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Home My WebLink About1994 - 006576 - new residence PERMIT CITY OF OR-ONO PERMIT TYPE: 2750 Parkway - P.O. Box 66 , - Permit Number Cristal 84, Minnesota 55323 Date Issued: C !'? (612) 473-7357 SITE ADDRESS: DESCRIPTION: SGL tr, Zoning LF-1LI iJ.VV 1:s.! ft - Fr•- e 73---3 0 0 • 4011ni \/q ? o Ser-/-4i//, EN . - REMARKS: ...STATE) ANr: ELECIRICA (STATE ', FEE SUMMARY: VALUiluN Oa-se $1 , 654 . 50 SEWER CONNECTION Flan Review $107S . 43 P'ee $B, 212 . 9? SAC Jnits 7 2 4 . CONTRACTOR: 14'6/ MN SSS91 THE UNOERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO OROIWiNCES ANO STATE OF MINNESOTA BUILDING COLE REQUIREMNTS . APPLICANTPERMITEE SIGNATURE ‘17. ISSUED BY:SIGNATURE CITY OF ORONO - BUILDING PERMIT APPLICATION Total . .a: $ Y„2/07q5 Date Received: Date Approved: Entered By: 1 permit j ? 14, 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: ZIP: o (work) g65--x969 NAME OF OWNER: - PHONE: (home) - C. 3 (. '� MAILING ADDRESS: CITY: ZIP: _ CONTRACTOR: PHONE: _ MAILING ADDRESS: - CITY: _ ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: / PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : 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 accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: • • 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. First Middle Last ` Address /) City State Zip Phone I understand my rights as stated above. Signature BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359 ASSESSING • 513.04 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. Subd. 2. Information required to be given individuaL An.individual asked to • supply private or confidential data concerning himself shall thecollecting state agency, be informed of: (a) the purpose and intended use of the request 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 iseaskederal law to to supplyinvestigative ive the data, ta. This_ requirement shall not apply when an individual pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue ma •lace the notice re.uired under this subdivision in the individual income tax or •ro.ert tax re and instructions instead o on those orms. Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be informdewhethr e is private esubject of or confidential.e Upon his individuals, and whether it is classifiedpublic, data on further request, an individual who is the subject of stored to hi privatm e ifo publiche desires, shall individuals shall be shown the data withoutany charge After an individual has been 6e informed of the content and meaning the data need disclosed to shown the private data and informed of its meaning, neednotto beeis section iso him for six months thereafter unless a dispute or action pursuant pending or additional data on the individual has been nr collectedicorupreare created. bye responsible authority shall provide copies of p mayrequire the the individual subject of the c��• The costs of making,le certifying, and compiling the requesting person to pay the copies. The responsible authority shall comply immediately, if possible, with any request e e made pursuant to this subdivision, or within lids five day si diof the date of th ce eisquesot, excluding Saturdays, Sundays and legal holidays, he ipossible. If he cannot comply with the request within that time, which shemplynforth the the individual, and may have an additional fivedays 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 public or private data concerning himself. To exercise this right, an individual shall notify in writingthe responsibley shall within 30 describing the nature of the disagreement. The responsible and attempt to days either: (a) correct the data found to be inaccurate or incomplete notify past recipients of inaccurate or incomplete e i data, including recipients ci i n s named correct the individual; or (b) notify the individual thatBement is Data in dispute shall be disclosed only if the individual's statement of disagr included with the disclosed data. appealed pursuant to the The determination of the responsible authority may be provisions of the administrative procedure act relating to contested cases. • • CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: /006 W'rLPHU ' TnAft-- PID: DESCRIPTION OF WORK: I\' E W R S ZONING REVIEW BY: d(; ((2.)VVY...v.- DATE APPROVED: 1O '24&- clAf BUILDING REVIEW BY: DATE APPROVED: /0- 2.-(9-C1/1 FEES TO BE CHARGED: Misc. Fees Calculated By: J 4.M-*- L- 0, PERMIT Yes i/ ..