HomeMy WebLinkAbout1994-006498 - replace existing . PERMIT
'CITY OF ORONO PERMIT TYPE: _
' 2750 Kelley Parkway- P.O. Box 66 `����=-�-���'Y�-�
Crystal Bay, Minnesota 55323 Permit Number: ;�.�;�;;._;.;,�_.�,,;
(612) 473-7357 Date Issued: � �;,_; _ �,:,
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: -� F��°G°�E �� =� ��=� - OWNER:
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� APPLICANT%PERMITEE SIGNATURE iSSUED BY:SIGNATURE
� ' CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $
�� ��• �� � Date Received: /`a� �� ��
Date Approved:
Entered By:
Permittt: C �
AI,L INFORMATION MIIST BS SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) �6dNER or CONTRACTOR
�
JOB SITE ADDRBSS: � �I C;(_% �,�`.j�'��� I�i � h�. ZIP: ��'���.��1 �
(work) `�:3� �%_�`i�
NAI� OF OWNER- 1�/a ti �` l I/L i!�� ��t� `i� ,� �y PHONE: (home) �`7/ - �� .3 Z�
MAILING ADDRESS: � �J�C� ( ���'p �I R �> _ CITY:� ;��'�it�C ZIP: -`"� �<��ll
CONTRACTOR: /Yi � /�t � ��t����Gti PHONE: �-I�j�I-��3�'
MAILING ADDRESS: �f�y(G:> G`. I�c��l. � (�l� l l�lt �� CITY: �'��� �f��1�1� ZIP: `J_����
STATE LICENSE: �
_ � � s .
ARCHITECT/ENGINEER: /�i r�� f�l� I.> /; 1�`-`:l 1� ��1�1 PHONE: E_ �I� - '%�I� �, -
MAII,ING ADDRESS: CITY: �C�7��"�tC'c�7 f-f ZIP:
NAME: ���TZl�'/"�/�� r�E�`� l l� (i>>�. REGISTRATION # 7Z_� �'�
TYPE OF WORR: New Addition Accessory Structure riove
Demo Remodel/Alteration Renovate Land Alteration
--� . _
PROPOSED WORK (describe in detail) : ` , L:� � �' �,) i/ZC , %. ' • 2 ft ' ' � �
_ � ,J �.
C t: �: %
,
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF BSDROOMS: GARAGE STALI,S: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding Iand) : $ �, ��(�(.,�
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.
� ? DATE: � -Z� -� 7
APPLICANT'S SIf�NATQRE: C�_ i <' !I�; / l(�r�;t� � �
�
, � CHECR OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRBSS OR LEGAL: � ���� ���"%° /�"C`�r.� �C d PID: �O-�/ 7 � a 3 � Y �`���
DESCRIPTION OF WORR: j � , l;(�''T .�� �'`�-�-,cLC C�1" �>�z�i�v� _
---------------------------------- ----------
----------------------------------
ZONING REVIEW BY: ��i1�-- DATE APPROVED: `0 ' `�'- `? y
BIIILDING REVIEW BY: � �.- DATE APPROVED: /U �-�/ y
FEES TO BE CHARGED: Misc. Fees Ca�culated By:
PERMIT Yes �No
PLAN REVIEW Yes f 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 Z nin District:
Fire Department: Post Off ce: Schoo]. District:
Lot Area: Width: De h:
�\
Survey Submitted. es No ate o Surv
Proposed Setbac s:
Front (Lak ) : Right Sid :
Rear (Str et) : Left Si e:
Adjacent Struct res : Wetland: % .
--7__
Bui�ding Heig t: De . Hgt. Peak Hgt.
Avg. Setback Lot Coverage:
xisti Proposed
Hardcover: -75 '
7 -250 '
2 0-500 '
500-1000 '
Hardcov Variance Re ired: es No Date of Council Approval :
Grading. Staff Approv Date: By: Council Approval Date:
Septic Staff Approva Date : By:
Zonin Fi�e: # Resolution # : Resolution Date:
REMARRS (in house) :
BUILDING REVIEW CHECR LIST ` ,
IIBC: /" /� CONSTRDCTION TYPE: i✓�/�
Sq Footage $ Per Sq Ftg
Basement x =
lst F7�oor x =
2nd Floor x =
Garage x =
x =
TOTAL
01
Estimated Construction Va�ue: $ Z�C��o
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Fi�J�ing
Footing Mechanical Fire
r�Framing- �3��-�,� �3Ac��=�<-c.�NS Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�� Board (Masonry) Lawn Irrigation
�_Final (Mfg.) Other
Other Wel7. (State Permit)
Electrical (State Permit)
--------------------------------------------------------------------------------
RF.MARKS (IN HOIISE) :
-------------------------------------------------------------------------------
REVIEW BY OT�tS: DATE:
Access: Existing New
Access Approval: Date By:
-------------------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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K��F CNiS PL�1� S�i •JN STT"t �T .A�C T)t,���
' � � 1�D ON'$ GARDE'�1L, �
MIKE AN�ERS�N
�Res�aas-s�o LLaccridscape Retaining Walls
7465 Eden Prairie Road • Eden Prairie,Minnesota 55346 • (612�34-8536
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WE PROPOSE ne y co rum�sr,mat i ar,a�or-com�e�e i� wKn e spea��aao�.for the sum ol:
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`�!�- � S�X ��ts a(C��� � i
Pn be ma es e• Authorized
Q� � � ����G /' ��� - I
UNess dhervvlse specl�ed on rad.anY damage caused to exfsiinq lawn, Nde: Thls propasa�rtgY be j^l � �
cable TV Ities or tefephone I rvYi be homeowners resQor�siWYty to repair. ���by us M not accepted within�CJ Oays.
ACCEPTANCE OF PROPOSAL rne above prtces,spec�►catlore and condltbns are satkstadory and are hereby aoceqteC. You are authorized to do the worlc as sQedtfed �
Payrt�eri wl�be made as outYned above.
! Si ature
Date of AcceptanoB �'
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� � - • l n Eden Prairie, MN 55346
�� 7� (612) 934-8536
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': _ ' ' Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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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 iocay , s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or I.icense requires Councii act�on
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
5. Your full. name is required to process this application or
permit.
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Address
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Phone
I understand my rights as stated above.
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BUILDING&ZONING—473-7357 • ADMINISTRATION&FIN.4NCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSIti G
�.04 RIGHTS OF �IIBJECTS OF DATA
Subdivision L 'I`ype of d�ta- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
S�� Z. J�{o�ma�.ion required to be given indivi�ual- An.individuel esked to
supply private or confidential data conet a d tamw hin the collecti g state gency,
purpose and intended use �f the reques
political subdivision, or statewide system; �b� �ownrcons quence aris ng from his
required to supply the requested dat�; (c) any
supplying or refusing to supply private or confidentiel data; and (d) the identity of
other persons or entities authorized by SiVidual iseaskedlto supplyinvest gative da a
requirement shall not apply when an ind
pursuant to section 13.8?, subdivision 5, to a law enforcement officer.
The commissioner of revenue me lace the notice reauired under this
subdivision in the individual income tax or ro ert tax re und instructions instead o
on those orms. . -- -
Subd. 3. Access ta �ata by in�vi�ual- Upon request to a responsible
authority, an individual shall be informad�wh ub�c, pr vateeor confidenUalre UP�n �
individuals, and whether it is classifie p
further request, an individual who is the subject of Q to�mrl�de if heudes res shall
individuels shall be shown the data witho �t ��Y t�ta. After en individuel hes been
�e informed of the content and meaning the data need not be �isclosed to
shown the private data snd infocmed of iis meaning, ��u�t to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the individ�he h�ateeor p blic datarupon$request by
responsible authority shall provide copies of P require the
the individual subject ofthe actual•costs of mak ng,l cert fyingy and compiling the
requesting person to pay _
copies. ssible, with any request
The responsible authority shall comply immediately, if po
made pursuant to this subdivision, or within five �f Simmediateat ompliance eisunot
excluding Saturdays, Sundays and legel holideys,
possible. If he cannot comply with the requese �thin�i��ntlw�ch toh omplynfw h the
individual, and may have an additional fi YS
request, excluding Saturdays, Sur►daYs and legal holidays.
Subd. 4. Procedure �►hen �ata is not accurate or complete. An indu�de�.mTo
contest the accuracy or completeness of public or private dat�heo��P��le authority
exercise this right, an individuel shell notify in Wr��e authority shall within 30
describing the nature of the disagreement. The respo
days either: (a) correct the data found to be lete data�includingreec Qients namedtby
notify past recipients of inaccurate or incomp
the individu8l; or (b) notify the individuel in�'v dual'es statementof disagreement is
Data in dispute shall be disclosed only if the
� included with the �i.sclosed data. be gppe�led pursuant to the
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
DATE T�ME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED //'(�'9 Y S = 3�
PERMIT N0. G 4�LFi' COMPLETED �_ �=��
ADDRESS Z7� �s� �6��T I�A%
OWNER 1�ueS-c,� CONTR'l�LKC A�4�so�
TELEPHONE NO. _ � S 3Y- �s S3�
� DESCRIPTION I�c ��n� ��;, wv4(f S
� 01 FOOTING 11 MECHANI L RI 19 EXCAV/GRADING/FILLINQ
y �FRAMING 13 MECHANICAL FINAL 19 LAi�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWEFi HOOK-UO 06 PROGRESS
� 07 DEMO-�ITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATI�N REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED – PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
i_� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOPOFDER POSTEO.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra r n 1 ite:
Inspector.
White Copyllnspector's 'le Canary CopylSite Notice