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HomeMy WebLinkAbout1994 - 006731 - remodel • PERMIT , CITY OF ORONO 4 PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: (612) 473-7357 SITE ADDRESS: DESCRIPTION: ,•• REMARKS: FEE SUMMARY: '•* • . . . CONTRACTOR: :1 I OWNER: ,• THE UNDERSDINEDHERE1:N REQUESTS PERMISSION TO MAKE TI-Pr-: REAL IMPROVEMENTS SPECYrIED AND TO DO A ..L, WORK IN '&4P.JCT (..-.:ONFLTANC.E yirTH C.DY OF ORONO OROINANCE3 AND STArE OF MINNESOTA euIL,-)1Nci COOE REQUIREMENTS . • L APPLICANT/PERMITEE SIGNATURE ISSUED BY SIGNATURE,..--64,e4. 4411.' CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ 425'• 3 C Date Received: L7/1.,/ Date Approved: Entered By: Permit#: / '7 3/ 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: x1!004 ujetj 1�AiFkl TP_ C?g.oro ZIP: -;. :3:3 I (work) NAME OF OWNER:']Av,L .AtkRA £1<14-0 1-i"\ PHONE: (home)X17/- 4l 8 V MAILING ADDRESS: "zc.u(.. LJe.•.* Le, a . CITY: 0A0fto ZIP: SS33 j DUv.-t7s0 4374 (eelF40 CONTRACTOR: Core-eft- LANC>SckP+4C. / {?ef^+GJt t) G PHONE: 141z -4116 MAILING ADDRESS:31SPR\Fs5` >^AME CITY: mCkn3I, pi A.) ZIP: S530-I STATE LICENSE: # 000 S`j91 ARCHITECT/ENGINEER: S 13„..._”, c=_2 d- PA E Pis(Z. PHONE: 9 C'I - 04iCia MAILING ADDRESS: b S A-1 0.Skk \ S+ , CITY: YYl r i s ZIP: Ste( NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration . Renovate Land Alteration PROPOSED WORK (describe in detail) : L1lcvny. 4eA 04,1\-404,1\-4-0-wc, +0 be-AN.0w. ba-''\ ) 0 ) STORIES: i zo' SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: S GARAGE STALLS: ATT. '✓ DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 5-,/oco . co 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: Z�-/J a � . 1: DATE: /L��P/9 .. ... , , , 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. 6'2f/dz.-id 1A First iddle Last 3/53 r51. r.^., Address 74)0(.--4— -7 :,,.. - s 3 6 `I City State Zip /1L — q / // Phone I understand my rights as stated above. — 1,,,441,,i7Z X/ Sign ure BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING 51.3.04 RIGHTS OF SUBJECTS OF DATA Subdivision 1. 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 • 1private or confidential data concerning himself within the be informed state agency, supply requested data purpose and intended use of the tem; (b) whether he may refuse or is legally political subdivision, or statewide sys known consequence from his req the requested data; (c) any ande (d) the arising from s supplyingplto supply 1 private or confidential data; f otrpersons refusing itoe supply ? state or federal law to receive the data. This_ other or entities authorized by investigative data, requirement shall not apply when an individual supplyenforcement officer. is asked to pursuant to section 13.82, subdivision 5, The commissioner of revenue ma •lace thhx rnotice i re.uired instead nderthis subdivision in the individual income tax or .rosert on those orms. Subd.an. Access to data by individuaL Upon request to a responsible authority, individual shall be informed whetherpublic,he rivateesubject of or confidential.ed data on Upon his inpublic data on individuals, and whether it is classified as � further request, an individual who is the subject of set to hi private ifo hdesires, shall individuals shall be shown the data withoutngof that data. After andivid disclosed to Scual has been informed of the content and meaning the data need shown the private data and informed of its meaning, urneed notto be eis section o him for six months thereafter unless a dispute or action P upon request by is 'n or additional data on the individual has been nr pule c datorreated. The pending provide copies of the private the responsible authorityushall The responsible authority may requirern the the individual subject of the data• certifying, and compiling requesting person to pay the actual costs of making, yi g� copies. The responsible authority shall comply immediately, if possible, with any request made e pursuant to this subdivision, or within five days i of hiatdate e c of th compliance request,is ot and legal holidays, excludingpossible. Saturdays, Sundays g 1 with the If he cannot comply with the request within that time, he shall so inform the have an additional five days within which to comply individual, and may and le al holidays• request, excluding Saturdays, Sundays g An individual may Subd. 4. Procedure when