HomeMy WebLinkAbout1992-004528 (building-kitchen remodel) : ., �'ERMIT
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1335 Brown Rd. South • P.O. Box 66 ��ls�I ���,���'
Permit Number: t at;c�._���_.
Crystal Bay, Minnesota 55323 Date Issued: i_7:..'�:=:1,/'�;�
(612) 473-7357
SITE ADDRESS:
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APPI_ICANT PFfiMITEE GNATUHE ISSUED BY:SIGNATURE u�-2'�.�
� — --
� CITY OF ORONO - BIIILDZNG PER�LZT A.PPLICATION
Total r ee: $ �/, g� Date P.eceived: ,�,<<��'L
Date P.Dvroved :
�ntered By: � �
�` �� Permitv: �/`�?Y
ALL INFORMATION MIIST Bg SIIBMIZTED IN FIII�L BEFORE PI.AN REVIEW WILL B$ STARTED
(See Check-cff List Encl
THE APPLICANT IS: (circle one) OAINER CONT_RACTO
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1
JOB SITE ADDRBSS: �I �� 2�'�' ���G� _ ZIP: s � � C/-� �-
(work)
N� OF OWNER:_;�r i,�' ��;r yL,�, N PHONE: (home)��/-��-��''� �
_x_nTLING ADDRESS: ���; �F�,�C�'U C�ri��`[�� _ CITY: �...�D4�vt ZIP: �,�j �( �-�
CONTRACTOR: � , r/'-�s�2--- C..�� „�,� ! ���/�:_ 6 � PHONS��C' +� �J ��/
MAII,ING ADDRESS: ���r�S ��-�-c.7,�-�fi..�i� CITY:�/�-J1i'��,�'}��_.j,� ZIP: S S a� ��►
� STATE LICENSE: $ �CSQ. ; �?S ��
ARCHITECT/ENGINEEFZ2: PHONE:
MAIZING ADDRBSS: CITY: ZIP:
N�ME: R.BGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
,
PROPoSF.D WORK (describe i.n detail) : ������% ����',.d�-C
STORIES:� SQ. FEBT OF EACH FLOOR:
NO. OF BEDROOMS: GARAGB ST1�LI�S: ATT. DET.
�'v
ESTIHATED CONSTRIICTION 4ALIIATIOA (eaclnding Iand) : $ � �� ���� �
i
I hereby appl.y 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 will be in accordance he approved plan.
� .�
APPLICANT'S SIGNATDRE: ��' DATE: ����'�����
D����h ►�' l'���,i-
- � CHECR OFF LIST FOR ISSIIANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 31�5 C�,4SC,J pID=
D$SCRIPTION OF WORR: k�T'CHGN Q,�-�vt.o�p�Z
-------------------------n-----------------------------------------------------
ZONING REVIEW BY: ('��� (�r--- DATE APPROVffi�: �-3l)-�(Z
BIIILDING REVIEW BY: DATB APPROVF.D: "1-3v��i Z'
FEES TO BE GHARGED: Misc. Fees Calculated By:
PERMIT Yes� No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No � PARR FEE
SAC � Yes No � SITE INSPECTION
Number of SAC Units OTHER (specify)
----------------------------------------------------------------
ZONING CHECR LIST Zoning Di trict:
Fire Department: Post Office: Schoo istrict:
Lot Area: Width: Depth:
Survey Submitted: Y s No Date o S rvey:
Proposed Setbacks:
Front (Lake) : Righ Si e:
Rear (Street) - Left Si e:
Adjacent Stru tures: Wetland
Bui].ding Height: Def. Hg . Peak Hgt.
Avg. Setback:
� L t Covera e: I
Exist'ng Propose
Hardcover: 0-75 ' I
75-250
250-500 '
500-100 '
Hardcover Var'ance Require : es No Date of Counci Approval:
Grading: Staf Approval. Da e: B : Council A proval Date:
Septic: Staf Approval Dat : BY=
Zoning File: Re oluti n #: Resoluti n Date:
REMARRS (i honse) : ,
BIIILDING REVIEW CHECR LIST ' �.
IIgC: $� � -3 CONSTRIICTION TYPE: �--
Sq Footage $ Per Sq Ftg
Basement X =
lst Floor X -
2nd Floor X =
Garage X -
x =
TOTAL
Estimated Construction Value: $ Zgs,00a e° _
Inspections Required: Work Requiring Separate Permits:
Site � �Plumbing Grading/Fi��ing
Footing Mechanical Fire
�_Framing Septic Water Connection
�Insu�ation Fireplace Sewer Connection
_�Wall. Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Well (State Permit)
�_Electrical. (State Permit)
-----------------------------------------------------------------------
REMARRS (IN HOIISE) :
-----------------------------------------------------------------------
REVIEW BY OTHL�2S: DATE:
Access: Existing New
Access Approval: Date BY=
------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
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Post Office Box 66•Crystal Bay,Minnesota a�323•Municipal Offices
•
s ' s s 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 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
Iicense.
4. If your requested permit or Iicense requires Councii action
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 application or
permit.
� l � � � �'�,�
First Middle Last
�S r� 5 �� � �✓�� ��
Address �
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1��1� �/f f�Z I�- l� J S -� � �'
City State Zip
G��_ G��7
,�
Phone
I understand my r' ts as stated above.
