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HomeMy WebLinkAbout1995-007047 - detached garage PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 k<1.J T I T r k,1 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: (612) 473-7357 SITE ADDRESS: DESCRIPTION: 4 Z_ J�T *V iiC ii_-i Wri U VYMAi-C -CC T I L I 411rr7lviit-.L- L11i I 4 f 7 171 I'j A VA 17 vrj;. L0N 22". A350.0100 VA TV.V/ Cii V.L ,q I ,_ jv T; 7 I L. "fL, _'_'i Ww* f:fv.? yny REMARKS: 43I.Juln-1111 LVVI )%V.L iv., Ott i`ti /7,1 /Oc vt"L.J. 0 T FEE SUMMARY: `J CONTRACTOR: OWNER: L,J 7' n C -if UM. THE UNDERSIGNED HEREBY REWESTS PERM Vz!3 1 L-IN TO MAKE THE REAL IMP R4VEMENTS SPECIFIED AND AGREES' TO DO ALL WORK INSTRI`CT COMPLIANCE WITH AL"L CITY Or ORCINO ORD itit=NCESAND STATE OF MINNESOTA BUILDING CODE, REONIREMEEMI-3. L l��AP/LICANT'/'PERMITEJIGNATURE ISSUED BY SIGNATURE CHECK OFF LIST FOR rISSUANCE OF PERMITS FOR OFFICE ADDRESS OR LEGAL: 3 S w�{ 2To``f PJ -PID: DESCRIPTION OF WORK: GA RIR-4-6 ----------- ------------DATE -- ---------- ----- S ------- APPROVED: _ ZONING REVIEW BY: �BIIILDING REVIEW BY: _ DATE APPROVED: G ----------------------------------------------- ------- FEES TO BE CHARGED: Misc. Fees Calculated By: Yes No PERMIT SEWER CONNECTION PLAN REVIEW Yes t/ No STATE SURCHARGE Yes --*-No WATER CONNECTION INVESTIGATION FEE YesNo PARR FEE SAC YNo SITE INSPECTION Ye OTHER (specify) ) Number of SAC Units ------------------- -------------- ZONING CHECK LIST Zoning District. Fire Department: L- • L Post Office: C- - School District: Cyt0N0 Lot Area: NO Width: �— Depth: Survey Submitted: Yes OC No Date of Survey: Proposed Setbacks: Front (1a4eL-) : 1�� Right Side: ((S Rear (St) : fV 4- Left Side: �IAr w Adjacent Structures: 140 ' Wetland: /J114- Building Height: Def. Hgt• ©.fes Peak Hgt. Avg. Setback: Lot COv rage: sting Prop sed Hardcover: 0-75 ' 75-250 ' 250-500 ' 500-1000 Hardcover Vari nce Req ' red: Yes o Da a of Counci Approval: Grading: Staf Approval Dat By: Council A proval Date:_. Septic: Staf Approval at Zoning File # esolution #: Resoluti n Date: REMARKS (in house) : BQILDING REVIEW CHECK LIST UBC: tJ- i CONSTRUCTION TYPE:- Sq Footage $ Per Sq Ftg Basement x _ 1st Floor x 2nd Floor x _ Garage x x TOTAL Estimated Construction Value: $ 15.dUy Inspections Required: Work Requiring Separate Permits: Site Plumbing Grading/Filling Mechanical Fire J&Footing Water Connection K Framing Septic Insulation Fireplace Sewer Connection Wall Board (Masonry) Lawn Irrigation Other Fina 1 (Mf g•) Well (State Permit) Other w.-Electrical (State Permit) ----------------------------------- REMARKS (IN HOUSE) : ------------------------------------- REVIEW BY OTHERS: DATE: Access: Existing New By:By Access Approval: Date ___________________ ----------------------------------- REMARKS (TO BE NOTED ON PERMIT) : T PROOF OF WORKERS' COMPENSATION INSURANCE COVERAGE Minnesota Statute Section 176.182 requires every state and local licensing agency to withhold the issuance or renewal of a license or permit to operate a business in Minnesota until the applicant presents acceptable evidence of compliance with the workers' compensation insurance coverage requirement of Section 176.181, Subd. 2. The information required is: The name of the insurance company, the policy number, and dates of coverage or the permit to self-insure. This information will be collected by the licensing agency and put in their company file. It will be furnished, upon request, to the Department of Labor and Industry to check for compliance with Minnesota Statute Sec. 176.181, Subd. 2. This information is required by law, and licenses and permits to operate a business may not be issued or renewed if it is not provided and/or is falsely reported. Furthermore, if this information is not provided and/or falsely reported, it may result in a $1,000 penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry payable to the Special Compensation Fund. Provide the information specified above in the spaces provided, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. Insurance Company Name: (NOT the insurance agent) Policy Number or Self-Insurance Permit Number: Dates of Coverage: OR I am not required to have workers' compensation liability coverage because: ( ) I have no employees covered by the law. ( ) Other (Specify) I HAVE READ AND UNDERSTAND MY RIGHTS AND OBLIGATIONS WITH REGARDS TO BUSINESS LICENSES, PERMITS AND WORKERS' COMPENSATION COVERAGE, AND I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT. (signature) (Date) Y d CITY OF ORONO - BUILDING PERMIT APPLICATION 2 3 Date Received: 64/96'- Total Fee: $ 3 7� Date ADDroved: Entered By: Permit': 7 ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED ( See Check-off List Enclosed) ------------------------------------------------------- APPLICANT IS: (circle one) OWNER or NTRAC ,THE JOB SITE ADDRESS: 1 -) 5 Awa- Ov.,N RYD _ ZIP: (work) )%N� PHONE: (home NAME OF OWNER: _ MAILING ADDRESS: U CITY: 01?0 no ZIP: CONTRACTOR: ��C71j PHONE: -7`}--e-120 MAILING ADDRESS: ZIP: S>� STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION - TYPE OF WORK: New Addition Accessory Structure_ Move Demo Remoael/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : q !d Abed VA 19 S ea_ CA f AP STORIES:__j_ SQ. FEET OF EACH FLOOR: S7-6 NO. OF BEDROOMS: 0 GARAGE STALLS: ATT. DET. EST114ATED CONSTRUCTION VALUATION (excluding land) : $ I hereby apply for a building permit and I acknowledge that the informatio: above is complete and accurate; that the work will be in conformance wit �hah� ordinances and codes of the City and with the State Building Code; understand this is not a permit and work is not to start without a permit; anc that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE- DATE: �j s �AL a CITY of ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices • 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 oeY°emit or licenseurnish will be used to requested. determine your for Pr 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 Aadre> ?