HomeMy WebLinkAbout1994-006402 (building- util. shed) ER1�iII� ��,� _
CITY OF ORONO ` - PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: -``� `=`t'����`�""
Orono, Minnesota 55356-0815 '-"-_`:.`€'-`-=
(612) 473-7357 Date Issued: ;_;:�3:=;-�;;_:,:._:::
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� '� CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ }-� � f� Date Received:
�; Date Approved:
,,r.,,`,-�.
Entered By: ' . �,.
Permit�: �°�`�
AI�L INFORMATION MIIST BE SDBMITTSD IN FIILL BEFORE PLAN REVIEW WILL B$ STARTF•D
(See Check-off List Enclosed)
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THE A.PPLICANT IS: (circle one) OWNER or CONTRACTOR
Jos sz� �nx$ss: s� �7C- I ��.���,�, 1���-(' , 2���-�'/r�-�� �'iLT1 zzp: �5�� � 1 �
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(work)�� _�� ����.'
N� OF OWNER: �c�"< <'��-��'-�u�°2-��l�C! PHONE: (home)Lf 7� '���1.S-
�iAILING ADDRESS: ��� � C ��'r; � IL��' CITY: -� ,`�- � �� ZIP: c� 5 �I �
CONTR�C'I'OR: �-- '� PHONS: �- �
MATLING ADDRESS: —_._ _ CITY: _ . ZIP: .
STATS LICENSE: �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRSSS: CITY: ZIP:
Np,�: R.BGISZ�TION �
TYPE OF WORR: New� Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : '� ./-��+=f c- � ���-1' �a � /
STORIES: SQ. FEBT OF EACH FI�OOR:
NO. OF BSDROOMS: GARAGB STALLS: ATT. DET.
ESTSMATED CONSTRIICTION VALIIATION (eacluding land) : $
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
��at the work will be in accordance with the approved plan. -
1, �-^�Q �� ` �
'�PLICANT'S SIGNAZ'QRE: �`�1- 1C t`.�_ ,2ea��� DATE: f
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`fr5 CITY of ORONO
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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 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 license 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 i.ocal , 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 information may become publ.ic.
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 apFlicatian o�
permit.
� /J ��/L.C-d_�Q_-�—i
U-U�-�..� _`� -
First Middle Last
C �/ ��1��-C� ��� ' -
Address
��� Cp�- ��_ � l/j ' S5 ` �% �
City State Zip
� / � - � `7` � -�- _
Phone
I understand my rights as stated above.
.� `�0 „�-�'`��`��
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Signature
BUILDING&ZONING—473-7357 • ADM�IISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESS[NG '
ye► ' �
�.� �G� �g �gJgC1S OF DATA
Subdivision L TyPe of da�8- The righ section�viduals on whom the data is
stored or to be stored shall be as set forth in th�s An.individu8l esked to
Subd. 2. Information requi�d to be given in�vi�uel.
� 1 rivate or confidentiel data concernin a�8m�hin the collect ng state agency,
supp y p uested d
purpose and intended use of the re9 tem; (b) whether he ma� refuse or from his
political subdivision, or statewide sys �own consequence arising
the requested date; (�) anY �d (d) the identity of
required to supply 1 rivate or confidentiel data;
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�vla law en orcementuofficer.
pursuant to section 13.62, subdivision 5,
The commissioner of revenue ma lace the notice reauired under this
s
ubdivision in the individual income tax or ro ert tax re und instructions instead o
on those orms. � -— � .
Subd. 3. AccesS to �ata by
����y Upon request to a responsible
uthorit , an individuel shall be informed wh ublic pr'ivateeor confident al.e Upon his
e y ublic data on
individuels, and whether it is classified as p �
e to him and, if he desires, shall
further request, an individu e �t8 wit out eny chargtored private or
individuels shall be shown th of ihat data. After an individual hes been
�e informed of the content and mearung the data need not be �sclosed to
shown the priv�an��he�a�.fte°�e�o8 i�sPuteor�action pursuant to this section is
him for six m
• •n or additional data on the in��du� h�gteQor p blic dataruQonarequest by
, pendi g require the
responsible authority shall provide copies The responsible authority maY �in the
the individual subject of the �ta• certif n and comp g
requesting person to pay the actual costs of making, Yl g�
copies. immediately, if possible, with any request
The responsible authority shall comply I1��Q � not
ade ursuant to this subdivision, or within five �f Slmme�gtea comp the request,
m P and le al holidays,
excluding Saturdays, SundaYS g 1 with the
ossible. If he cannot comply with the request within i��ntw�ch toh omp y form t e
p have an additional �ve daYS
individual, and may S�� �d le al holidays.
request, excluding Saturdays, YS g
te or complete. An individugl maY
Subd. 4. Proce�u'e �►hen data is not eccura �mself. To
contest the accuracy or completeness of public or private �tthe�responsible authority
exercise this right, ar► individual shall notify in writing
escribin the nature of the disagreement. The r�po e ore nC�mQlete and at mpt to
d g
days either: (s) correct the data found to be inacc
notif ast recipients of inaccurate or incomplete de believesdthe datalto be correct
y P eement is
the individusl; or (b) notify the individual that
Data in dispute shall be disclosed only if the individusl's statement of �a� t to the
• included with the �isclosed data• be 8ppealed pursuan
' The determination of the responsible authority may
provisions �f the administrative procedure act relating to contested cases•
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
� � _ FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � l v � =�S� ��L PID:
D$SCRIPTION OF WORR: S l�L- �
------------------------------_-----6 4
------------------- ,p /� n �
ZONING REVIEW BY: d�n�o C`�n�--- DATE APPROVED 9 Y
BIIILDING REVIEW BY: DAT$ APPROVED: �l-�' �`��
---------------- --
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes—� No ✓ SEWER CONNECTION
STATE SURCAARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------
ZONING CHECR LIST , Zonin��istr ct: �-
�
Fire Department: �Po t O�'fic . �--�� S o i i�
Lot Area: Wi t . epth.