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BUILDING&ZONING—473-7357 • ADbtIlVISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSItiG
�,3.04 RIGHTS OF SIIBJBCTS �F DATA
gubdivision L Tppe of dat�- The rights of individu8ls on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. Z. Infor�8�on �d t� be ��� ��vi�uaL An.individual asked to
� supply private or confidential data concera a amwithin the collect ng state age�,
purpose and intended use of the requeste
political subdivision, or statewide system; (b) whether he ma� refuse or is legally
required to supply the requested date; o��c nf det al data;e9andc�d)�thenident ty of
supplying or refusing to supply private
other persons or entities authorized bndi idual iseeskedlto supplyein estigat ve da a
requirement shall not apply when an
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue o�property tax reound instr�uctions insteadhos
subdivision in the individual income tax
on those orms. . - -- -
Subd. 3. Access to �ata bY in���' Upon request to a responsible �
authority, an individual shall be informed whether h��gteeor confidentialre Upon his
individuals, and whether it is clessified as public, p ublic data on
further request, an individual who is the subjecc��e to himrlande if he desires, shall
individuels shall be shown the data witho of�hat data. After an individual has been
6e informed of the content and meaning t� �ta need not be disclosed to
shown the private data and informed of its meaning, u�uant to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the indi of the hri ate or public dataruQongrequest by
responsible authority shall provide copies P require the
the individuel subject of the data. The responsibl cert f �nityar►d compiling the
requesting person to pay the actual costs of making, Yi g�
copies. irnmediately, if possible, with any request
The responsible authority shall comply of the date of the request,
made pursuant to this subdivision, or within five days
excluding Saturdays, Sundays and legal holidsys, if immediate compliance is not
possible. If he cannot comply with the request within that time, he shall so in�orth the
individuel, and maY have sn additional five da}'s �++iithin which to comply
request, excluding Saturdeys, SundaYs and legal holidays.
Subd. 4. Proced�e �►hen data is not acciu'ate or complete. An individual mgY
contest the accuracy or completeness of public or private data concerning himself. To
exercise Lhis right, an indivi�u81 shall notify in writing the responsible authority
describing the nature of the disagreem to beTnaccura e oren omplete and att pt to
days either. (e) correct the data found
notify past recipients of inaccurate or inc�olmp�t rie t�ie esthe datalto be cor ect
the individuel, or (b) notify the individ eement �.s
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the disclosed data. ealed ursug�t to the
' The determination of the responsible authority may be aPP P
provisions of the administrative procedure act relating to contested cases.
DAT TI M E
CITY OF ORONO CALLED IN 8 i z
INSPECTION NOTICE SCHEDULED � � z— '3 " �
PERMIT NO. connP�ErEo �/ _�
ADDRESS � S
OWNER CONTR.�r�(=�� �
TELEPHONE NO. �3�'� 7�� _
� DESCRIPTION ���J
tti 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
� 02 FRAMI 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
h
3 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
W 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 10 PLUMBING FINAL 23 SEPTIC FINAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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d WORK SATISFACTORY:PROCEED f_� PROJECT COMPLETE
W
W ❑CORRECT WORK&PROCEED f-] ISSUE CERTIFICATE OF OCCUPANCY
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ` pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOPORDER POSTED.CALL INSPECTOR �- CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
I
OwnerlCon o qn site:
i
Inspector. -
White Copyllnspector's File Canary CopylSite Notice
DATJ� TIME
CITY OF ORONO CALLED IN �/l'Z I�1-'
INSPECTION NOTICE SCHEDULED �'/i �/5 � �t ' �Q
PERMIT NO. '�_`7�� COMPLETED � �_
ADDRESS /9 i �'-l� ��. -
OWNER ':��= __ CONTR. G�%i2J
TELEPHONE NO. ��L�/l�'� _
� DESCRIPTION /�'��z-�-z�n� -'��������
ly� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
� 02 FRAMING 11 MECHANICAL F�NAL 18 EXCAVIGRADINGIFILLING
�
031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL� 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTA�L. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC F�NAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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W
� ❑ CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
Owner/Co o te:
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice
��
CITY OF ORONO CALLED IN �_�AT� /C,TG�� Q�`'
INSPECTION NOTIC�/ .-� scHEou�Eo " -`�'�-- �/1�-�'���n'
PERMIT NO. J��� � � COMPLETED � �
�, � .
ADDRESS��I� �� z�x� ��' L�'�
OWNER r`-% �`�'� _CONTR. I1�-�1-g2.' ��-��
�� � � �
TELEPHONE NO. �•-� � � � �
� DESCRIPTION
l� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
`02FRAMING 11 MECHANICALFINAL 18EXCAV/GRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q OS FINAI 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 D %`'��' 27 SEPTIC MAINT. 21 COMPLAINT
9 PLUMBING RI ��, 15 SEPTIC INSTALL 22 FOLLOW-UP
= 10 PLU AL 23 SEPTIC FINAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMM S:
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d J�WORK SATISFACTORY:PROCEED [-1 PROJECT COMPLETE
� �❑ CORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
O C� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlC ra or o ite:
Inspector. � �
White Copyllnspector's File Canary CopylSite Notice
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11 NOT APPROVED — All work Shall be ON
These comments a for your intormat!P41� ��z & zoning codO NO
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11 NOT APPROVED — All work Shall be ON
These comments a for your intormat!P41� ��z & zoning codO NO
1� cab�* builo
in full compliance with apo'Odfjc�jjy noted in this (eViffW
5 including items not 9P T
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