HomeMy WebLinkAbout1994-005923 - beam - basement-8" blk PERMIT
CITY OF ORONO ' PERMIT TYPE: F.i1ILDING
2750 Kelley Parkway • P.O. Box 815 Permit Number: 00 9*2—*='
Orono. Minnesota 55356-0815 Date Issued: i:i 1 E•`-?
(612) 473-7357
SITE ADDRESS: TURNHAM RD
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P . I . N. r 1-11 3-31- {I�ici:
DESCRIPTION:
BEAM-BASEMENT-3"
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Building Permit Type _r :'RE:t CIDEL
!�..u i l dile Work Type �tl NCIVATE/REMODEL
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FEE SUMMARY: VI_t l _E IF I ; ;_;
Ease Fee $1S .00
Surcharge -----------
Total Fee �
C09.M-k 0TCRNDQ, J T::*T 14 7`3 7 2 0 9 66.5- OWNER: MIKE
14.E 1 E j=AYZA TA BLVD r 8-S TURNHAM RD
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APPLICA /PERMITEE SI ATURE ISSUED BY:SIGNATURE
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CITY OF ORON& - L"GILDING PERMIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By: Permits:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: 3-�� I Z}��� ZIP:
�/
/� C
(work)
NAME OF OWNER:�K LE. ��- t 1 PHONE: (home)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: LU v t)F—(ZsO l j - L 1 t'�1.U 0( - PHONE: q 23 -
MAILING ADDRESS&21 E s;- G WZATA, CITY: Al2_ ZIP: S
STATE LICENSE: _(D
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION
TYPE OF WORK: New Addition Accessory Etructure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : PVT I N �QgoE RF-Arl
aEC'tEtd i >TR c.JRLL � �1�
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
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 accords ce with the approved plan.
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APPLICANT'S SIGNATURE. �� DATE:
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.
First fAiddle Last
(P1 l S .5yt�5 R
Ad rd ess
M roc ���.D f`1 (�.) • ���, �
City State a Zip
q 2 2- 6pC3
Phone
I understand my rights as stated above.
ignat re
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING -
wAt
513.04 RIGHTS OF SUBJECTS 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. to
Subd. 2. information required to be given individual An-individual asked
supply private or confidential data concerning himself
m itthin the collecting stat gency,
purpose and intended usbe informed of: (a) the
e of the requested
political subdivision, or statewide system; (b) whether he may refuse or is legally
(c) any
known consequence arising from his
required to supply the requested data;
supplying or refusing to supply private or confidential data; and (d) the identity of
other persons or entities authorized by state or federal law to receive the data. This.
1 when an into supply investigative data,
requirement shall not appy individual is asked to a law enforcement officer.
pursuant to section 13.62, subdivision 5,
The commissioner of revenue ma rolert tax reJIM relt
tic
ound instructio 11 dred under this
thus
subdivilj�sion in the individual income tax or,
on those f orms. -
to data by individual• Upon request to a responsible
Subd. 3. . Access
authority, an individual shall be informeda he bLc he
eeor eonfidentiale Upon his
individuals; and whether it is classified p public data on
further request, an individual who is the subject of Stored to him and, if he desires, shall
individuals shall be shown the data without any data. After an individual has been
Be informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its uteoorr action pursuant to this section is
him for six months thereafter unless a disputeected
pending or additional data on the individual
h en collor public dataruponarequest by
responsible authority shaIl provide copies of the private responsible authority may require the
the individual subject of the data. The resp certif n and compiling the
requesting person to pay the actual costs of making, certifying,
copies. - immediately, if possible, with any request
The responsible authority shall comply i of.the date of the request,
made pursuant to this subdivision, or within five aysi of.th ate compliance -is not
excluding Saturdays, Sundays and legal holidays, he
atif P If he cannot comply with the request within
within whithat ch to comply mply wi h the
individual, and may have an additional five days
request, excluding Saturdays, Sundays and legal holidays.
to or.complete. An individual s . To
Subd. 4. Procedure when data is not accura
contest the accuracy or completeness-of public or private data concerning
ht an individual shall notify in writing the responsible authority
exercise this rig , nsible authority shall within 30
describing the nature of the disagreement. The respo to
days either: (a) correct the data found to be inaccurate or n�recipientsenamedt by
notify past recipients of inaccurate or incomplete
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 disagr
included with the disclosed data. ealed pursuant to the
t relating
The determination of the res ponsible authority to contes ed cases.
provisions of the administrative procedure ac
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR -OFFICE USE ONLY
ADDRESS OR LEGAL: PID'
DESCRIPTION OF WORK:
----------------------
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED:
-------------------------------------------------------------------------- -----
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 PARR 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 Date of Survey:
Proposed Setbacks:
Front (Lake) : Right Side:
Rear (Street) : Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No Date of Council 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 V T •
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
Final (Mfg.) Other
Other —Well (State Permit)
Electrical (State Permit)
----- -------------------------------------------------------------------------
REMARKS (IN HOUSE) :
------------------------------ ------------------------------------------------
REVIEW BY OTHERS: DATE:
. Access: Existing New
Access Approval: Date By:
--------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
ATE, TIME
CITY OF ORONO CALLED IN / 9SG
INSPECTION NOTICE SCHEDULED / iV �Q
PERMIT NO. COMPLETED A�
ADDRESS.-
OWNER
DDRESS OWNER CONTR.
TELEPHONE NO. '� 3 '22 O
DESCRIPTION
W 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL B 12 WATER HOOK-UP 34 TREE REMOVAL
05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
? 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
CC
W
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cc
J
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O
W
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Q
2
W
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W
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WW WORK SATISFACTORY:PROCEED 11 PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for t next"nspection 24 hours in advance.473-7357
Owner/Con rat on tt
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE /123 SCHEDULED 2 '/6 %,y
PERMIT NO. COMPLETED K
ADDRESS _:, S fL 0
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
O&FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 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
10 PLUMBING FINAL 23 SEPTIC FINAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
W
a
cc
O14 T6 14
cc
O
o n r 1
W
Qhim `
Z
W
W
C
d
W M WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
4j
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
J_p/
ALL FOR REINSPECTION TEMPORARY
d
OBEFORE COVERING
PERMANENT
CORRECT UNSAFE CONDITION WITHIN HOURS. [- PHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrr site:
Inspector.
White Copy/inspector's File Canary Copy/Site Notice