HomeMy WebLinkAbout1995-006901 - remodel basement PERMIT
' CITY OF ORONO PERMIT TYPE:
2150 Ke+�ey Parkway- P.O. Box 66 Permit Number: �`� '� �- ` _
Crystal Bay, Minnesota 55323 - - _ . . .
(612) 473-7357 Date issued: _
��ITE ADDRESS: _._ :. ..,._ .
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DESCRIPTION:
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FEE SUMMARY: .�`''
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CONTRACTOR: . ��E.�= ;;�.:;;_ - :;,� . _ .. . OWNER:
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A PLICANT%PERMITEE SIGNATURE � ISSUED BY:SIGNATURE
�
� CITY OF ORONO - BIIII.DING PERMIT APPLICATION
�, Date Received: 3'��' fS
r ( /���'�i _��
Total Fee: $
_ , Date Approved:
Entered By: ' /
Permit�: �c%yG'/
ALL INFORMATION MIIST BB SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Enclosed)
-----------------------------------------------------------------------------
THE A.PPLICANT IS: (circle one) OWNE or CONTRACTOR
JOB SITE ADDRSSS: ����%� � ���. ���'Z��'V� I��:�` ZIP: � � 3 `-� �>
'(�`�`�-; (work) ��-7 "� Z `7�
<} ) � /� r
N� OF OWNER: �� � Lc=��L� /-�{C f� S PHONE: (home) ���'��'��✓�
*�iAILING ADDRESS: ��.%(�G� �j �S�cil,�,`� CITY: 1�.� ' ��� ZIP: � � �j`.7�
CONTR.2�CTOR: �t=,� �� �`7 - L�a �Jt��G-,�U ��c.KS PHorr�: �/�7G� �`��%��'
MATLING ADDRESS: i ��'O !�i 1-.�`"�-� CI�': �v �� ZIP: ��J � S�-
STATS LICENSE: � ���Z'
ARCHITECT/ENGINEER: �� PHONE:
MATLING A�DRBSS: CITY: ZIP:
N�: REGISTRATION u
TYPE OF WORK: New Addition Accessory Structure Move
Demo Re.*nodel/Alteration_� Renovate Land Alteration
PROPOSF.D WORK (describe in detail) : I"�%MD�" � ��� i s��
�;��-.�.� �.:r����
STORIES: SQ. FEBT OF EACH FI�OOR:
NO. OF B�DROOMS: GARAG$ STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ �i�>�-/C�� �
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
tnat the work will be in accordance with the approved plan.
� ���� 3-15 -`�.�
APPLICANT`S SIGNATORE: ��� DATE:
� CITY OF ORONO . �ate " :, � •
A���RESS
• CC;�;E, �� Connected to
, . SEPTIC SYSTEM INVENTORY CARD Municipal Sewer
' Address f�fi�� /IJ, ��'(�f��� �( Propertyl.D.Z7-]�Pr-23 yZOn�� WELLDATA
� ' �Standard trench I
. O Mound I
System type O Otner � �� �, 2-� °'
Legal Description UNr�Q �
� ov
Permit No. Date of permit '- ,..� � t
Installer ' v �
d
No. Bedrooms Garbage c �
Building type �'�Jj)�NC� or GPD � g,� �' Laundry f�Dishwasher Disposal �° = I
, E a 0
SEPTIC TANKS: Material �oNC gGoC� Capacity 1) ✓ 2) /�_ o d �
w �
�o
Proper outlet and inlet "' °'
Baffles _ Liquid depth to RO level � >
_...__. :: O
Height of tank bottom above water table � f0
Distance to nearest building �.3 in �
�
DRAINFIELD: Total length of lines �5 � � Number of lines � � Trench width 2 � '
Total treatment area(s ft.) /50 r � '�
q• Height of drainfield above water table iIJ�,Q/2 �,�1']"' �
, �
U
Type of filter material Soil type �a
i � d
Distance from nearest bld � �._
9• � � Tile size Perc rate ' o � a .c
min/in
�� q '� O v
Depth of fill over drainfield � '� '�_Depth of rock over tile ° " �• �
undertile c a. ,: v
� E N —
N C �
O a �j 3
L
,�
; - -----
- -----
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LOCATIO�J � 1,
� INSPECTION RECORD PUMPOUT RECORD SKF'�H- i
DATE COPAPLIANCE DATE GALLONS � �
i I
� �7-/�,-�3/ Nn S�a�F�c�n�G Nc7%�2��_ � 7-2/Pl �bo0 � �
�-9��56 ,�- l�p-o , I
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ur_c��� �I �`�Qi gC�C7 �,
/_i� n�C'✓l�rv ri��-n�:�r�..;.•�ec a":'YJ tU s rL=YI---
�v�s���e,�-s�a,✓e� �ur ii�zy 0
�-a0 8e ���c=r���rH�s ;�.v ,yf��e 2- S'�1 �
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1� D�tG�
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O C
Include: 1) Well location ,
2) Distance from,�buse to „ �'
� ��_1's�tic tanks,di box, lo�$
_� �nfie ^ p�A�
C-- CONFORMING S -S�/RSTANDARD N - NONCONFORMING 3) North arrowan�ro�d ��`G
,%UDT� — �F 7"/='�NCH �ND� �ZO� Fr�v� i��rc H — /V� caNn�Ec��ION No� DrT�H ��€ �U�r-
S/17ELL G� _SeuJ��F
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L.,c ��(� ;7..,,
�:V
.-� v��$ � a�'
�� �` � ���� C ITY of ORONO
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�' � �`� ' Post Office Box 66•Crystal Bay,Minneaota 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 Iike to inform you that your request for a permit or
Iicense 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 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 ar
license.
4. If your requested permit or Iicense requires Councii. actian
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva��
data on yourself.
6. Your full name is required to process this ap�.•licatica o�
permit.
���. .
First Mid le Last
l��O� �Dt-f`�, �rtT� J�G�'
Address
��-- /�'l� �5 �
Cit State Zip
���' �-l[."�
Phone
I understand my rights as stated abov .
Signat re
BUILDING&ZONING—473-7357 • ADMINISTRATIOIV&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G
�.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision L Tppe of data- The rights of individuels on whom the data is
stored or to be stored shall be es set forth in this section. An.individuel asked to
Subd. 2. Information required
to be given in�vic�uaL
� u 1 rivate or confidential data concerning �gmWi�in the collecti g state agen Y�
s PP Y P
purpose and intended use of the requested ��� Whether he may refuse or is legally
political subdivision, or statewide system;
1 the requested dat8; (c) any known consequence arising from his
required to supp y 1 rivate or confidential data; end (d) the identity of
supplying or refusing to supp y P State or federal law to receive the data. This.
other persons or entities authorized by 1 investigative data,
requirement shall not apply when an indt�vigig enforcementuo f icer.
pursuant to section 13.B2, subdivision 5,
The commissioner of revenue mav lact taX re°una instQU�teo su nsteadhos
subdivision in the individual income tax or r• er v
on those orms. � - -- � .
Subd. 3. Access
to �ata bY in�v��' UPon request to a responsible
authority, an individuel shall be informed whe b C hPr V8 eeor c�nfident al.e Upon his
individusls, and whether it is clessified as p � ublic data on
further request, an individual who is the subject of e to�mrl�ae if he desires, shall
individuels shall be shown the data witho of�hat da a• After an individual hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private data snd informed of its meaning+ u�uant to this section is
him for six months thereafter unless a diSPute or action P dgta u n request by
endin or additional data on the individual h� ate or publ�c ed or �eated. The
� P g. require the
responsible authority shall provide copies The hresponsible authority may ilin the
the individual subject of the data• certif n and comp g
requesting person to pay the actual costs of malcing, Yi g'
copies. immediately, if possible, with any request
The responsible authority she]1 comply
•dg if immediate compliance is not
made pursuant to this subdivision, or with 11 f ive'days of the date of the requ�he
excluding Saturdays, Sundays ar►d legal � with the
ossible. If he cannot comply with the request within that time, he shall so inform
p hsve sn additional five days within which to comply
individuel, and m Saturdays, Sundays end legal holidays.
request, excluding
Subd. 4. Procefi�e �'►hen data is not accura te o r c o m p l e t e. An individuel may
contest the accuracY or completeness of public or private data concerning
himself. To
exercise this right, an individuel shall notify
in writing the responsible authority
describing the nature of the disagreement. The�r��ore n flmplet and at pt to
days either: (a) correct the data found to be ina
notif past recipients of inaccurate or incompleterie bel e esdthe datalto be correct
y or {b) notify the individual tha
the individuel; eement ls
Data in dispute sha11 be disclosed only if the individual's statement of �g� t to the
• included with the �isclosed data• � aQPe�e� pursuan
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
---- ' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
� FOR OFFICE USE ONLY
AnDx�s s ox LEc-�: /G�,C; ���-C�f. ��t����� /2�� PID: �Z � //�'-a 3 y� �o as.
D�SCRIPTION OF WORR: /.-�,(-d�.�'yc�.�'�t ��'?'`�'�-1�
------------------------/--------------
ZONING REVIEW BY: /�/i4 DATE APPROVF�D:
BIIILDING REVIEW BY: :/' ,l'v � �/-�- DATE APPROVED: `�� 7��S
------------------ ------
-----------------------------------------------
FEES TO BE CHARGED• Misc. Fees Ca�culated By:
PERMIT Yes � No
PLAN REVIEW Yes 9/� No SEWER CONNECTION
STATE SURCHARGE Yes J No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
-----------------------------------------------
ZONING CHECR LIST Zoni g Dis ict:
Fire Department- Post Office School D' strict:
Lot Area: Width: Depth:
Survey Submitte : Yes No Da e of S rvey:
Proposed Setba ks :
Front (La e) : ight Si e:
Rear (St eet) : Left Si e:
Adjacen Struct res: Wetl nd:
Building He' ght: Def Hgt. P ak Hgt.
Avg. Setba k: Lot Co erage:
E ' sting Pro osed
Hardcover. 0-75 '
75-250 '
250-500 '
500-1000 '
Hardc ver Variance Requ ed: Ye No Date of Council Approv 1:
Grad'ng: Staff ApprovaJ. ate: By: Council Approval D te:
Sept' c: Staff Approva]. Date: By:
Zoning File:# Resolution # : Resolution Date:
REMARRS (in house) :
�;.,. �-=�
BIIILDING REVIEW CHECR LIST
IIBC: �"3 CONSTRIICTION TYPE: U� - . '
Sq Footage $ Per Sq Ftg , _
Basement x -
lst Floor X -
2nd Fl.00r X -
Garage X -
x =
TOTAL
ec_a
$stimated Construction Value: $ �d� r
Inspections Rern�;red: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical. Fire
oCFraming Septic Water Connection
�Insu�ation Fireplace Sewer Connection
�WaJ.I Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Wel 1 (State Permit)
_�Electrical. (State Permit)
-----------------------------------------------------------
REMARRS (IN HOIISE) :
-------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
--------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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t�l0i APPfiGVEI:) --- C:Ut�P��;,;� � �y'.1;34vii;
�'•�ase �Umrnt+rtks area t�r yc�ur Itrfo���c,t!t�n. Aii u�wk stiati bc cte�rP
�re Psei��u�n'��'t�«ae +�ith �ll aa��,x�.�:�: �. >�:r�. t� T,�Ing �o e�
•r;;��rn<x�,ks; i���:I ��i~ 'F ms n�t .�::+'ia�.e,`,� ,x�"yii in
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v�� ! ,q','�'� �L�, : v ;♦r :,t' ;'ii?'7'E�
;�- �4P�20`'�fl VVITH CURRECTIORi3 AS NOTED
ZX� ' � =``1 ivl�'t' APPRUV�J -- !�:JRRECT & RESU�3MlT
0 �`��,,� comrt-��rts ��e r•�,�y��r informatic�n. All work shall be ti��t
r-�,(p,T , ,. . � � -� :aui c+Wr+W'!an;:� �vith rM! e��lCar�+k� ��c�!t� & zonh�g c�0�f41 1�
(l`�17.'`��� � � i:::r�z�►ani� tna��'r,g itams ?��^t vp1r:•lilce{�y mte«i In t?i4a rev�
G � L p ' , . � . . , ,�,;^d' . ":'?.a,s� � n�.,� �ert �`e c'�+`` �?1�
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DATEt,� TIME
CITY OF ORONO CALLED IN ' I - �- �
INSPECTION NOTICE SCHEDULED J � �J -� :3c� Q �/�i.
PERMIT NO.���-iG I COMPLETED �^- k
ADDRESS '
OWNER CONTR.
TELEPHONE NO. ��� � �40 �
� DESCRIPTION 51M� ��vtc��
�
lL 01 FOOTING �11 fv1ECHANICAL RI 18 EXCAV/GRADING/FILLING
Qy�"FAAM-iiTG�i 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
�
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED C; PROJECTCOMPLETE
W C CORRECT WORK 8 PROCEED r' ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. _� pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance.473-7357
OwnerlContra o o ite:
Inspector.
White Copyllnspector' File Canary CopylSite Notice