~No PLAN REVIEW Yes h No SEWER CONNECTION 41 1 uiS.O O STATE SURCHARGE Yes - No WATER CONNECTION INVESTIGATION FEE Yes No ✓ PARK FEE SAC Yes-771 es No SITE INSPECTION Number of SAC Units 'J. OTHER (specify) ZONING CHECK LIST Zoning District: fn-)a Fire Department: (Y100/1/4/4 Post Office: M/4..J School District: ivl5'iurcA. Lot Area: Width: pSyte..cJvci#4-/t- Depth: Survey Submitted: Yes p( No Date of Survey: 4- 23 y`/ Proposed Setbacks: . -rt (Lake) : �sy ' '!' Right Side: a Raa-r (Street) : -70 ' 1: Left Side: /00 ' t Adjacent Structures: N/4 Wetland: 0.7G Building Height: Def . Hgt. ) Peak Hgt. Avg. Setback: JAcAhrr GGT a Nvc-r 0002 Lot Coverage: 0.k Existing Proposed Hardcover: 0-75 ' 75-250 ' / 2 ./ c73') 250-500 ' 500-1000 ' Hardcover Variance Required: Yes No D&. Date of Council Approval: Grading: Staff Approval Date: 1U-4 -4 c( By:/?C) , Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution # : Resolution Date: REMARKS (in house) : BUILDING REVIEW CHECK LIST UBC: /2-3 CONSTRUCTION TYPE: NW • Sq Footage $ Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 3`10,ono °-2 Inspections Required: Work Requiring Separate Permits: Site 0cPlumbing Grading/Filling p(Footing '!'Mechanical Fire pr, Framing Septic Water Connection Insulation a Fireplace D�Sewer Connection g Wall Board 'c (Masonry) O( Lawn Irrigation oe Final (Mfg.) Other Other A( 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) : RATE TIME CITY OF ORONO CALLED IN W�s %-- INSPECTION NOTICE SCHEDULED _ i , / ' 3' 0 PERMIT NO. (-.' '-'/C---- COMPLETED 'tt ADDRESS Qc ,moi y/./.. .c-, � ,- ' OWNERa_.. CONTR. TELEPHONE NO. 7 3 S'n (-X5 r `f 72 - 76- 52- DESCRIPTION ---/-2-,---t--(_/---,/- - ' -' 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG Q /W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREETLANDS Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION cr = 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS I-. EMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT J Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W• 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 o COMM!'NTS ,.CC doe S fJ d✓� Vl ,1r Q. >. -- - GC e • ' Ct Stat rs vtt� all ccll-- ►lGl 1L0.c S [ Q \ Ai u L6- rty'6 cerise1.... W z W cc -s CJ ORK SATISFACTORY:PROCEED tit PROJECT COMPLETE [i CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W _/ CI , CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORE COVERING PERMANENT 0 CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 7, CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance.473-7357 Owner/Cont n t Inspector. White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN I/-11)-494 INSPECTION NOCEr,� SCHEDULED //' /d 'tii 3D PERMIT NO. (2 5 COMPLETED ADDRESS j 00( OWN ER Q..10-4-.40.,-.• CONTR. TELEPHONE NO. FG 7 - 171 D-7 DESCRIPTION 01 FOCMFRI, 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q 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 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT cQ 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 g OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc cc v OLA( Tra cle ea Gas • pv\ PDQ lt'vtctS z �2 WORK SATISFACTORY:PROCEED � �_ PROJECT COMPLETE CORRECT WORK&PROCEED . ISSUE CERTIFICATE OF OCCUPANCY Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. r PHOTO TAKEN INSPECTOR WILL RETURN El 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/Contract sit : Inspector. White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN 2-2— INSPECTION .ZINSPECTION NOTICE SCHEDULED s SC S" 6Pe/J 6.-`t-? PERMIT NO. C 'D 7 C, COMPLETED ,,b a= % ADDRESS /o c (.)—S(LAO(404-% 1n2As L OWNER ( iR U.storbc= CONTR. TELEPHONE NO. DESCRIPTION LLQ 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING V, C.9RAMING 13 MECHANICAL FINAL 19 LAKESHORENVETLANDS y Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS • 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 14 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNER/CONTRACTOR TO MEET YOU: YES NO o COMMEN S: cc Lu -- 1 .& - . •• s a \ Ao'u_ -E - o — P fi�(_ F0F+- szz&s. rit �er- ids' GM S Q 16 ejAAAAS , 1 c4, _ 16 eilik,647 Oe ,GQM PSS l W z W cc d W ❑WORK SATISFACTORY:PROCEED C PROJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ORRECT WORK,CALL FOR REINSPECTION TEMPORARY O° BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 Owner/Contractpr-gn site: Inspector. -t`�� N.641 White Copyllnspector's File Canary Copy/Site Notice