HomeMy WebLinkAbout1991-004069 - add/remodel . PERMIT
i ��`��Y OF ORONO PERMITTYPE: �:t�;t��_�tE�t;
, �35 Brown Rd. South • P.O. Box 66 Permit Number. �-:4��:-'_'`�
ystal Bay, Minnesota 55323 Date Issued: � �-���'-`%'-+�
�ti�2) 473-7357
SITE ADDRESS:
�:;i_, �,t,�lj,��� ;�� _
�_:;.�
� —7 �� "i 4_i i
�'' . � . i4 . i l:�—1 1 ,— __—�+.�'"�_ i
DESCRIPTION:
-.,:
;;[;r�,;�..�i�:�;y 1�:� �)��.����.
i=;!a 1 ���11l'� i'`t:'i'!fI 1�.� i�1:.`=.c. :_:�-'-i-'��,3}j!1"�C ti��_;IJr L
�i�f :; �t;'� �: � c. �?�.�..•f'•.
����1 1 �.!�)'' � �''.'. �� r` i I`1 - -
(1;�;�. i 1 t�C(,,{�'.=t1[��`{ — —
—' �-�t'�i
�.t��i'I_.L.j'L.,��i.j,iiii I vF�� .
� � � �
f
��r���k?','����a<��:� ��a. �,��. , �?�. :�� "
REMARKS:
L1! ! V� L!�`L T�L'
1 1 fjl71�4•L V1L{1UL -
FEE SUMMARY. 1+11J1t V1•L{ ��+� '
i t %f� (�Aj { T��V�1(
ti1;-tI__���i y�i_�i�� �i!_� .i_)(is_j vi �Let 11 i
7��i77ilitrJf}ik �
1i'J1t1VVVVV
�i+ t C�1 "'�
v 1 v� i .v.r
t=�t41F. �'�'`�: �� i I .�.l�-� ?r:�'�!fY'H�� n
�.� 1LLi'�V{/VV
I"��...� f�� , t i�. �
L`��til ntv��'�? �'% i}r�
�%� vi� J.vv
'_ y� �a�_�ii�} Ti i%v r'1�
�_�lsf�`(._il��''�� _.—_'__��.�_... , _ 1_!illftl�• 1L 1lV�V
'#�'_7;� i f'j I:L':•�i'u3_i'U"ie• virfi
�ij'f.ct 1 �'�'-�"'' - • - t���•Lit � t e��{�n �uv
ed-%iVft��ii i•/�r'��? �iii Ti?+9t
1tii�fY!-V UYVd 11V1 !17 •iv'
�I:'��:�1
CONTRACTOR: OWNER: -- ��.�'� �`L{'T'; +_
s�i;��ii•i ��i���,�+��zL
.�._;i:; ��fi�_��:{i+! Fiij _.
, �;:;°�i 1
�1Ei+_�:�1{�; �1s i
i},�`-� —=:i it_�
_ . _ ._ --- —___ __�
.. . ,: �=;.-:t'-.!_,�? `j.i:i i# t._ T� . _.. .. r'•tV r _ -;;,i_f:�i �;i i t�ft-i(�:,� s��'�ii. �1_. `-ts._ ... . . —u. .�_.__.._...____..
r
..,.� �:— :-�: ! i- _a___ _ ..',,a _ _ . a 1 i �t����`
�J3tids.li.'_C'l:3 i�::i'a�"�t.1 fl:._clt_��i �l i, i i. t �' _ _ _ . . _ 4 t Y��[ [ e�f
�i�i�W.. ' - .. r... .,. «. .r ' . ._"�3 . 5•C"' L!� f.f` f;�{_i_ t;i ! 7 �..)ty
` i i:-;r:. T i�.}. -, i r•,1.1 I L•[_.Fi'i�'�_ i F�4t'+��.:C_ .
� _ . _ -.� ..__. :_. e r,r�i-:= i ��� L,�i�i l-���_� ''�'_ . _. - r -r-:, - •� _ .
' � .� 's_i�ii r-,�t;�' f".!
'+s'�E `• I" _�_ .� �tr- -.3�=��;N, =i �TS_�1Li`ilt;:3 _t.?.+�_, i'1:�:��;_� i }�,�_� �._{ {'�
� `__'i 1`^E;'�i- 3_I _ :.. . ..._ . (' .,I.} �� i T'1 f f. '_�� !�1 I,�`�1 ii,:,•_•_: � 4_:•- _ �
t�;-�i!°.:;.
___ _ ___ _—_ _ _-�-- -- ---- _�_ ---___ _ _
Ar'r��C��NT�PERt '�� �F�IGNATURE ISSGED BY�SIGNATURE ���jt�✓�
' � CITY OF ORONO - BIIILDING PERMIT APPLICATION
'a'�t�i ��� ; 5 � C�� • ��? `� Date Received :
�`� T_L T___. ____-l -
� � ✓Q l..0 c:UU1 V V C:.i.
�nt�.red By: `t
� Permit�: �Q(��i
=.L.L I*�FORMATIO*7 MIIST BE SIIBMITTED IN FIIZL BEFORE PLAN REVI�T WZL�L B$ STARTED
(See Check-off List Enclosed )
--------------------------------------------------------------------------------
`�'HE APPLICANT IS: (circle one ) OWNER or CONTRACTOR
.;OB S ITE ADDRSSS: '�3���� , �I�Zt;')'l l�"� Z IP: ,�3�f�
(work) 3-��-1�<�S
T�iA1KE OF OWNER: .G�L11�✓G�t 1`6�1�h� �r�ti� PHoxE: (home) �7,�`�,��
P�.AII,ING ADDRESS: 4-�I: �j . I >�'�� P'CL\ CITY: L��7v1�c� ZIP: � �'l,�j �
CONTRACTOR: — PHONE:
:�SAILING ADDRESS : — CITY: - ZIP: —
'�YPE OF WORR: New Addition Accessory Structure Move
Demo Remod�/Alteration Renovate Land Alteration
P�OPOSED WORR (describe in detail) s �1G�(1� �-L�i)V'��C I�-l) SG� � '� �'kl�l�. �k(:P� W��
,
�,� h� t1;h lC�FC�'YI L� �`�iG�{'S L T u�C� bZ.l�1l!�ti �\lLU(; l�r4 Yb.'C� n�cf,l.1 �TC�`!�U�4'X'.�'-4� �"L r��1� �V11��4�+'l�l.t/V��L�.,
, _
STORIES: Z� SQ. FEET OF EACH FLOOR: ( ��-(,�(,j �
;.7. O� �$^itL'OMS:�_ GAP.P,GE STALI,S: ATT. Z� DET. — .
ESTIl�lATED CONSTRDCTION VALIIATION (excludinq land) : $ 1� IU��GO _
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 wil 1 be in accordance with the approved plan.
�PPZ�ICANT'S SIGNATDR.E: ��`�)I �)Uc..t-z/VV�- DATE: I l,''�� .!�
1
� ' -awe�
. �ssur�,.v-=�
` �.�..�.�+�i�'c�_.. 3
• _i��si-!,' . jI��'"��
:...��31���4V�a.Pt.<4
ya�! �Y
` �����.� ��r�, � ��, ���1\ �
�^4"�"y�'��J Post Office Box 66•Crystai Bay, Niinnesota 55323•iYlurucipal CiiTices
•
�_:�- � '• �n the North Shore of Lake Mirnetonka
�— 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 or
license.
a. If your reauested pe�-mit or Iicense requires Council actio*�
to approve, some information may become public.
5. You have certain rights under ri:5. 13.04 to review prica��
data on yourseif.
6. Your fuly aa::e is r��7�i�e� '�^ P'-'��A�S tnis applicaLion or
permit.
�ri�t�� l-��lm �`��.�m _
, .� ��4 .�}1 a T<d S i
L'1 1 J l.
!�•�t; .'S ���ZG�'1 �C%�
Address
�,�'l� - i�? �''I!'� ���1
City State Zip
�7 3- ����ti�
Phone
I understand my rights as stated above.
'�
ZG� /�����'n-�
Signature
BUILDING&ZONING -473-7357 • ADM[NISTRATION&FINANCE -473-7358 • PUBLIC WORKS -473-7359
ASSESSIN G
. .
r� iT3
r13,44 RIGH'T5 OF �'iB•��.i�j� :'r :"'.�
, �pe of data- The rights of individuals on �ri cm t?�e da`fi i'
Subdivision ..
stored or to be stored shell be as set forth in this section. An.individual esked to
Subd. 2. Information required
to be given indivi�usL
� ivate or confidentiel aata concerning �mWi�in the collecting state agen Y�
supply pr uested data
purpase and intended use of the req from his
or statewide system; (b) whether he may refuse or is leg Y
political subdivision, }�own conset�uence arising
required to supply the requested date; (�) anY �d (d) the identity of
supplying or refusing to supply private or confidential data;
ons or entities authorized by state or federal law to rice�vest gat ve data,
other pen 1 when en individual is asked to supp y
requirement shall not avp Y to a law enforcement officer.
pursuant to section 13.82, subdivision �,
The
commissioner of revenue mav place tgX re°und i�tau�te�ns�n�teadhos
subdivision in the individugl income tax or pro�ertv
on those orms. - -
Subd. 3. Access to �ata by
����. Upon request to a responsible
an individuel shall be informed whet�c h r vateeor confide t�e Up°n �
ndividuels, end whether ;t ;s classified as pub , P 4 ublic data on
Q ta �im and, if he desires, shall
further request, an indinc�u�l �La wit�out any chargtored priva�e °a been
individuels sfiall be shown th� of that data. After an indi��u� �
�e informed of the content and mea�ng the data need not be disclosed Lo
S�own the private c'.ata ar:d �nfarmQd of its u�Q o�BCtion pursuant to this section is
him for six months thereafter unless a �SP uDuc �ata u�n "��`�est by
" or additionat �°:s on the individua1 h�s gt�or P llected or created. T �
, pending � ro�de cflpies of the pri refl�re the
res�onsible authority shall p � T�;o responsible authority�mC Y��m�i�i15 tho
the indivi�ual sub;s^-t of tne ��a• c�rt;fying,
requesting person to pay the actual costs of making,
copies.
' y if ssible, with any request
ihe respo�sib?� ���*-h�rity shall comoly immediates O1 the date of thA request,
ursuant to this subdivisiort, or withia five day
ma�e p �nri�4� �d 1Q�� holidsys, if immediate compliancs is not
excluding Saturda}�s, S�•--.
• e, If he cannot comply With the reauest WI�I withintwhich to�cor.iP1Y K h tr`
possibl
individual, and msy have an additio� i�� holidays.
request, excluding Saturda��s, Sund�Ys g lete. An individual maY
Subd. 4. Proced�e when data is not accs�ate or c+omP �mself. To
� or completeness of public or private data concerning
contest the accuracY in writing the respcnsible authority
exercise this r�g�t� � lnd�v�du81 e��n� tThe responsible euthority shall within 30
describing the nature of the disagr lete and attempt to
days either: (a) correct the data found to be inaccurate or incflmPeci ients named by
notify past recipients of inacc�het n�V a�P�t heg belie esdthe data to be correct.
the individuel+ or (b) notify eement is
Data in dispute shall be ciisclosed only if the individuel's statement of disagi'
• included with the disclosed �tg• �ible authority may be 8PPe8�e� P�u�t to the
' The determination of the respo tp contested cases•
provisions of the administrative proc�dure act relating
� rsr.-^�+� ��a ��.+..� +'.�f�D TL`L'TT�l�Tf�r^ f�T,� Tit�T,��TT�
' L.IIL�V1� Vl'1' L1Ui 1'Va� ivuvc�a��,,.� v� � 1�
, FOP, OFFIC� USE ONLY
�D�ss oR �c�: ���1 S ��l'�C�ti� � ���: 0 3 -i�7 -a3 -- �.z - o �//
;yS������r.� ^� ;+7n��_ �-�y��-- `�-c.i.b /���� a�iTiO V�
------------------- ---------- ----------------_-------------------------
ZONING REVIEW BY: �j_�, DATE APPROVED. �/-/�-� /
BQILDING REVIEW BY: �D . � DATE APPROVED: ���IBqI
FEES TO BE CHARGSD: Misc. Fees Calculated By:
PERMIT Yes l� 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 Zoning District: ��-��
Fire Department: Post Office: School District:
�
Lot Area: Width: �� � Depth: 4�0
Survey Submitted: Yes� No Date of Survey: � g4 _
Proposed Setbac?cs : r
Front (Lake } ; N� Right Side : ��
Rear (�t� : � 7S/ Left Side: ' ,nJA-
Adjacent Structures : wetiand:
Building Heignt: Dei. iigt. �c'' 9�•
Avg. Setback: Lot Coverage:
Existi Froposed
vardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File• # Resolution �: Resolution Date:
REMARKS (in house) :
$IJTT_T)T?3f_ R�JT�l f'??F.CC� T.TS'T' � ' .
