HomeMy WebLinkAbout1990-003120 (Demo/remodel) � �ERMIT
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PERMIT TYPE: ;;�j��;,z,,�;;
1335 Brown Rd. South • P.O. Box 66 Permit Number: =:iti?=; 3
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Cr stal Ba , Minnesota 55323 ;y;;'i�f��;;_,
y y Date Issued:
(612) 473-7357
SITE ADDRESS:
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APP ERMITEESIGNATURF ISSUEDBY SIGNATURE
�' ` � CITY OF ORONO - BIIILDING Pffi2MIT APPLICATION
Total Fee: $ Date Received: �"�3 ��'
, -
Date Approved:
Entered By: �,���. �fs
Permit#:
AT•T• INFORMATION MLTST BE SIIBMITTED IN FIILL BEFORE PLAN REVIgW WILL B$ STARTED
(See Check-off List Enclosed)
THE APPLICANT IS: (circle one ) OWNER or ONTRACTOR
JOB SITE ADDRESS: /� �7L-� f�-C_�v�- t�(�ek c�a ZIP: �S 3�i �
(work)
NAME OF OWNER: t.,�,I`��I. U� '! L�J�r r/�. PHONE: (home) µ'11 _
,
MAILING ADDRESS: / �"� � �k}��j? CITY: ('�j�L ti,',� ZIP: ...��_��
CONTRACTOR: NU�-`��=v��J I�tJ� / �/�'� PHONE: �;�;, % - ���CI��
'�IAILING ADDRESS :_(� >"?I L�`�>�'Jo°r� f-��� S�. CITY: �7�'Lt� ZIP: � SS�{ I�
TYP$ OF WORK: New Addition Accessory Structure Move
Demo_�_ Remodel/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) : (�E✓��Cx,�,�,i �� ��jP-�TI-(- - f��r�� �u'Cr dv�c� _
�!k/� ft�v1� r�,����.,�.�`� _ �.vc�.��e�� J�✓� . 5f�v«i� '��Nk , �77� �Lf�l .
STORIES: SQ. FEET OF EACH FLOOR:
��10. OF B$DROOMS: GARAGE STALLS: ATT. DET.
7�STIMATED CONSTRIICTION VAI�IIATION (egcluding land) : $ �r�, OC�C�
�_ 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
inderstand this is not a permit and work is not to start without a �ermit; and
that the work will be in accordance with the approved plan.
"tPPLICANT'S S IGNAR'QRE: , iVV' '� DATE: 7-�._�j - c��
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�� �� �� ��� �` CITY of OR011'�TTO
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.f`�* � ' � Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
; Y'wt�,:'�..
� - s � On the North Shore of Lake Minnetonka
DATA PRNACY 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
qualif�.cation for the permit or Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Your full name is required to process this application or
permit.
�� ;;7 �iz.i�'i�'i7 ��l�E'��l�U ilZ
First Middle Last
/�Z-�j �l r`��f r.�G'�l7 L-d�
Address
L2;%���7�s�T F-k /"�'1 i't�' S���J� �
City State Zip
� �� ��,�5' ,
Phone
I understand my rights as stated above.
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Signature
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
. , .
S1.3.04 RIGHTS OF SIIBJECTS �F 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 requ�� tO � ��� ����L An.individual asked to
� supply private or confidentiel data concernindg t8mw hin the collect ng state gency,
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 date; (c) anY known consequence arising from his
su plying or refusing to supply private or confidential data; and (d) the identity of
P
other persons or entities authorized by staau��e�kedlto supplyinvest gat ve data,
requirement shall not apply when en indlvl
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue mg ropertv tax re�und instructionsui ateadho5
subdivision in the individuel income tax •r �
on those orms. . -
Subd. 3. Access to �ata by in�ivi�ue�l• Upon request to e responsible
authority, an individuel shall be informed�wh ublic, pr vateeor confident alre UP°n �
individuals, and whether it is classified p ublic data on
further request, an individual who is the subject of se t�e�mrl�v�aae if he desires, shall
individuels shall be shown the data withou�fan�y ��a. After an individual rres been
�e informed of the content end meaning the data need not be �isclosed to
shown the private date and informed of i� ute orgaction pursuant to this section is
him for six months thereafter unless a d�SP
, ending or additional data on the individ�e h� gteeor P bl c datarupongrequest by
P
responsible authority shall provide copies o P require the
the individual subject ofthe actual•cos h of making,l cert fYingy a�d �ompiling the
requesting person to pay -
copies. ssible, with any request
The responsib1Q authority shall comQly immediately, if po
made pursuant to this subdivision, or with lidavs �f Siinmediateatcompliance eisu not
excluding Saturda5�, Sundays and legal �
possible. If he cannot comply with the request within�i��nt�ch toh omplynw�h the
individual, and may have ar► additional five days
request, excluding Saturdays, Sur►daYs and legal holidays.
Subd. 4. Procediu'e �►hen data is not accurate or complete. An individuel may
himself. To
contest the accuracy or co aP�dual shallPnot fy inrwr ting tthe�responslble authority
-exercise this right, an ln nsible authority shall within 30
describing the nature of ttie disagreement. The respo
days either: (a? correct the data found to be lete d taeincludingreec pients namedt by
notify past recigients of inaccurate or incomp
the individuel; or (b) notify the individual that he believes the data to beementci
Data in dispute shall be discl t ed only if the individual's statement of disagr
• included with the �isclosed da a be 8ppe�1ed pursuant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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' �� DAT TIME
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CITY bF ORONO cN �E�iN -'
INSPECTION NOTICE scHE�u�E� � �`�� 9�%
PERMIT NO. �v COMPLETED ,-��,� � Z- Z'�
ADDRESS ��'� � ��
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OWNER �` �G I� ,I�'C' CONTR. ��������� :�YYY_r ��
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TELEPHONE NO. ; i-� �
� ❑ FOOTING '� ❑ MECHANICAL RI ❑SITE WELL
/
W �l FRAMING�__ �� MECHANICALFINAL ❑WELLTESTPUMP
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❑ INSULATION ❑ FIREPLACEMIOOD BURNER ❑ EXCAVIGRADINGIFILLING
y ❑WALL BD. ❑WATER HOOK-UP ❑ LAKESHORFJWEfLANDS
O
Z ❑ FINAL ❑ METER SETITURN ON ❑TREE REMOVAL
Q ❑ DEMO—SITE ❑ SEWER HOOK-UP ❑ SITE INSPECTION
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❑ DEMO—FINAL ❑SEPTIC MAINT. ❑ PROGRESS
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� ❑ PLUMBING RI ❑SEPTIC INSTALL. ❑ COMPLAINT
Z ❑ PLUMBING FINAL �SEPTIC FINAL ❑ FOLLOW-UP
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ORKSATISFACTORY:PROCEED C PHOTOTAKEN
❑ CORRECT WORK 8 PROCEED ❑ CITATION ISSUED
� ❑CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
� BEFORE COVERING � Cl ISSUE CERTIFICATE OF OCCUPANCY
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r on sit •
Inspector.
White Copyllnspector's File Canary CopylSite Notice