HomeMy WebLinkAbout1992-004545 - after the fact deck PERMIT
CITY OF ORONO • = PERMIT TYPE: �,����C'���
1335 Brown Rd. South • P.O. Box 66 Permit Number: t�t: ,q
Crystal Bay, Minnesota 55323 Date Issued: i:�:/C��.f'��
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: - A��F�1 i c a���:���j�i,'":f,' ;�.,..N'��'�d,�f Yt�U},,
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APPLICANTrPERMITEE SIGNATURE ISSUED BY SIGNATURE �
CITY OF ORONO - BUILDING; PERMIT APPLICATION
Total Fee: $ 1�� 7�'' Date Received:
Date Approved:
Lxitered By: � '
Permit�: '�� y�
AI�L INFORMATION MIIST BE SIIBMITTSD IN FIILL BEF�RE PI.AN REVIEW WILI� B$ STARTED
(See Check-aff List Enclosed)
---------------------------------- -----------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
- ��y� ��SG� va/J'f/��'- �Y'drl� zzP: S'S��f/
JOB SITE ADDRSSS. '
(work) '�7/"�r��
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NAMF: OF OWNER: �I w�n Y� ~'�» C��'!� � C � U�-�L PHONE: (home) 7 7� ' ��lv L
IKAII�ING AnDxEss: ,Z9�� C`��Sc v �ve n fi ��'. cz�: ��-f� /�: zIP: SS 3`"1/
CONTRACTOR: pH��'
MAILING ADDRESS: CITY: ZIP:
STA�S LICENSE: �
ARCHITECT/ENGINEER: PHONE:
MATLING ADDRSSS: CITY: ZIP:
N�: RBGISTRATION n
T"PE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) : `/��-m v � � ���'"�` `,C'C��E f! Sr
STORI$S: SQ. FE$T OF EACH �I.00R:
NO. �F BSDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ 3. 5�t% VU
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 t:� start without a permit; and
t�:4t the work will be in accordance with the approc•ed plan. •
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APPI,ICANT'S SIGNATIIF?.E: � �� DATE;�� , _
k`;.
:��k CITY of OR4N0
;.
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Officea
•
� - � � 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 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 Iicense.
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 reguires Counci3. action
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review prica��
data on yourself.
6. Your full name is required to process this apFlication or
permit.
.� r w;,�. �� ��. C���
' First iddle Last
� %��� �SC-c1 f�i�J`� K�Jk
Address
�i�Ll�'�, /��� �5� ✓�
City State Zip
��% - �� �� � �
Phone
I understand my rights as stated above.
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Signature �
BU1LDIiJG&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSES5ING
573.04 RIGHTS OF SIIB.7ECTS OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
Subd. 2. Information requ� tO � ��� ����� An.individual asked to
� su ply private or confidentisl data concerning �amWi hin the collecti g state agency,
P
purpose and intended use of the requested da
political subdivision, or statewide system; (b) whether he may refuse or is legally
required to supply the requested date; (c) any known consequence arising from his
supplying ar refusing to supply private or confidentiel data; and (d) the identity of
other persons or entities authorized by state or federal law to receive the data. This.
1 when an individual is asked to supply investigative data,
requirement shall not app y
pursuant to section I3.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mg ro�ert tax re�und instructionsui ateadho5
subdivision in the individual income tax •r
on those orms. . --- -
Subd. 3.
Access to �ata bY in�vi�' Upon request to a responsible �
authority, an individual shall be informed whether h��ateeor confident al.e Upon his
individuals, and whether it is classified as public, p ublic data on
further request, an individusl who is the subject��ge to�mri�ae if he desires, shall
individuels shall be shown the date withou�fan�y t �ta. After an individual has been
�e informed of the content and meaning the data need not be �isclosed 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 additionel data on the individ�h h� gte or p bI c datarupona equest by
responsible authority shall provide copies of P require the
the individual subject oft�e actual•cos h of makng,lcerti yingyand compiling the
requesting person to pay -
copies. + immediately, if possible, with any request
The responsible authori.y shall comply
made pursuant to this subdivision, or within five �f Simmediatea compliance eisu not
excluding Saturdays, Sundays and legal holideys,
possible. If he cannot comply with the request within that time, he shall so inform the
individual, and may have sr► additionel five days v+iithin which to comply with the
request, exeluding Saturdays, SundaYS end legal holidays.
Subd. 4. Procediu'e �►hen �� � ublic o�p ivate datg i�once nnng himse1f• To
contest the accuracy or completeness of p the res onsible authority
exercise this righL, e.r► individual shall notify in writing P
describing the nature of the disagreementbeTnacciu�pa e ocin omplete and att pt to
days either: (a) correct the data found to
notify past recipients of inaccurate or incomp�t�ea beI e esdthe datalto be correct
the individuel; or (b) notify the individuel eement is
Data in dispute shall be dis�ta d oniy if the individual's statement of disagr
• included with the disclosed � BPPQ�ed pursuant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
:`�
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� CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFF'ICE, LSE ONLY
ADDRESS OR LEGAL: 2��{O C-�A S� P�i�►7 1� PID=
DESCRIPTION OF WORR: �=C�1�
------------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: 4S - `�-5 2
BIIILDING REVIEW BY: �,�tnw�.- DATE APPROVED: �'f'" `1' `1�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes f 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: L./� -��--
Fire Department: V�/l�ouNr� Post Office: wu4�Zq-cyd SchooJ� District: �11�L,
Lot Area: i� Z - .�(/�C/L�5 Width: 4s0� Depth: /4-i/c: / 7 S �
Survey Submitted: Yes y No Date of Survey: (� - Z S� G Z
Proposed Setbacks : �
�� (Lake) : �7� -� Right Side: �i
� (Street) : /� �f} Lef t Side: 1V�I�
Adjacent Structures: �¢`rTY�c.1+L� Wetland: /✓fl�-
Buil�ding Height: Def. Hgt. J�1 (q- Peak Hgt. (it���
Avg. Setback: vA2��nlc.i Lot Coverage: N ��
Existing Proposed
Hardcover: 0-75 '
75-250 ' �J-��o
250-500 '
500-1000 '
Hardcover Variance Required: Yes� No Date of Council Approval: 7-Z -��-
Grading: Staff Approval. Date: By: Counci� Approval Date:
Septic: Staff Approval. Date: BY=
Zoning File:# /�]5 y Resolution #: / Resolution Date: �-2�-5�-
REMARKS (in house) : '
BUILDING REVIEW CHECR LIST '
. �
IIgC: g� K-3 CONSTRIICTION TYPE: �-
Sq Footage $ Per Sq Ftg
Basement X =
lst F7.00r X -
2nd Floor X -
Garage X -
x =
TOTAL
c3c
$stimated Constructioa Value: $� .�L`'�'� "
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/Fi�]�ing
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�l Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Well (State Permit)
E�ectrical (State Permit)
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�FIKARKS (IN HOQSE) :
----------------------------------------------------------------------------
REVIEW BY OTHEFtS: DATE:
Access: Existing New
Access Approval: Date BY=
------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
� .:�
. �:-;:F
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. `'�' '"'S COMPLE� t(
ADDRESS � O L,GC S tp
OWNER CONTR.
TELEPHONE NO. _
� DESCRIPTION CJ��
l� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
� 02 FFAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
�
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q OS NAL 13 METER SET/TURN 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 INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d WORK SATISFACTORY:PROCEED i] PROJECT COMPLETE
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� C�CORRECT WORK 8 PROCEED r; ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ! CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on ite:
Inspector. � �
White Copyllnspector's File Canary Copy/Site Notice