1
uBcs�-I Sf3 coxsTxxrlcTzo� 1`��- � --
Sq Footage $ Per Sq Ftg
.^.acamont Y =
lct Flnpr X =
2nd Floor X =
Garage Y -
x =
TOTAL
Sstimated Construction value: $ �Q,ODC�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well (State Permit
Other Electrical (State Permit)
gxMARxS (IN HOOS$) :
-------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
ticcess i:pprovai: Date �Y�
-----------------------------------------------------------------------------
R��iARXS (TO BE �dOT� OI7 PERMIT) :
� � , ORONO
COPY
Certi`i�ate oi Sur�ey
fcr E:'i:ce Eren Hor�es
of :,�t ?., Alocx 1, Stron�hold ` � ' ? �` ' �
� y .3.� w� � J'!:�
uer.r.epir. Cou^ty, Mir.nescta ' '. `_-�,.' , �._ ���i�
._ f � J
a� ��'�' r� ��+�� _. .�;�
- .. 1 • �. n
N89°5816�W
--1 �- --o� - 38t.4i- - - - - y - - -\ �\- �
� � t
5 � I g -��y. . 7j 4 , �
�i � � � ;:i',3 �\ \z
Me J}�:,o � v
` ��
.o I 5 �� � Y `�'w�
� � \
N I � IQ�( ��,.��>:, \
�
� m I ,t.��`'' �R_a - � _
� N I 2 h z.�J� � �
- .�� ,
�I I ' �J � � �
1 S \
ol � N
Z � � Qra�e�a9t � �Q
..� ��,I,ty CaSemenis � \ . .
I �„� \\�
I , Q
n tD \ ��
�vi � �� oc n
o N 0�
I j ' �-�' {90.59 � � o�y�y �o
� ' G ,/ R:Ii0.00 \ �y.�N p.
I � p:84° � d: m�0 h
\�3g2�
�
/ ,' ,�, �3j N 89'S5_57 E 175.68�
L� ����0
,�, ..� �� B i
�` OUTLOT �
O �� l i_..'.. , , . r„ I
M �
I hereby certify tt-�t this is a true and correct recresentation
of a stirvey of tt�.e boundaries of ;.,ot 2, Rloc� 1, Strcn�holc , the
location of all existin� build�ngs, if ar.y, thereor., and the
pro�sed lc�ati^•r. of fl oroposed buildir_�;. It coes not purpert
te �now' oLher i:;.provemer.ts cr er.c^each�er.ts.
GORD()N R. COFFIIi CO, , INC.
�?��,.����
Scale: 1" = 1C:C' ��Gordon P.. Coffin Reg. '^ 4
Ua te : 4-1C-84 Mark S. Gronberg Re F. ;Jc .12755
o . Iror. ;rarker Land 5urveyors and Planners
;,ong Laice, Minnesota
�1�,��
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC �., SCHEDULED
PERMIT N0. � COMPLETED
,
ADDRESS
OWNER � �'7 � G��n�CONTR.
TELEPHONE NO.
.
� DESCRIPTION �� ' �✓ -G�
�
Ly 01 FOOTING 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
Z 0 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINA 14 SEWER HOOK-UP 06 PROGRESS
� MO-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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
fl COMMENTS:
�
w
a
x
�
0
a
�
0
�
W
�
Q
�
z
W
�
W
�
�
d ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
W
� ❑ CORRECT WORK R PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContra or o e:
inspector.
White Copyllnspectors File Canary Copy/Site Notice