Survey Submitted: Yes�_ No Date of Survey: -7-�Z� 5 �-
Proposed Setbacks:
Front (Lake) : /t��/� Right Side: �C� �
Rear (Street) : S � Left Side: S�(
Adjacent Structures: I "Zo � Wetland: itl�`¢
BuiJ.ding Height: Def . Hgt. /v�/�- Peak Hgt. C� •/�
Avg. Setback: /��/4- Lot Coverage: t� •I�
Existing Proposed
Hardcover: 0-75 '
75-250 ' b. � .
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approva�:
Grading: Staff Approval ate: By. Co ncil Approval Date:
Septic: Staff ApprovaJ. Da e: BY=
Zoning File:# eso�ut' n #: Res lution Date:
REMARRS (in house) : �- ,
i
BQILDING REVIEW CHECR LIST , ,
�C: �'{�(, � CONSTRIICTION TYPE: �� -
Sq Footage $ Per Sq Ftg
Basement X ,
lst Floor X
2nd Floor X
Garage X =
�l�c,n � 9Z x �r. o � /,soo _-
TOTAL
$stimated Construction Value: $ /, 5 pdo-
Inspections Required: Work Requiring Separate Permi.ts:
Site � Plumbing Grading/Fil�ing
Footing Mechanical Fire
�Framing Septic Water Connection
InsuJ.ation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
D�Final (Mf g.) Other
Other Wel� (State Permit)
Electrical. (State Permit)
------------------------------------
REMARRS (IN HOIISE) :
---------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
By:
Access ApprovaJ.: Date ______________
------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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�. GENERAL �''$��`� �
q -b "�? �ERMI'1' NO. .�..�,..�•
Prior to begiruling construction, the area seRec�t`��;����f'or`������ation must be leveled
and cleared of obstructions. :� , � , ,,�-f.� 4�;���{-��;;;�;� ,aS ,,�:!���?
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I�C . .•� !��rC�J — �.I�R�CL� �t {���JUL1Yi. ..
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'" il �=� � � d: :r,�tstic�'�,,; ' .;�,� & �v�5i�€1 •
Separate all lumber, hardware, etc. into indiu�;�a,��stack� o�1i1�� i��s� � �,^��� ��, t' t ,
r 4 a ,t.,ia
3- F��'�ME FIGURE a.
PREPARATION °S"i� "
Unfold each frame, setting -
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aside two frames to be used as
Phone: GReenwood 3-8352A R L E I G H C. S M I T H ��
OR� 0 C
Registered Professional Engineer and Laad Surveyor
16215 Wayzata Boulevard Wapzala, Minnesofa
'�' P�AT o� suRVEY
OF PROPERTY OF <� '`�, �� : i J i'd •� � \}� I O T� I� `{ � 7 �P� -�
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'LDING C .F�rtTIFICATE OF SURVEY
, 19� I hereby c�.�tify that on J V �-Y �� , 19��
° the I surveyed the property described above and that
tt the above plat is a correct representation of said
i survey.
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ATE. TIME
CITY OF ORONO CALLED IN / �
INSPECTION NOTICE scHEou�E� / � �� -��
PERMIT N0. � 6 COMPLETED _�, j
ADDRESS�� �1 -��-�'Jr �.rc�
OWNER ' , c� CONTR.�
TELEPHONE NO. �?� - ��� J
� DESCRIPTION ��r,�
� 01 FOOTING 11 MECHANICAL R� 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TfiEE REMOVAL
Z 04 W D. 12 WATER HOOK-UP 17 SITE INSPECTION
e FINAL 14 SEWER HOOK-UO O6 PROGRESS
�
J 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBIN(3 FINAL 36 FOUNDATION REMOVAL
� OWNEH/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: �-�_v��h� �� ��,� :O��.¢��,�
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� C CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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OO ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARAANGE ACCESS.
Call for the next i spection 24 hours in advance.47�73 'rJT
OwnerlContr ct n si e:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN ) �'�
INSPECTION NOTICE , q SCHEDULED _G�� il_r ' ��
� � � �_
PERMIT NO. � COMPLETED �
ADDRES � `' �
� �
OWNER i CONTR. r,Qr�
TELEPHONE NO. '�� — �7 �� 5
� DESCRIPTION _,����—'
� FOOTING_ 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNd
y 02 FRAMING �j 13 MECHANICAL FINAL 19 LAI�SHOREMlETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q .
Z 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMQ—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
2
� 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES�O
� COMMENTS:
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d WORK SATISFACTORY:PROCEED -- PROJECT COMPLETE
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� - CORRECT WORK&PROCEED ;- ISSUE CERTIFICATE OF OCCUPANCY
W
O �l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlContra on t -
Inspector. �
White Copyllnspector's F le Canary CopylSite Notice