HomeMy WebLinkAbout1990-002817 - kitchen remodel �ERMI'� ,
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i5 Brown Rd. South • P.O. Box 66 ��t��'�}=��`j=r�3�-
i Permit Number: t:ii i;�:=;1 r
�stal Bay, Minnesota 55323 Date Issued:
(612) 473-7357 `-:�'''�-�`f`_'``
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATUFE
� 4, ` CITY OF ORONO - BOILDING PERMIT APPLZCATION
Total Fee : $ Date Received: �7 � G1�
Date Approved: `�'��J-���
Entered By: � '
Permit#: �� �`
AT•T• INFORMATION MDST BE SIIBMITTED IN FTJLL BEFORE PLAN REVIE'W WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLIGANT IS: (circle one ) OWNER or C NTRAC OR
JOB SITE ADDRESS: ��S�/ CC��a-- � ZIP: tiS`�5��� I
(work)
NAME OF OWNER: �f U �`� 7`u Lc q� PHONE: (home) �����"� `�7 7
MAILING ADDRESS: ����( �ic,SC U �� CITY: Q ��nU ZIP: `�-���'� r
CONTRACTOR: �� ��` ��'�r � C� PHONE: � 7 � —��3 �-
MAILING ADDRESS : �!1 C!C' j� �s-C �i'" CITY: s �-i �- a �/� ZIP:{�'����
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remode�/Alteration_� Renovate Land Alteration
PROPOSED WORR (describe in detail) : �c�TG/-� �� ��uG`'`�� �"`
c�.h,` ,. .�'�s f„� � � ; �
STORIES: "� SQ. FEET OF EACH FLOOR: �..
NO. OF BEDROOMS: � GARAGE STALLS: ATT. � DET.
�
ESTIMATED CONSTRUCTION VALIIATION (egcluding land) : $�d d��
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 will be in accordance with the approved plan.
APPLICANT'S SIGNATQRE: '� DATE: �'J U
. r
� z��ii�*
i���•. ry
-V��' �` � � CITY of ORONO
�. ..�-�.
;- � �:� �}
:�y� � �'��4:i Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
W'�� � .
� - � � On the North Shore of Lake Minnetonka
DATA PRNACY 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 wi31 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 Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review privatE
data on yourself. -
6. Your full name is required to process this application or
permit.
�-Q r I r e � c, ,-� « ���r L
First Middle Last
$ Y 5— � (
Address
W cc E� d.�v r..o � S3—3 1
City State Zip
� � y �� � �
Phone
I under and my rig s as stated above.
;�G
Signat /
BUILDING&ZON[NG—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
S13.04 RIGH'!'S OF SIIBJECTS OF DATA
Subdivision 1. Type of data- The rights of individusls on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information �
d to be given in�v��' An.individuel asked to
� su 1 private or confidential data concernina �amW hin the collecti g state agency,
PP Y uested
purpose and intended use of the req tem; (b) whether he ma� refuse or lfrom hlis
political subdivision, or statewide sys �c� any �own consequence arising
required to supply the requested dat8;
su plying or refusing to supply private or confidential data; and (d) the identity o
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�via law enforesment offlcer.
pursuant to section 13.62, subdivision �,
The commissioner of revenue ma le�t tgX re°una instQuctionsunsteadhos
subdivision in the individual income tax or pr�� V
on those orms. . -- .
Subd. 3.
Access to �ata bY i����' Upon request to a responsible
authority, an individual shall be informed�he buc'hpr vateeor confident al.e Upon his
individuels, and whether it is classified p ublic data on
e to him and, if he desires, shell
further request, an individusl who is the subject of stored private orvidual hes been
individuals shall be shown the date witho ofan�y ��tg. After an indi
�e informed of the content end meaning the data need not be disclosed to
shown the private data end informed of its meaning, uMuant to this section is
him for six months thereafter unless a dispute or action p
� endin or additional data on� the individu8l h� a eeor Public datarupon request by
� p g• require the
responsible authority shall provide copies The hresponsible authority maY �in the
the individual subject of the dats• certif n and comp g
the actual costs of making, Yi g�
requesting person to pay -
copies. ssible, with any request
The responsible authority shall comQly immediately, if po
made pursuant to this subdivision, or Wlt� lida e �f Simmediateatcompliance ei�.su not
excluding Saturdays, Sundays and legal ho ys�
ossible. If he cannot comply with the request �thin that time, he shall so in�orth the
P hsve an additional five ys witiun which to comply
individuel, and maY �d le el holidays•
request, excluding Saturdays, SundaYs g
Subd. 4. Proced�u'e �►hen data is not eccurate or complete. An individuel may
himself. To
contest the accuracy or completeness of public or private �tthe�responslble authority
exercise this right, an individual shall notify in writing
describing the nature of the disagreement. Th a�r�P�e 1�bCe n ompleL and att pt to
days either: (a) correct the data f ound to be in
notify past recipients of inaccurate or incompha ehe bel evesdthe dataito be correct
the individual; or (b) notify the individual t � eement is
Data in dispute shall be disclosed only if the individual s statement of disagi'
• included with the disclosed data• be aQpealed pui'suant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
' „ CHECX OFF LIST FOR ISSIIANC? OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEG�L DESC�IPTION: �tv� ( ��� �r /�-�� -
PID: 2 C�- ��� • 2 3 2 � QQ"� a"�-
DESCRIPTIQN OF WORR: ��'UTZ'� !Q�.. �N L� -- � l� C�'�'�' l ��I�E."I,,..
---- ---------------------------_-`J-----------------------
-----------------=�,..J��
ZONING R$VIEW BY: DATS APPROVED� / � ��
BIIILDING REVIEW BY: .DATS APPROVED: Q
pERMIT ISSU$D BY: DATE:
------------------------------------------------------------- �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �lI No SEWER UNIT $
�
�
PLAN REVIEW � Yes No SEWER CONNECTION
STATE SJRCHARGE Yes J No WATER CONNECTION ��
PENALTY Yes No PARK FEE
SAC Yes No SITE INSPECTION
OTHER (specify)
---------------------------------------�
ZONING CHECR LIST Zoning District: � �'. '� ` �--
� ��r �d School District: 1"� '�'��`�f-
Fire Department:f��C}'�4..I� Post Office:���
/� ►
Lot Area:�2 r d'c�Q ;-�. :� Width: �-D� � Depth: ��O �
Survey Submitted: Yes No� Date of Survey:�' / /U�T ��`�� � �
��-
Proposed Setbacks :
F � t" � "+
Front (Lake) : � � ��i�gTit`' Side: ''� ���'���
� ' ; .�.�'' ' ; '
Rear (Street) : `"} �" `�� Left Side: %
Adjacent Structures : _ _ _ Wetland: -
Existing � Proposed
Hardc�ver: 0-75 ' �(/���/�
� .� .. ' C_
' � a v
75-250 ' �, �_..� �'�:._."''�' � �
Hardcover Variance Required: Yes Nv � Date of Council Approval:
.,..,.__ __._
Grading: Staf f Approval Date: --�-"""�"'"` BY= Council Approval Date:
�.
Septi�: Staff Approval Date: �• BY= �
Zoning File- # Resolution # : Resolution Date:
REM�RRS (in house) :
. ---- - _. .
.----._..
BIIILDING REVIEW CHECR LIST
IIgC: �Z_� 8� CONSTRQCTION TYPE:��I
BLDG SIZE: H. L. W.
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor X -
Garage X -
X -
TOTAL
Estimated Construction Value: $ ��, ��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing � Grading/Filling
Footing Mechanical Fire
�Framing Well Water Connection
Insulation Septic Sewer Connection
�Fall Board Fireplace Other
inal (Masonry)
Other (Manufactured)
�_F.MARTCS (IN HOIISE) :
------------------------------------------------------
R$VIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
7 -
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED 23 d /�=UO
PERMIT NO. COMPL�� � �
ADDRESS o��OS�G C�t,SGv •
OWNER CONTR.
TELEPHONE NO.
C FOOTING C PLUMBING RI ❑ FIRE PREV.
� j�FRAMING ❑ PLUMBING FINAL ❑ FIRE SUPRESSION SYS.
t�y C INSULATION C MECHANICALRI ❑ EXCAVIGRADINGIFILLING
� ❑WALL BD. iJ MECHANICAL FINAL � LAKESHOflENVETLANDS
� ❑ FINAL ❑ FIREPLACE/WOOD BURNER ❑TREE REMOVAL
Q ❑ DEMO—SITE J'WATER HOOK-UP ❑ KENNEL UCENSE
� C DEMO—FINAL G METER SETITURN ON ❑SITE INSPECTION
� G SEWER HOOK-UP ❑ PROGRESS
= C� SEPTIC MAINT. ❑COMPLAINT
J G SEPTIC INSTALL. ❑ FOLLOW-UP
Z ❑ SEPTIC FINAL
O ❑ SITE WELL
� ❑WELLTESTPUMP
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
�
WO �- CORRECT WORK&PROCEED ❑ CITATION ISSUED
Q C CORRECT WORK,CALL FOR REINSPECTION G ISSUE CERTIFICATE OF OCCUPANCY
V BEFORECOVERING TEMPORARY
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. PERMANENT
INSPECTOR WILL RETURN
Cl STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrac site:
Inspector.
White Copyllnspecto's File Canary Copy/Site Notice
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