HomeMy WebLinkAbout1992-004405 - deck PERMIT
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CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South r P.O. Box 66 Permit Number: 00440-5 j� I li,
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS:
21540 WATERTOWN RD
CH
DESCRIPTION:
If: X12 DECK
Building Permit. Type SF-ADD/REMODEL
Building Wc,rE:. Type DECK
t_jBC Occupancy 8-:1 R-3
C.:const.ruct.icft, Type 4'N
Z{,iinci u FSR-18
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REMARKS:
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FEE SUMMARY: ,r w,M
Ease Fee $35 . 0 )
Plan Review $2 • 7S rTr4 f#c it rf}1!!
Surcharge 1-75
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CONTRACTOR: OWNER: - Applicant. -
G!IRMAN THOMAS
F.40 WATERTOWN RD
OR1 ANO MN 55:3'56
476-6147
THE UNDERSIGNED HEREBY REQUESTS PERMISSIJON T�f MAS-::E THE MEAL_ l MPR+VEMENT0
SPECIFIED AND AGREES TO DO ALL W+FRt--:: IN STRICT COMPLIANCE W1!H ALL CITY OF
f+Ri 1NI-3 ORDINANCE,:) AND STATE OF MINNESOTA BtJ I LD I NG CODE RE( TS.
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APPLICANT,PERMITEE SIGNATURE ISSUED BY:SIGNATURE ���
CITY OF •ORONO - BUILDING PERMIT APPLICATION `
rj , ,S� Date Received:
Total Fee: $
Date Approved:
Entered By: r J
Permits: 1-44nS
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
---------------------------------�OEDR
----------------------------------------
THE APPLICANT IS: (circle one) or CONTRACTOR
JOB SITE ADDRESS: �(,/ C) L�,�GZ�I�Y'(�Z7lyl2 ZIP:
(work)
NAME OF OWNER• /! -Ilia S l�?!�l"llVt l2 PHONE: (home)
MAILING ADDRESS:.- &,yl) /tet //C ` OL��y/ /�GL CITY: �j/�d/�C D ZIP: -5 _,23S-_(,
�
CONTRACTOR: Ow/'��.GPHONE:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION n
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : « /�' �� C-f e L
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
- o
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 accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE:
P
s
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.
/-,-U c ��� d�`tau 0-41
-tlzma.S PMV/-/r-k C`z0-0111/Ket Al
First Middle Last
10 J
42 G 40 �)ahr T 0 u) /2 A17
Address
Or doy
City State Zip
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
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513.04 RIGHTS OF SUBJWTS 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.
Subd. 2. Information required
to be given individual. An.individual asked to
PPY private rivate or confidential data concerning him`sietlffin the
informed
requeed data collecting state agency,
purpose and intended use of the
(b) whether he may refuse or is legally
political subdivision, or statewide system; known consequence arising from his
required to supply the requested data; (c) any and (d) the identity of
supplying or refusing to supply private or confidential data;
other persons or entities authorized by state or federal law to receive the data. This.
P 1 when an individual is asked to supply investigative data,
requirement shall not appy .
pursuant to section 13.82, subdivision 5, to a law enforcement officer
der
tice re �i
The commissioner of revenue ma place
tax re°und uLstructionsuinsteadhos
subdivision in the individual income tax orproper
on those lorms. ---
Subd. 3. Ace= to data by individual. Upon request to a responsible
authority, an d data on
individual shall be informed whetherublic he
vateis eor confidential.subject of Upon his
individuals; and whether it is classified asp public data on
harge to him and, if he desires, shall
further request, an individual who is the subject of stored private or�du� has been
individuals shall be shown the data withoutof an t 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 me pursuant to this section is
him for six months thereafter unless a dispute
pending or additional data on the individual has ateeor publ ct data rupon ar quest by
ted. The
P g. require the
responsible authority shall provide copies of the p require
the
The responsible authority may
the individual subject of the data. certifying, and compiling
requesting person to pay the actual costs of malting, Yl g�
copies. immediately, if possible, with any request
The responsible authority shall eomQly
made pursuant to this subdivision, or within idfii a aysi of the da compliance request,snot
te of the
excluding Saturdays, Sundays and legal hoI ys,
if ocomply with the request within that time, he shall so inform the
ional five days within which to comply
ssible. If he cannot individual,, have an additand may Sundays and legal holidays.
request, excluding Saturdays,
to or complete. An individual may
Subd. 4. Procedure when data is not accura himself. To
contest the accuracy or completeness hof public Orin write therncerm
esponsibleauthority
exercise this right, an individual shell notify
describing the nature of the disagreement. The responsible authority shall within 30late and attempt to
days either: (a) correct the data found to be inaccurate or incomp
notify past recipients of inaccurate or incomple t he believes ng rdata ito be correct
the individual; or (b) notify the individual tha statement of disagreement is
Data in dispute shall be disclosed only if the individual's
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 1.,`T6 ��C/ e -� ��i d PID: 3 -13 a c�a�
DESCRIPTION OF WORK:
--------------------------- -------------------------------------------
ZONING REVIEW BY: _ DATE APPROVED:
BUILDING REVIEW BY: cy(� lXAw► DATE APPROVED:
---------------------- -----------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓. No
PLAN REVIEW Yeses' No SEWER CONNECTION
STATE SURCHARGE Yeses 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 Ro.-, a
Fire Department: 1.0t5 (_^1CA_, Post Office: IVIG School District: A11C_
Lot Area: Al It- Width: A116- Depth: AflG
Survey Submitted: Yeses No Date of Survey:
Proposed Setbacks:
Front (tea) : N'A Right Side:
Rear (Slx�a�) : D�-F Left Side:
Adjacent Structures : /JWetland: A114
Building Height: Def. Hgt. Peak Hgt.
Avg. Setback: A Lot Cov rage:
Ex sting Prop sed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Varia a Requi ed: s N Dat of Coun ' 1 Approval:
Grading: Staff pproval ate: By: Council Approval Date:
Septic: Staff pproval D te.. By:
Zoning File: # Res lution Resol tion Date:
R_RMARKS (in ouse) :
I� E
BUILDING REVIEW CHECK LIST
DBC: gg (Z-3 CONSTRUCTION TYPE: -
Sq Footage $ Per Sq Ftg
Basement x =_
1st Floor x -
2nd Floor x =_
Garage x
OECD- �ZX�b=1 2x g.oa = lrSbo
TOTAL
Estimated Construction Value: $ 1 SZ p oc�
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 (Mf g.) 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) :
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N971 �.1 SCHEDULED
PERMIT NO. u COMPLETED L
ADDRESS
OWNER CONTR. „s+_
TELEPHONE NO. `7 7(c - (,/4 7
D IPTION���
Ot FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 ING 11 MECHANICAL FINAL 18EXCAVIGRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z
04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT 21 COMPLAINT
U, 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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t4id 1 WORK SATISFACTORY:PROCEED Li PROJECTCOMPLETE
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W ❑CORRECT WORK&PROCEED 1] ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra c ite:
Inspector.
White Copy/Inspector'.File Canary Copy/Site Notice