data is not accurate or complete. himself. To shall notify in writing the responsible authority contest the accuracy or completeness of public or private data concerning exercise this right, an individual describingthe nature of the disagreement. The inaccurate rc�a oc incomplete and attempt to thority shall within 30 days either: (a) correct the data found to be data, including recipients named by notify past recipients of inaccurate or incomplete the individual; or (b) notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement to the • included with the disclosed data. be appealed pursuant The determination of the responsible authority may provisions of the administrative procedure act relating to contested cases. Ai.... CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY / /., 42‘i PID: )/, // ?" C<t/ ADDRESS OR LEGAL: G�;C;6 L0-�� y �: �.�� �:. DESCRIPTION OF WORK: ZONING REVIEW BY: � � I .. DATE APPROVED: N14 BUILDING REVIEW BY: �I / IK DATE APPROVED: /Z,- L I -ci FEES TO BE CHARGEDFEESA. Misc. Fees Calculated By: PERMIT Yes No PLAN REVIEW Yesy' No SEWER CONNECTION STATE SURCHARGENo_� WATERFCONNECTION INVESTIGATION FEE Yes No SAC Yes No '- SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning D, strict: Fire Department: Post Office: Soho. District: Lot Area: Width: Depth Survey Sub acted: Yes No Date o Survey: Proposed S: tb: cks : Front '(L:ke) : Right Side: Rear (St , eet) : Left Side: Adja ent tructures : W-tland: Building Heigh : Def . Hat. Peak Hgt. Avg. Se pack: Lo . Coverage: Existing 'roposed Hardco er: 0-75 ' 75-250 ' 250-500 ' 500-1000 ' Harccover Variaa •e Required: Yes No Date of Co ncil Approval : Gr-ding: Staff Approval Da e: By: Counc 1 Approval Date: Septic: Staff Approval Daae: By: Zoning File:# Resolution # : Resolution Date: REMARKS (in house) : BUILDING REVIEW CHECK LIST —+w DBC: R- > CONSTRUCTION TYPE: JLV Sq Footage $ Per Sq Ftg Basement X 1st Floor X = 2nd Floor X = Garage x = x = TOTAL Estimated Construction Value: $ ZS 000°n?' Inspections Required: Work Requiring Separate Permits: Site Plumbing Grading/Filling /7 Footing AMechanical Fire 4 FramingSeptic Water Connection Insulation Fireplace Sewer Connection Wall Board (Masonry) Lawn Irrigation p'.Final (Mfg.) Other Other Well (State Permit) y Electrical (State Permit) REMARKS (IN HOUSE) : REVIEW BY OTHERS: DATE: Access : Existing New Access Approval : Date By: REMARKS (TO BE NOTED ON PERMIT) : D?T TIME CITY OF ORONO CALLED IN //q/9.5 INSPECTION NOTICE SCHEDULED PERMIT NO. (073 COMPL ED h ADDRESS c7,7620 OWNER de %got ,i ON R. TELEPHONE NO. ' 72_ - 4/1/ DESCRIPTION 1 / • 01 FOOTING ,,/ ECHANICAL RI 18 EXCAV/GRADING/FIWNG c t 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O 03 IN ULATION 0 K 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 04 WALL BD. Q‹ 12 WATER HOOK-UP 17 SITE INSPECTION Z 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS I-- 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT Q 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 Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO oy COMMENTS: cc W CC D `� W CC W W dWORK SATISFACTORY:PROCEED CC � PROJECT COMPLETE L CORRECT WORK&PROCEED L ISSUE CERTIFICATE OF OCCUPANCY O Li CORRECT WORK,CALL FOR REINSPECTION TEMPORARY O 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 ins ction 24 hours in advance.473-7357 Owner/Contra• 4 •n site: Inspector. White Copy/Inspector's File Al Canary Copy/Site Notice DAT TIME CITY OF ORONO CALLED IN / INSPECTION NOTICE SCHEDULED / -ZZ19.S$ / :30 PERMIT NO. 6711 COMPLETED ADDRESS X6,0 6,..j6 44e-et-, �•�! OWNER CONTR.CONTR. C 1,�,t` TELEPHONE NO. 47-7- '_I//�' OO DESCRIP ON .1 FOOTING l< 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING • 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE)WETLANDS O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION = 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS F-* 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT W 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cce o ill 0 Uf r�Ql (vt�U crAC ©{� ° . 1 I • s • rd AA o.71 cc W z W cc dWORK SATISFACTORY:PROCEED - PROJECT COMPLETE W • ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY OU 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 inspecti•n 24 hours in advance.473'7357 Owner/Contractor on sit:. Inspector. I White Copyllnspector's File Canary Copy/Site Notice