HomeMy WebLinkAbout1994-006120 - chg closets to mudroom PERMIT
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CI�Y OF ORONO PE�iMIT TYPE: : :..::.:.
2750 Kelley Parkway • P.O. Box 815 Permit Number: � = � � �
Orono, Minnesota 55356-0815 �`� z.�'�'
(612) 473-7357 Date Issued: ^,:�r ;_
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ _��� �� Date Received:
�
Date Approved:
Entered By: � �� permit�: ��'� �
AT•7• INFORMATION MIIST BB SIIBMIT'��D IN FIII�L BEFORE PLAN REVIEW WILL B$ STAR�ED
(See Check-off List Enclosed)
------------------------------------ -----------------------------------------
THE APPZIGANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: L Z$ �h-2v y CI�-�tS Q � �"_. . �r o ►^� ZIP: .S .5 3�l 1
(work) � y2- 3� ��
N� oF owr�Ex: Co h ��e 1� S � � � � PHorr�: (home) Ll t�9- R$ L4
IKAILING ADDR.ESS: ( ZS� C �e�x C�� �r • CITY: W��,�u ZIP: S S 3q 1
CON�CTOR: S�1M p$��=
MAIZING ADDFZ$SS: CITY: ZIP:
STAT$ LICENSE: ,�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRBSS: CITY= ZIP'
g�: RBGISTR2�TION n
TYPE OF WORR: New Addition Accessory Struciure Move
Demo Remodel/Alteration X Renovate Land Alteration
PROPOSED WORR (describe in detail) : ���h � �'a C �o S C t S � v�--o G
�M U � r'G G V"�
STORIES: SQ. FEBT OF EACH FI,OOR: a� �� � D
NO. OF BBDROOMS: GARAGB STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding 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
unde�stand this is not a perm ' t a d work is not to start without a permit; and
that the work will be in acc rda ce with the a proved plan.
.�APPLIC.ANT'S SIGNATDRE: , DATE. Z
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�,j CITY of ORONO
�� C.,.Y
Post Office Box 66•Crystal Bay, Minnesota 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
license from the City of Orono or any of its departments may require
you to furnish certain private or confidential information.
You are notified that:
l. The information you furnish wiZl 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 grocess the permit or
license.
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 �o review pri�a��
data on yourself.
6. Yaur full name is required to process th�s aprlication or
permit.
��R�, L C�o � �c L� S!`t/ 7<'�
First Middle Last
f z � C �-{E �� C(�l a4 S � �� • -
Address
o ��►� � r-� � .�� 3 � �
City State Zip
�f 4 �=l ' �( �Z �
Phone
I under and rig ts as sta
.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FIN,aNCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSING
,. .
�.� �G� �g �gJECTS OF DATA
Subdivision L Type of data- The rights of individuels on whom the data is
stored or to be stored shall be es set forth in this section.
, Subd. 2. Information required t° be g��� u'���' An.individuel asked to
� su 1 rivate or confidential data concernindg tgmW hin the collecti g state gency,
PP Y P
purpose and intended use of the requested
tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �C� gny �own consequence arising from his
required to supply the requested dat8;
su lying or refusing to supply private or confidential data; and (d) the identity o
PP 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 enforcementuofficer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma �le�tv tgX reouna instQU�te°sunsteadhos
subdivision in the individuel income taat or r•
on those orms. — - .
Subd. 3. Access
to �ata by in�ivi�ual- UP°n re4uest to a responsible
authority, an individual shall be informed wh ublic pr vateeor confidentisl.e Upon his
individuels, and whether it is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individual who is the subject of stored private or
individuels shall be shown the data withou�t an�Y ��tg. After an individuel has been
�e informed of the content and meaning the data need not be �isclosed to
shown the private data and informed of its ute orgaction pursuant to this section is
him for six months thereafter unless B d�SP
� endin or additional data on the individual h� 8te or pu 1 c datarupongrequest by
P g• require the
responsible authority shall provide copies of the p n g ilin the
the individual subject of �e gc��•�o� of mak ng,l cert f �nl,y�a comp g
requesting person to pay t -
copies. ssible, with any reQuest
The responsible authority shall comply immediately, if po
made pursuant to this subdivision, or within f8� ��,Ysimmediateat omplis.nce eisu not
excluding Saturdeys, Sundays and legal holid y ,
ossible. If he cannot comply with the request wi�i withint hich toh omplynW�h the
P heve sn additional five da�
individual, and maY �d le al holidays.