-u(4J(4 R ss c> -xce ,S ;CA .fin L„ s 31 City State Zip Phone I understand my fights as stated above. Si ur BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359 ASSESSING A, x.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. to be given individual An.individual asked to Subd. 2. Information rid be informed of: (a) the Supply private or confidential data concerning himself in the collecting state agency, purpose and intended use of the requested (b) whether he may refuse or is legally political subdivision, or statewide system; {mown consequence arising from his required to supply the requested data; (c) any or refusing to supply private or confidential ederal law to receive the identity en it Of- supplying state or other persons or entities authorized by 1 investigative data, requirement shall not apply when an indtoviaig s asked to en orcementuofficer. pursuant to section 13.829 subdivision 59 uired under The commissioner of revenue ma elace tax reound instrtice ouctions nsteadhos subdivision in the individual income the I tax or pr��er V on those i6rms. — Subd. 3. Access to data by �� L Upon request to a responsible subject of stored data on authority, an individual shall be informed whetbLc hPrivatis e or confidential. Upon his individuals, and whether it is classified asp , public data on further request, an individual who is the subject charge to hiored m and, if he desires, shall individuals shall be shown the data withoutof any data. After an individual has been Se informed of the content and meaning a need not be disclosed to shown the private data and informed of its meaning, the data to this section is him for six months thereafter unless a dispute or action p quest b pending or additional data on the individual hasa a or public datacollected uponreq The P g wire the responsible authority shall provide copies of the private authority may requin the the individual subject ofthe ache tual.costs of mThe aking, certifying, and compiling requesting person to pay copies. possible, with any request The responsible authority shall comply immediately, if pursuant to this subdivision, or within five days of the date of the request, made p and le holidays, if immediate compliance is not excluding Saturdays, Sundays that with the possible. If he cannot comply with the request within t withintwhich to comply form the P have an additional five y5 individual, and may request, excluding Saturdays, Sundays and legal holidays. lure when data is not accurate or complete. An individual may Subd. 4• Prose private data concerning himself. To contest the accuracy or completeness al public or p the responsible authority exercise this right, an individual Shad notify r �rsib a authority shall within 30 describing the nature of the disagreement. The responsible incomplete and attempt to days either. (a) correct the data found to be in or notify past recipients of inaccurate or incomplete he believestheng rdatalto be correct• the individual; or (b) notify the individual that disagreement is Data in dispute shall be disclosed only if the individual's statement of included with the disclosed data. be ealed pursuant to the The determination of the responsible authority m o tested cases• provisions of the administrative procedure act relating >q �.:..�,N`.& . vtue y �o f 7 Ae .SUSSF L Co* USE-S"M AVMM SOUTH sommomms sun C.4 � 5 CITY OF ORONO ORO .� ' _t_ .. t• �- ;- 1SITE PLAN GVD ,., ° PPROV D , - Ww.0O3.. v-ISa� 6 r/' 7.; IRZ3 DISAp D y jar Vls,oNs • . " . b - ��.� lUarel-7ow .�_/�oa4'_ 10,Z7 DA !41 TE ;er m t4 CA Uy lb • q' i ?r` �a ¢., • d,�•• t='' � i+r i;..-�ti�4 .ti: �'art-:1 f n.l'•3�+V • 1. �iZ � Y 'IL- � ,may. .0 � r, ='� dT �' ► T '�' 4w6r•j%'��'�. ` .�-"'"'r.v��k?� .'S 'i.` F�i� `^N�i jet rti v tqqo • u c a ;� : "? • DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED `) &0 PERMIT NO. 70 47 COMPLETED ADDRESS qS61 OWNER -[.lliy> CONTR. _ TELEPHONE NO. DESCRIPTION 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING CZEEQ RAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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-UP 06 PROGRESS 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT 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 o COMMENTS: cc W CL. cc Z) O cc O LL W cc Q Z W z W cc d W<vc ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC W ORRECT WORK&PROCEED C, ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. F- PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR I I CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next i�s action 24 hours in advance.473-7357 Owner/Contra�on site. Inspector. White Co'y/Inspector's File Canary Copy/Site Notice Qry' DATE TIME CITY OF ORONO CALLED IN Vd INSPECTION NOTICE SCHEDULED PERMIT NO. "Y7 COMPLETED T ADDRESS OWNER �Q'Is'1 CONTR. TELEPHONE NO. q 7 41, .2 3 DESCRIPTION 4� _e__ 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q INAL 14 SEWER HOOK-UP 06 PROGRESS 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 2 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a J O O W W cc Q 2 W Z W J 1IORK SATISFACTORY:PROCEED X(ROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN 11 CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance.473-7357 OwnedContra n it Inspector. White CopylInspector's Fil Canary Copy/Site Notice