HomeMy WebLinkAbout1994 - 005858 - add/remodel PERMIT
CrrY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number:
Orono, Minnesota 55356-0815 t",t_i I=-1 !`I`
(612) 473-7357 Date Issued: ;- c- -
01/04./94 .
SITE ADDRESS:
462.5 WEST BRANCH H }i
_,! .,. 117-23-22-0014}_f-23-T":' ...`^,( 4
DESCRIPTION:
Building Permit Type SF-ADD/REMODEL •
Building Work TyI-=.= REND r'AT(:,!RrMODt_L
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CITY TI L' Vl\%VtYQ
FINANCE iANC .%_J�I II i L L
1313100000
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1350100000
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01 CEN 184.93
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RECEIPT—TRW YOU
REMARKS: #294050 C001 R01 Ti5:4
01r'04/i4
SPPARATF PI-RI f 1'. , PFWIRFD PAR PIRG, MFC:-1 �t SfFL FCLICH l PERMITFEE SUMMARY:
VALUATION— .__ 1$20t ,.,,_,t_•=
Base Fee
PlaitReview $184 . q3 I
Surcharge -._.. '.�3 .-1 ! 1A
I c t. I l !-e e $484 . 48
CONTRACTOR: OWNER:
MOUND MN sS::fi-7.4
472-6E78
THE Li. DER:S I GNE D HEREBY REQUEST'_ PERMISSION TO MAKE THE REAL IMPROVEMENTS
S1"'E :: ; -IED AND AGREES TO DO ALL WORK IN STRICT COMP!I ANCE WITH ALL c:I-t;` OF
JRs:IE op'1 I NANc: °_= AND STATE OF MINNESOTA B 1 I LD I N=i CODE REQUIREMENTS .
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A •LICANT/ 'MITEE SIGNATURE ISSUED BY:SIGNATURE
- ~ CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ 1.1.0X° Date Received:
Date Approved:
Entered By:.i.. -'--->‘ I mo_'; S . k�`c
Permit#:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
THE APPLICANT IS: (circle one) (WNE&or CONTRACTOR
JOB SITE ADDRESS: (4-6 Z.S UUC.�rt (3c cmc-_> Rd ZIP: 5 3 6 `-(
(work) eit-72 -- .6 75
NAME OF OWNERS, Sk ( hc=r -v- S. (�`-'`c c- PHONE: (home) S�r'r`c
MAILING ADDRESS: `(6 '- (--Z)eS+ (( � c.,V-, CITY: (Y)C)LAn0-1 ZIP: 5z�6`{
CONTRACTOR: C W n e?c v PHONE:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: ( r K-- V---‹..OLD C \1 A 135.3 o c�c c PHONE: J 36.-2(PSV
MAILING ADDRESS: ( c0 9 o ( (2 (, -j (k r c le O✓, CITY: Cr !-)(-),:_---`t - t S ZIP: 55,Y0
NAME
NAME: Cr e--r-‘‘..... uJ(2- ( I REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration X Renovate Land Alteration
PROPOSED WORK (describe in detail) : Rca rrNocAe \ , t- r c�c "T- \ r Si-
-4-1 r"3 "c\f-, , f\dlcA �� I Li, ,(Th c_),o(JO
STORIES: L SQ. FEET OF EACH FLOOR:
O. OF BEDROOMS: y GARAGE STALLS: ATT. DET. ``{
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 30i (5-0-0
I hereby apply for a building permit and I acknowledge that the information
above is complete and acc ate; that the work will be in conformance with the
.)rdinances and codes of . 'e City and with the State Building Code; that I
.inderstand this is not a p - :mit and work is not to start without a permit; and
that the work will be in afrdance with the approved plan.
APPLICANT'S SIGNATURE: , ► DATE: 12 22--9
� 1.._1.►t. 3
A.
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
ORONO 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.
ma() si lr_: e_ {-
First
First Middle Last
L6 7 WCS` 0,c-
Address
ff. o 3 6
City State Zip
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING—473-7 35 7 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING -
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.