request, excluding Saturdays, SundeYS g
te or complete. An individual may
Subd. 4. Procediu'e when data is not a�a himself. To
contest the accuracy or comgleteness of public or private data concerning
exercise this right, ai'L individuel shall notify in writing the responsible `a��n i30
describing the nature of the disagreement. The responsible autholete and attem at bto
days either: (a) cortr f Inaccurate ordincomplete dataeincludingrecipients name y
notify past recipien
the individuel; or (b) notify the individual that he believes the data to beementcis
Data in dispute shall be disclosed only if the individual's statement of �g� t to the
• included with the �isclosed data• be BpPe�e� pursuan
� The determination of the responsible authority m o contested cases•
provisions of the administrative procedure act relating
, CHECR OFF LIST FOR ISSIIANCE OF PERMITS
. , . FOR OFFICE USE ONLY
� ADDRESS OR LEGAI,: [ �CJ ��''l.°W �--1/�C(S � PID:
DESCRIPTION OF WORR: `�'��D��
---------------------- -
-------------------------------- ---- -- --------_
ZONING REVIEW BY: � _ Q,�.� DATE APPROVED: � o�-`�
11 l
BIIILDING REVIEW BY: � -V DATS APPROVED: S o2 S
-------------------
FEES TO BE CHARGED: Misc. Fees Ca�culated 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 (specif y)
----------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Width: Depth:
Survey Submitted: Y s Date of Survey:
Proposed Setbacks :
Front (Lake) : Right Side:
Rear ( Street) : Left Side:
Adjacent Structures : Wetland:
Building Height: Def . Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No Date of Council ApprovaJ.:
Grading: Staff Approval�. Date: By: Council Approval Date:
Septic: Staff Approval Date: BY=
Zoning Fi�e: # Resolution # = Reso�ution Date:
REMARRS (in house) :
BIIILDING RL�7IEW CHECK LIST � �
�C: �_ �j g � CONSTRIICTION TYPB: �
Sq Footage $ Per Sq Ftg
Basement X -
lst F]�oor � p _ x , a.q�— = O
2nd F�oor X -
Garage X
x =
TOTAL " �� " �
$stimated Construction Value: $ (J v �� �%D
Inspections Rern�ired: Work Requiring Separate Permits:
Site P�umbing Grading/FiJ.�ing
ooting Mechanical. Fire
�raming Septic Water Connection
�(Insu�ation FirepJ.ace Sewer Connection
Wal�l. Board (Masonry) Lawn Irrigation
Fina 1 (Mf g.) Other
� We1J. (State Permit)
Other
Electrical (State Permit
----------------------------------
REMARRS (IN HOIISE) :
------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date __________________
----------------------------------------------y-------------
REMI�RRS (TO BE NOTED ON PERMIT) :
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �v �,�fJD
PERMIT NO. coMP ETEo
ADDRESS
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q '62 RAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
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 INSTALL. 22 FOLLOWUP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d WORK SATISFACTORY:PROCEED �� PROJECT COMPLETE
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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.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance.473-73�J7
OwnerlContr�n 't :
Inspector. ��
White Copy/lnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE T SCHEDULED ���-�`l' S; ��.=�
PERMIT NO. Cr� �y COMPIETED S-� i`t � ;3�C�
ADDRE�S �2 � CF-��'/ C-(-�/45%�
OWNER ���v�c r-t f CONTR.
TELEPHONE NO.
� DESCRIPTION
� �I FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
� 031NSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 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
Q
� 09 PlUM81NG RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTO TO MEET YOU:_YES_NO ,�
� COMMENTS:�r�_�rA�n�.1 1��� •: �
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContract te:
Inspector. _
White Copyllnspector's File Canary CopylSite Notice
DATE � �TIME
CITY OF ORONO CALLED IN ��' S _ �� ��
INSPECTION OTICE �/(� SCHEDULED �y- g� �`-�
PERMIT NO. /_-JC r �7 0 COMPLETED �}7
i
ADDRESS � . �2� ��-c_- �
OWNER %�Gi//I° L��`�7`�'��"+�.�
CONT .
TELEPHONE NO. ��=� � � ����' '%��
� DESCRIPTION
� O1 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 D. 12 WATER HOOK-UP 17 SITE INSPECTION
�OS FINAL � 14 SEWER HOOK-UP 06 PROGRESS
� 07�EtatO=SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,� pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
G INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
OwnerlContr n si e:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice