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HomeMy WebLinkAbout1993-005474 PEI�MIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway • P.O. Box 815 Permit Number: ��:=T.�..`�%' �`v'=_ Orono, Minnesota 55356-0815 Date Issued: �-"s�''�`�`� (612) 473-7357 c_:'=;i;',i ;��:=: SITE ADDRESS: =����,�:� �,�a�°_,��,,i� �C� � -.}, �' � . �;. . i�`:-1 S�- � _.__-�:}i'rt�tl DESCRIPTION: r`c�t:�:: �=�L-3� ?3^;?�t'� ��!=.'!'(fil T• i Yi=��� '_;(---�..�Eif;!�.�3�E�_�#1�� �;L�i 3 �.+�2 E`f'=: 4?�==+1'��. i }'�'r �%�t•i,. I j`';i_. f_':_�i.€f��w'E'�t"w _ _ —._-� �,,.�_;�{�.'�.'i•I.�i , i ii:'i j �V�. __ ;it.� ::e �__,3;_ —:`� fi� .".t r! _ _ � " 18r . . _.3.—. Ty�;L — ' ijil . _!t . .. ..!!V :'::F "'"'�'1.: '�*: �_ � _'2 :.1._!t _.u..e ,� •{y ' ir_.�___... .. _ __ � . � -sr . . . :.L ._'t .. - � - _�!!L�JV .. . s...... . .. .. / � "�.'_•. . "i��'.....� . .... REMARKS: FEE SUMMARY: ���i�}�Z�i��i_ii�� �'� f ���_)F� �'�:=�.= k�fr 3= ;;S_i�'1 (}!.3 �'"�=Vtlf F;'�',v�rii '�_"_', rC '.;zt;i,r�-;=��z_;,� _____—____:...��_7•'=, ..�^ }..�7 �_;� �.'_y!_;. .�i�i CONTRACTOR: OWNER: — E��:��� i.r,�;�-�#. — I' 1 S ���-te-?tti3� � ��'t•i'fi��... ='`-;F,t i �:�=;`;:_:T[33� fi i) : trii_t,�.�l I �'��''; ��.":!�';-� {.`_.�1..�.?�.,__.� ?��C -�-�,�J._ r.,-..--r.-. __. . . .. _- - � - _ - • - - f— � i��'s; � :=`— i i o-:c'' #i '.:L;',: !.ii — ` ,''i-; _F''"iitil T �:t,'� �^ �-<<:_ _y; �-__ E i-1:.... '�:}Y..��::�?s.:�E i'.��_ �F!.._t'.��t..'�i . .__ .fi`,�... . _ f__� .. ._ _ _ S i.... i'.. . . �'-.r v E f!. . ._._. ...._ ..: .. ?.t_¢: ..� F��€�'. � _. _._..._._ .i. ..' ' . ' ' . _ . . . _� . .... " " ' _ � .. , . . ; ;.p . _ ... '��"��'"?_:S.r 1.'_L7 ::�'�3t.i :,_:�-i�:.�.' . _. r`_%�_. . ._..i.. .. ..i?-;�`, F.E`; _ ii-:,'€f� ! _.`_.s'.'�. ._...!-=iiv(_.— :� `.� F •l i�' _-}:_ '�.' ;"3= '{- ' ' i(�;3 - ' .� '�i ;} =�S n. _ F "�i�`:l_ __... _ .. . . . . ._..._... ... .. . . _. � _. �.... .._ _. ..1._.iei"1::.. .J ' . �'�#<._ _ , . . . __. _.. � ._.,n. ..,_.. ... x :. � _ .._._._ 1 i ._ ._ _.._.� . ...... , _. �:i.i��i;`i`-i x _ , I ��, J '�� � � APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE �- CITY OF ORONO - BIIIZ.DING PER'�LIT APPLIC�,TION Total Fee- $ 7 � S� Date Received: ��-L�` ��� Date P_��roved: �, _ - - Entered By: � ,�� �-��,j . P e^*�i t Q: 7 AT•7• INFORMATION MIIST BE SIIBMIT'�� IN FITLL BEFORE PZ.AN REVIEW WII�L B$ STAR�ED (See Check-off List Enclosed) ---------------------------------- --=�r--------------------------------------- THE APpZICANT IS: (circle one) WrIER �or CONTRACTOR � ?�� �- C�` l� p S1�tJ 4_ ��D zzP- �� 5 ��� � JOB SITE ADDRSSS: (wcrk) ��,�j_-�.��, l� • �� I L l� � �z L �„�, �_ f L kj � t4 rl.�� 1 PHONE: �home) 7 73_j"��f � N� OF OWNER- :�iAII,ING ADDRESS: � /�� N�Y S i� �-- IVJ CITY: /1��I�L.�..�C./� �yl.� ZIP: JS 3�`� CONTRACTOR: PH��' 'cSAII.ING ADDRESS: CITY: ZIP: STATS LICENSE: � ARCHITECT/ENGINEER: PHONE: �i�SLSNG ADDRBSS: CITY: ZIP: �A�� RBGISTRATION a TYPE OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration ✓" Renovate Land Alteration PROPOSF.D WORR (describe i.n detail) : ��%'�l �%� � j�d C� � d �t-1�- �-i"�C�� �-�"1 �."�'fi V- S t�c,��� S I � ,S �` �Y�"� :aTORIES: SQ. FEET OF EACH FLO�R= :a_ OF B$DROOMS: GARAGS STAI.LSs ATT. DET. . �-' , ��:STgSATED CONSTRIICTION VALIIATION (eacl.nding land) : $� ��% L��' � hereby apply for a building permit and I acknowledge that the iaformation bove is complete and accurate; that the work wil.l be in conformance with the _:rdinances and codes of the City and with the State Building Code; that I .nderstand this is not a permit and work is not to start wit:�out a permit; and ,'�at the work wiI 1 be in accordance with the approved plan. . � �` �) _?PZICANT`S SIGNATURE: � l,�t,�(�,j,��. f7�,�` '�C�tnL� DATE: '" "`� CHECX OFF LIST FOR ISSIIANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR I,EGAL: 3�16� (3 A�( 5 l 47 C (Z.p PID= DESCRIPTION OF WORR: Oc_Ll� - ---------- ----------------------------------------------- _ ` -------------- Z ONING REVIEW BY s ,,._ DATE APPROVED: �'�D '�-3 BDILDING REVIEW BY: � DATB APPROVED: � '�' rS1 ------------------ --- FEES TO BE CHARGED: Misc. Fees Ca1cul.ated By: PERMIT Yes ✓� No . PLAN REVIEW Yes (/' No SEWER CONNECTION STATE SURCHARGE Yes �'�No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC � Yes No SITE INSPECTION Number of SAC Units OTHER (specify) ------------------------------ / ZONING CHECR LIST Zaning District: /1,�/13 _ Fire Department• � _ Post Office• � School District: JllD�o Lot Area: � C�t�?�'�,� Width: Depth: Survey Submitted: Yes� No Date of Survey: � c���posed Setbacks: � ► • Front (Lake) : � �O�� Right Side:�'� � Rear (Street) : ,$�r� Lef t Side: 2�0� Adjacent Structures: /3-'�1iActi� Wetland: N� Peak H t. ~� Building Height: Def . Hgt. �•I� g Avg. Setback: /✓�/Y�` Lot Coverage: ��i4- Existing Proposed Hardcover: 0-75 ' 75-250 ' 250-500 ' 500-1000 ' Hardcover Varianc Req ' red: YeS NO Date of Council Approval.:__ Grading: Staff Ap roval ate: �"`�_ y; Council. Approval Date: Septic: Staff App oval D te: By' Zoning File:# es lu ion �� Resolution Date: REMARRS (in hous ) : .�.. _, . BIIILDING REVIEW CHECR LIST �, . _ IIgC. �� �--� CONSTRIICTION TYPE: .�.y- Sq Footage $ Per Sq Ftg Basement X = . lst Floor X — 2nd Floor X = Garage X — x = TOTAL . $stimated Construction Value: $ /S�� Inspections Required: Work Reqniring Separate Permits: Site � PZumbing Grading/Fi�J.ing �Footing MechanicaJ. Fire Framing Septic Water Connection Insulation Fireplace Sewer Connection Wal.l Board (Masonry) Lawn Irrigation �Final (Mfg.) Other Other Wel Z (State Permit) Electrical (State Permit) ---------------------------------------------------------- REMARRS (IN HOIISE) : �r ------------------------------------------------------- REVIEW BY OTHL�F2S: DAT'E: Access : Existing New Access Approval: Date BY= ------------------------------------------------- REIrSARRS (TO BE NOTED ON PF.RMIT) : � �• �.� ,"`;�6�-� �.,.,r;�.�:� a�x{ ',� �J�}� �'�* h E"�� ��• v�� � ��'��_ � +��,:� C I'TI' Of UR�leTO ��:r .� `� c�. - -�;,,,�.� ,r Y e. uJfK��� , ��.5�'{t'.�. ;_�- � Post Office Box 66•Crystal Bay,Minnesota 5a323•Municipal Offices 'a"_�;"f .'. 9 �. . � _ � � 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 Iike to inform you that your request for a permit or I.icense f rom 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 Iicense 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 Iocal, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or Iicense requires Councii action to approve, some inf ormation may become public. 5, You have certain rights under M.S. 13.04 to review pri�a�� data on yourself. 6, Yaur full name is reguired to process this applica�ian or permit. j)'Jlc� �� � ��� �-���- �l� /�R� ��I. First Middle Last 3`� +� � ���l S� r �)`� ►��-��_ Address a'k� 1�I�L� ��L l�11L` /Y1 � 5 � 3 S � City State Z1p ,� 7� - ! ��S Phone I understand my rights as stated above. _ ���'��. ; ��. '� , �� ��-�i� ; .� ��.� ,�'� � � � f�.�_ Signature BUILDING&ZONING—473-7357 • ADMllYISTRATTOV&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING — - - �� . i �_04 RIGHTS OF SIIBJECTS OF DATA � Subdivision L Z`YP'� of data. The rights of individuels on whom the data is r stored or to be stored shall be as set forth in this section. Subd. 2. Information required to be given in�vi�uaL An.individuel Esked to � " supgly private or confidenti8l data concernin�8m�sit�h�in the collecting state agencY, purpose and intended use of the requested (b) whether he may refuse or from his political subdivision, or statewide system; �oWn consequence arising required to supply the requested date; (�) �Y � su lying or refusing to supoly private or confidederal law to receiae the data.1tThis. PP state or f other persons or entities authorized by �vesti ative datg� requirement shall not apply when an individual is asked to supply g pursuant to section 13.82, subdivision �, to a law enforcement office:. The commissioner of revenue mev p1er2V tgX rei�und instr�ucteonsunsteadhoi subdivision in the individual income tax or rr�� on those i orms. . - -— - " . Subd. 3. Access to �ata by in�vi�i- UPon request to a responsible uthorit an individusl shall be informed whether h��ate or confident al.e UPon h�s a Y� ubl�c individuals, and whether it is classified as p r P ublic data on e to him and, if he desires, shall further request, an individuel who is the subject of stored private or individuels shall be shown the data withou�fan�y ��g. �ter an individual h� been �e informed of the content and tT►ea.rung the dats need not be �sclosed Lo shown the private data and informed of its mLan�ac�on p��ugnt to this section is him for six months thereafter unless a d�SP � ending or additional data on the individuh h�ate or p blic dataruponarequest by ' P require the responsible authority shall provide eflpies o t p the individuel subject oftrie actual�co tis of mPaking,l�ert�fYingye�'d �ompiling the requesting person to pay - copies. ssible with any request The responsible authority shall comply immediatelYof th date of the request, made pursuant to this subdivision, or within five ��immediate compliance is not excluding Saturdays, Sundays and lege.l holideys, ossible. If he cannot comply with the request withi wiihin which toh omply w�h the P hsve sn additionsl £ve days individual, and maY �d Ie al holidays• request, excluding Saturdays, SundaYS g diu�e when data is not ac�ate or complete. An individuel may Subd 4. Proce himself. To contest the accuracy or completeness of public or private data concerning in writing the responsible authority exercise Lhis right, ar► individual eQ�n�°tTh resp��ible autharity shall within 30 describing the nature of the disagr lete and attempt to days either: (a) correct i�c��a�e ord�comple e daLaeincludingPecipients named by notify past recipients of the individual; or {b) notify the indi��� i��dua�1,�SLatemen Of disagreement is Data in dispute shall be disclosed only • included with the �isclosed data• egled ursuant to the ' The determination trat ve pro�dui'e a t relat ng to contested cases• provisions of the admin�s . ''� a� r ? �� � ' °. ir� r + � :. - . r �`y� �h! :Y Y � � �'r� S,E . '� �; ! 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'`h.y I .�Y yM ' �1 �\' .C� `Y . F;: . 1 `y , � ; .Y `� N v�� ,tl' � -� � t�'.�`�< , Y '"` p - h, � i ';�w.� � +''.�,l " _ ry } , .r� � �.� ! � :�_Y���� . � '�+ ��iXt� . � I � I l7 l ��/lSL . .'.��t%M1 `�� . M t �t `t i � � � ��i��' �i5 .'I � �"'] �] 17 �J �#�S�{, 3��F .j a � — _ I � o F�— -� ;� � .' , ' 4�; ; ; �."� � . � ` 1 ) �� ,� £� �.�� —/ , :�j kYr . ? " liz� � �I `T- S�-i� �2 7 3J �r ` '� j ..� ,� x_�, e � r � �� � � � • �- 'r:,�t' . . �,'�'�ytf � (/;� �u��r� ;��'{ •i � ���'.. � ` � f i- . f Z�, J } {t - .� �N t . � .��. \+���1�^��•� I', . '� �s �• ��1.� ��^ S��t�. // � ���f :I � ,P7�. '.* �r"y� i � Q ��'• 't ¢ -� ,'�^ . �� � , 1'��'�h 1 -� ';:t, � ; +,'.��: ;'. N �N V �l n ;.,;� � ,� � ' ��,�� � 1 ° S �i � �• ��K ;' ! J I;�d .. , \I�`1 '�P DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED ��"S 3 �O�e�`� PERMIT NO. COMPLETED � �� v 7� ADDRESS 3��v �45�0�= OWNER CONTR. TELEPHONE NO. � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING � 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS � Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL Q 05 FINAL 13 METER SETITURN ON 17 ITE INSPECTION � 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT � 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP J 10 PLUMBING FINAL 23 SEPTIC FINAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENT : �J E � w O Q'� � � � c [O f' � � � 0 a � 0 � W � Q � Z W � W � � d W C1 WORKSATISFACTORY:PROCEED r=; PROJECTCOMPLETE � � CORRECT WORK&PROCEED C', ISSUE CERTIFICATE OF OCCUPANCY W � C;CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT [7 CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN '/ INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED C' INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnerlContract n si Inspector. White Copylinspector's File Canary CopylSite Notice