Subd. 2. Information required to be given individual An.individual asked to
•
supply private or confidential data conced tamwlthin tself he collecting state agency,
be informed of: (a) the
purpose and intended use of the requested
political subdivision, or statewide system; (b) 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 data; and (d) the identity of
other persons or entities authorized by state or federal law to receive the data. This_
requirement shall not apply
when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5, to a law enforcement officer.
d
nder
The commissioner of revenue mavrolert the re°und instructionsunsteadhos
subdivision in the individual income tax or
on those orms.
Subd. 3. Access to data by individual• Upon request to a responsible
authority, an individual shall be informedh ublic, pr vatr he is s o confident al.subject of stored
UP°n �
individuals, and whether it is classified p ublic data is
further request, an individual who is the subject of stored private ifhim and, o hep desires, shall
n
individuals shall be shown the data withoutany charge. 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 meaning, ursuant to this section is
him for six months thereafter unless a dispute or action p
pending or additional data on the individual
has been
nr collectedicorupe created. bye
responsible authority shall provide copies of private mayrequire the
the individualesubject of the actualhe . The costs of making, e certifying,,and compiling the
requesting person to pay
copies.
The responsible authority shall comply immediately, if possible, with any request
sof the date of the request,
made pursuant to this subdivision, or legal thin five holidays,�f immediate compliance is not
yexcluding Saturdays, Sundays g
possible. If he cannot comply with the request within that time, he shall so inworth m the
individual, and may have an additional five days within which to comply
request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of pubor
inrivate writng tthea °responslb a author ty
himself. To
exercise this right, an individual shall notify
describing the nature of the disagreement. 'I'naresponsible nc incomplete and attempt to
shall within 30
days either: (a) correct the data found to be
notify past recipients of inaccurate or incomplete he believesata, the ng recipients
to be
the individual; or (b) notify the individual that correct.s
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.
BUILDING REVIEW CHECK LIST A' ''`
IIBC: Q- CONSTRUCTION TYPE: '
Sq Footage $ Per Sq Ftg
Basement x
1st Floor x
2nd Floor x
Garage x
x
TOTAL
dc4
Estimated Construction Value: $ 3C).00
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
_Footing Mechanical Fire
)(Framing Septic Water Connection
Insulation _Fireplace Sewer Connection
A Wall Board (Masonry) Lawn Irrigation
)( Final (Mfg.) Other
Other Well (State Permit)
p( Electrical (State Permit)
REMARKS (IN HOUSE) :
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT) :
41- CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 4421' (.ve5T ( 4Ncti r2 PID:
DESCRIPTION OF WORK: (24:73o-L- /
ZONING REVIEW BY: �,/66_ . DATE APPROVED: /-,3'51
BUILDING REVIEW BY: / // // DATE APPROVED: /-3- c
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 CHECK LIST Zoning District:
Fire Department: Post Office: School ' strict:
Lot Area ► Width: •epth:
Survey -ub �'C/ ted: 1 es No Date of Surv= y:
Proposed - k •ack
Fro (L=ke : Ri•- t Side-
Rear (Stree ) : L=ft Side-
Adjacent S iuctur=s: Wetl.nd:
Building Height Def. ' gt. P-ak Hgt.
Avg. Setback: Lo, D. erage:
Exis .'ng •ro•osed
Hardcover: 0-7 '
75-2561
250-500 '
500-1010 '
Hardcover Var ance Required, Yes No Date of Counci Approval:
Grading: Staff Approval Date: By: Council A royal Date:
Septic: Staff Approval Date: By:
Zoning File:# Resolution - F#:Cn Resolution Date:
REMARKS (in house)K—
/" �O C t TION 6rAy
4 - ff oN Pow o niat A,,A1r
DAT/E TIME
CITY OF ORONO CALLED IN 94 19. J, Set 441
INSPECTION NOTICE 1�i� SCHEDULED �'3 Y /Oih
PERMIT NO. COMPLETED td /�J��
ADDRESS `"l % 3 L( c �41�/
OWNE• .I_.'l • ' CONTR. /1/P—,
TELEPHONE NO.
DESCRIPTION /1-2,t/1/ /fj'2
W I :. •c 11 MECHANICAL RI 16 WELL TEST PUMP
. 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
03 IN ULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
• 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
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. U PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrae> n''t :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice