
1 $ ; { I i • purari�.t i11�tu;iinB �c,,; nuc r ALL TIMES
; j t ^ i E:is
L) I ' { KEEP IIS pi_AN S Ot t
SITE. A
-�
IDENTIFICATION OF PREMISES REQUIROZ
Approved Addresses Sha TBe Ulsplaye , Y,
Bil�LD1'Nfi PER IT Fsl_rl'�
plainly Visible And Legible from The
r f�l~:ME
Street Fronting The Property { , !17;-
�.__.
> --- - r,
C 1 mi rr NO.
li;r1"MITTLED
L5-,'�t 1'I'?('ic AS N0TaD
NESUBIMIT
-'-hzM be done
_ vitt
B�DROOM i _ R !�nr,ci �� °�V:.c n.r; code re.
• n� u Iii thi:, review.
•REGI IRED-y , s P rl;;'; r _ a �n� �,{; r. {T
FIRE EXI"I• �.r.._ TIMLES.
20"
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 40
PERMIT NO. " /��� COMPLETED
ADDRESS 11� 7_S r4 a eelt
OWNER CONTR.
TELEPHONE NO. X71- k3,1- el
DESCRIPTION �2�6'c�rn�� �✓
Uj 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
02FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
ti ATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
h 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
07 —FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 9PLUMBING RI 14110 3 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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WWWORK SATISFACTORY:PROCEED El PROJECTCOMPLETE
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
11 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
'.
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73557
Owner/Contrac on te:
Inspector.
White Copy/Inspector's Fil Canary Copy/Site Notice
CITY OF ORONO CALLED IN DATE TIME
INSPECTION N TIC SCHEDULED -4a
PERMIT N0. . COMPLETED l� A
ADDRESS 23 j22S-S- I(Qq n
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
T 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
C 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 1y E INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
4 07 DEMO— 27 SEPTIC MAINT. 21 COMPLAINT
WZ=
_ 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
co COMMENTS:
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0
0
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W
Z
W
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Uj WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
cc
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on I
ite:
Inspector. so ild-Amd
White Copyllnspector's File Canary Copy/Site Notice