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Home My WebLink About1994-006618 - add/remodel PERMIT CITY OF ORONO 2750 Kelley Parkway - P.O. Box 66 PERMIT TYPE: Crystal Bay, Minnesota 55323 Permit Number: (612)473-7357 Date Issued: J. SITE ADDRESS: WAYZATA LVO ...7R DESCRIPTION: 1 "i,L '.Jjj-!--fliji-I d iri,i 1,411.1"i i.-H' i i r v C.ci 1-1 f r U I c-j y c;zz R b r" f 14L c vvvvv v v I'D i"i.A A A A 1.l'iv1 V",Vv i.,-j ilii v W.)v v L I Ir')ti LY �AAA CjAi T REMARKS: FEE SUMMARY: r, In v C1 I CONTRACTOR: OwNf A T tj T 4% Ci C. THE UNDERSIG 'NED HEREBY REQUESTS PERMISSION TO MAKE THE, REAL IMPROV8MENI'�; A -E WITH ALL CITY OF SFECIFIED AND AGREES TO DO ALL WORK IN STRTT CCOMPLTANS -E 'TATE OF NNESOTA BUILDING CODE REQ VIREMENT�5. ORONO ORDINANCES AND ea�') APPLItANT/PERMIT OIGNATURE ISSUED BY:SIGNATURE ~ CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ "/ C� Date Received:4L Date Approved: Entered By: ' Permit#: .ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) -------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNS or CONTRACTOR / JOB SITE ADDRESS: C��CII/.�c7' tS�✓�/ ZIP: ��yJ-6 (work) �3 1AME OF OWNER: >e L P c 1 tC• PHONE: (home) MAILING ADDRESS: 3 3 % CITY: ZIP: CONTRACTOR: (,�/(�s �2 cr PHONE: MAILING ADDRESS: P08 r,C,�37 CITY: ZIP: ,�✓` S b• STATE LICENSE: # ARCHITECT/ENGINEER: p,5 PHONE: Ill)?-22= MAILING ADDRESS: 2r) An CITY= ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration y Renovate Land Alteration PROPOSED WORK (describe in detail) : A ,,,/ ZZA Urd�r�yrl .�tiA Ui 7 e� .�errr�y/�dQ i incl ui z)11s iv e A eIoSe �.3) o 1 'e i��✓ ��c 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 irdinances 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: CITY of ORONO CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices OF ORONOOn 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. 1. First Middle Last c Address Cit State Zip Phone I understand my rights as stated above. all-A/0 A 2.r�� Signature BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359 ASSESSING 93.0.4 RIGSTS OF SUBTEM 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 hall be informed of: (a) the supply private or confidential data concerning himself Win the collecting stat agency, PP y purpose and intended use of the requested political subdivision, or statewide system; (b) whether he may refuse or is legally P (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 o other persons or entities authorized by state or federal law to receive the data. This - ply when an individual is asked to supply investigative data, requirement shall not a P ursuant to section 13.82, subdivision 5, to a law enforcement officer. is tice re it" der The commissioner of revenue ma olert tax reound uLstructionsui111i i.ired h nsteadof subdivision in the individual income tax or r on those orms. - --- - - Subd. 3. Aceess to data by individual. Upon request to a responsible d data on authority, an individual shall be informedawhether ublic,privateis eor eonfidentiaLsubject of e Upon his individuals; and whether it is classified P public data on further request, an individual who is the subject of set tc himrland, if hdesires, shall individuals shall be shown the data withoutof any data. After an individual has been 6e informed of the content and meaning the data need not be disclosed to shown the private data and informed of its ute oection pursuant to this section is him for six months thereafter unless a dispute ending or additional data on the individual a has ateen collected or Qublic dataruponcreated. request by P require the responsible authority shall provide copies o t prta. The ivate authority may compiling the the individual subject ofthe ache tual costs of making, certifying, and comp g requesting person to pay - copies. possible, with any request The responsible authority shall comply immediately, if made pursuant to this subdivision, or within five days of the date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, to comply all so inform the individual, and may have an additional five days within whichrequest, excluding Saturdays, Sundays and legal holidays. Subd. 4. Procedure when data is not accurate or complete. An individual may himself. To contest the accuracy or completeness-of public or privvvate d ang eorcesponsible authority exercise this right, an individual shall notify responsible authority shall within 30 describing the nature of the disagreement. The respo Tete and attempt to days either: (a) correct the data found to be inaccurate or incomplete notify past recipients of inaccurate or incomplete he believes ng recipients be correct• the individual; or (b) notify the individual tha tement of disagreement is Data in dispute shall be disclosed only if the individual's sta • included with the disclosed data. be appealed pursuant to the The determination of the responsible authority m o contested cases. provisions of the administrative procedure act relating CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Lk)A'(ZA–IA 63LV� PID: DESCRIPTION OF WORK: --------------------- -- ------------------------------------------------ ZONING REVIEW BY:_Si DATE APPROVED: BUILDING REVIEW BY: DATE APPROVED: ------------------------ ------------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes V-" No PLAN REVIEW Yes�N0 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 Of ice c ool District: Lot Area: fl— Width: D the Survey Submitte : Yes No Date of Survey: Proposed Setbac s Front (Lak ) . Righ Side: Rear (Str et) Left Side: Adjacent tru tures: We land:- Building and: Building Heig t: D f. Hgt. eak Hgt. Avg. Setback: Lot Co erage: xisting Prop sed Hardcover: 0 75 ' 75 250 ' 250 500' 500 000 ' Hardcover ariance Requi ed: Yes No Date of Counci Approval: Grading: taff Approval ate y: Council A proval Date: Septic: aff Approval Da e: By: Zoning F le:# R s lut'on #: Resolutio Date: RE KARKS Un house) : -:s BUILDING REVIEW CHECK LIST UBC: -2 CONSTRUCTION TYPE: F� Sq Footage $ Per Sq Ftg Basement x 1st Floor x - 2nd Floor x = Garage x x = TOTAL ort 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 _f�Fina l (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) : uwx DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED Y PERMIT N0. (.(.« COMPLETED - Y ADDRESS Z_7Z5 W A}ZthTl% C3w1O OWNER CONTR. TELEPHONE NO. DESCRIPTION 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING tQ 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O 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-UO 06 PROGRESS E` 07 DEMO--SITE 27 SEPTIC MAINT. 21 COMPLAINT v W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION REMOVAL OWNER/CONTRACTOR TO MEET YOU: YES_NO Zt COMMENTS: W a O O cc O U- ti cc Q 2 W Z W Or Z) d ef�PGVORKSATISFACTORY:PROCEED PROJECT COMPLETE WC CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR G CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnedContractA s' . Inspector. White Copy/Inspector's File Canary Copy/Site Notice D TE TIME CITY OF ORONO CALLED IN INSPECTION N TILE SCHEDULED i PERMIT NO. COz9'52) ADDRESS OWNER CONTR. TELEPHONE NO. DESCRIPTION T.F0013Na 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG 02 FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS p INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION tiQ 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS � 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 v 10 PLUMBING FINAL 36 FOUNDATION REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: p f�tl 1•�j5 , ,� s- ee�p 0 a QZ 0 W QZ Q L ;it W Z W cc LU W RK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORECOVERING 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 inspection 24 hours in advance.473-7357 Owner/Contractor te: Inspector. White Copy/inspector's File Canary Copy/Site Notice