HomeMy WebLinkAbout1995-006885 - install patio door PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 1;j
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued:
SITE ADDRESS:
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: p p P.';T
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THE VNDERSIGNED HE ELY REQUESTS PERMISSION TO MAKE" THE REAL IMPROVEMENTS
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.M-PE AFIED AND A6REE'-:. TO DO ALL WORK IN ':-:.TRICT C.0P, ILT ANCX WITH ALL CITY OF
ORONO ORD S AND STATE OF MINNE SQTABVILDING (Xi E' REQUIREMENTS-
APPLICANPPERIVIITEE,8VNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: Date Received:-j-3/- f,5r
Date Approved:
Entered By: *
Permit#: &331
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) 77�1r CONTRACTOR C /
JOB SITE ADDRESS: 2 2 w ZIP:
(work) ���2�3 �c
NAME OF OWNER: t v. o r r�Sv n c_ kAPHONE: (home) L
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MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: PHONE:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION u
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : 0 A&C_- 0
- e�.j� A, � � A � � OcDc
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
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
crdinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work ' s not tp start without a permit; and
that the work will be in cor hce with t app o d plan.
i
APPLICANT'S SIGNATURE� DATE: J
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
-O 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 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.
C A) C_ �w1 � i1
First yMiddle Last
2 z0 : �t
Address
Oro A'\ C:)
City State Zip
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
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513.04 RIGEnS OF SIIB W75 OF DATA
Subdivision 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. An.individual asked to
Subd. 2. Information required
to be given individual
private or confidential data concerningmwithf in the collecting state agency,
sube informed of:
pply pv refuse or is legally
purpose and intended use of the requ statewide em;d (b)Whether he may from his
political subdivisi
in
requested data, (c) any known consequence arising
required to supply private or confidential data; and (d) the identity of
supplying or refusing to supply P ce
ive the data This,
state or federal law to reinvestigative data,
other persons or entities authorized by
requirement shall not apply when an individual is asked to supply
pursuant to section 13.82, subdivision 59 to a law enforcement officer.
nder
The commissioner of revenue ma lace tax re°arid instructionsu nsteadhos
subdivision in the individual income tax or ro art
on those orms. ---
Subd. 3. Access
to data by individual Upon request to a responsible
authority, an d data on
individual shall be informed whetbher h r s teeor confidentialsubject of e Upon his
aut Y+ classified as pu P public data on
individuals; and whether it is class
e to him and, if he desires, shall
further request, an individual dela w the
any chargect of e
private f hedhas been
individuals shall be shown the of that data. After an individual
Se informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its meaning, nt to this section is
him for six months thereafter unless a dispute or action pursuant
upon request by
or additional data on the individual has e or c public ed or created.req The
pending provide copies of the pre p require the
responsible authority shaIl p The responsible authority may require
the
the individual subject of the data.
P certif n and comp B
requesting person to pay the actual costs of making, Yi g+
copies. if possible, with any request
The responsible authority shall comply immediately,
ursuant to this subdivision, or within five days of the date of the request,
made p Sundays and legal holidays, if immediate compliance is not
excluding Saturdays, with the request within that time, he shall so info
the
possible. If he cannot comply within which to comply
individual, and may haveanaddition legal v holidays•
request, excluding Saturdays, Sundays
Subd. 4. Proceduz'e when data is not accurate or complete. An individual may
himself. To
contest the accuracy or completeness-of public or private data conce concerning
authority
exercise this right, an individual shall notify in writing the resp to
describing the nature of the disagreement.
The responsible authority shall within 3 0
tte
da either: (a) correct the data found to be inaccurate incl ding eecipients named by
Ys
notify past recipients of inaccurate or incomplete ' Bement
the individual; or (b) notify the individual that he believes the data to be correctis
.
Data in dispute shall be disclosed only if the individual's statement of disagreement
included with the disclosed data. be appealed pursuant to the
The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ( Z Z C TONK A W 14 (2-oAO PID:
DESCRIPTION OF WORK: Z 1� (r� lY`' N-r u0 0 A-
ZONING REVIEW BY:---y-/-�-�/�nrN.. -------DATE APPROVED:-- /J �------------------
BUILDING REVIEW BY: C &VIt, DATE APPROVED:
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes No J 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 CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Width: Depth:
Survey Submitted: Yes No Da of Su vey:
Proposed Setbacks:
Front (Lake) : fight Si e:
Rear (Street Left S ' e:
Adjacent St uctur s: Wetlan
Building Height. Def. Hgt. Pea Hgt.
Avg. Setback: Lot Cover ge:
Ex' sting Propos d
Hardcover: 0- 5 '
75- 50 '
250- 00 '
500- 000 '
Hardcover V riance Req it d: Yes No Date of Counc' 1 Approval:
Grading: S aff Approva ate: By. Council pproval Date:
Septic: Staff Approval te: By:
Zoning File: # Resolution # : Resolu ion Date:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
1
UBC: CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =_
1st Floor x -
2nd Floor x -
Garage x -
x =
TOTAL
Estimated Construction value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
Fina l (Mf g.) Other
OtherWel l (State Permit)
Electrical (State Permit)
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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) :
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DATE - TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. (L Y Y J COMPLETED —�4�
ADDRESS lob--1 6 /C/
OWNER .G�:= " CONTR.
TELEPHONE NO. /V 7 ,2 - 36, 0-6
DESCRIPTION
Ly 01 F TING 11 MECIANIUVAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
E 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:RYES_NO
COMMENTS:
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W ORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r, PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRA E ACCESS.
Call for the .n cti n 24 hours in advance.473-7357
Owner/Contracto ite:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice