HomeMy WebLinkAbout1994-006486 - front entry � PERMIT
� CITY OF ORONO PERMIT TYPE: �.
2750 Kelley Parkway- P.O. Box 66 `���-��_� �-'�• '`��
Permit Number. �:����;�Er,�i,-:;�,
Crystal Bay, Minnesota 55323 � - . _ . _
(612) 473-7357 Date Issued: ; ;�,:;;:-;;�M;dG
SITE ADDRESS:
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CONTRACTOR: � F�`r=°�°= ?� =���=� — OWNER:
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APPUCANT%PER EE SIGNATURE ISSUED BY:SIGNATURE �,
s
„ CITY OF ORONO - BIIII.DING PERMIT APPLICATION
Total Fee: $ ,���c� �5
Date Received: �- ,/ j'- %`�
Date Approved:
Entered By:�/��.
Permit�: l���l�'�
AL.I� INFORMATION MIIST B$ SIIBMITT� IN F[TLL BEFORE PI.AN REVIEW WILL B$ STAR�ED
(See Check-off List Enclosed)
'�HE APPZICANT IS: (circle one) OWNER or ONTRACTO�
_.._--�°---�--
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JmB SITE ADDRRSS: ,� � � � ���� �`v� ZIP:
(work)
N�ME OF OWNER: ��/V`�CL �/'Y) i �� PHONE: (home) ��J !S�y
1�ATI,ING ADDRESS: /o�� C11��/ ��� ��2��e CITY: ZIP:
CONTRACTOR: ������54� �/��� PHONE: 1"'�/ � � ��.:�
MATI,ING ADDRBSS: � �L�1�!�� ,�_ CITY: � /� ZIP: �
STATS LICENSE: ��(�j(f /�7�i'�
ARCHITECT/ENGINEER: PHONE:
MATLING ADDR,$SS: CITY: ZIP:
g�: RBGISTRATION �
TYPE OF WOR.R: New Addition Accessory Structure Move
Demo Remodel/Alteration_�- Renovate Land Alteration
PROPOSED WORR (describe in detail) : �C'� /`LZD.,�t/// �N7L��
STORI$S: / SQ. FEST OF EACH FLOOR:
NO. OF B$DROOMS: '' GARAGE STAI.LS: ATT. DET.
� .�- ,
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ /1����.
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
tnat the work wil 1 be in accordance 'th the approved plan. , �
A.PPLICANT'S SIGNATDRE: DATE:�/ C ���
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p. � �Aa�,�,,,
� J �� � CITY of OR4N0
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;._ ', � ,,",��' :, Post Office Box 66•Crystal Bay,Minnesota 5a323•Municipal Offices
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� _ � '� 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 wou3d Iike to inform you that your request for a permit or
license 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 license requested.
2. You may refuse to supply data, but refusal may require thai
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 Councii action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�ate
data on yourself.
6. Yaur fulZ name is required to process this apglicaticn or
permit.
,f�►�-� �,��,�� ����•yP��.�/
First Middle La t
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Address
/��d�.� ��'� ����
�lty State Zip
y�� ���.
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING-473-7357 • ADMINISTRAT(ON&FINANCE-473-7358 • PUBLIC WORKS -473-7359
ASSESSING
- - •
�.� �G� Og y�gJgCTS OF DATA
S
ubdivision 1. TyPe of da�8- The righ secti�viduels on whom the data is
stored or to be stored shall be as set forth in th�s An.individual asked to
Subd. 2. Information requir�d
to be given in�vi�ual.
� 1 rivate or confidentisl data conc�rnindg �am� hin the collecti g state agency,
supp y P uested v refuse or is legallY
purpose and intended use of the req tem; (b) whether he ma, from his
political subdivision, or statewide sys �c� any �own consequence arising
required to supply the requested data;
1 rivate or coo�i federal law8to receive the data.1tThis-
supplying or refusing to supp Y P State
other persons or entities authorized by lnvesti ative data,
requirement shall not apply when an individuel is esked to supply g
pursuant to section 13.62, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace taX re°und instructions insteadho5
subdivision in the individual income tax or oropert
on those orms. � -— - .
Subd. 3. Access
to �ata bY indiv��L UPon request to a responsible
uthorit , an individusl shall be informed whe blic h rrvateeor confident al.e Upon his
a y ublic data on
individuals, and whether it is classified as p �
�t8 without any charge to him and, if he desires, shall
further request, an individusl who i� the subject of stored private orvidual has been
individuels shall be shown the of Lhat data• After an indi
�e informed of the content and mearung the dats need not be disclosed to
shown the private data end informed of its meaning, u�uant to this section is
him for six months thereafter unless a dispute or action P data u n request by
in or additional data on the individuel h� ate or pu 11 ted or �eated. The
, pend g rovide copies of the pri require the
responsible authority shall p �d compiling the
the individual subject of th BC��'cos h of mak ng,l cert fyingy ma
requesting person to pay the _
copies. y if ssible, with any request
The responsible authority shall comply immediatel , P�
ae ursuant to this subdivision, or within five days of the date of the request,
mg P snd legal holidays, if immediate compliance is not
excluding Saturdays, SundaysWith the request within that time, he shall siinforth the
possible. If he cannot comply within which to comp y
individual, and may have en additio� le eldho idaYS•
request, excluding Saturdays, SundaYs g lete. An individual may
Subd. 4. Proc�e�e �►hen data is not accu�ate or con►P �mself. To
contest the accuracy or completeness of public or private date concerning
exercise this right, en individual shall notify
in writing the responsible authority
escribin the nature of the disagreement. The r�P�te orenCflmPl t and att pt to
d g
days either: (a) correct the data found to be inacc reci ients named by
notify past recipients of inacc�heten��dual Phat he believesdthe data to be correct.
the individuel; or (b) notify , eement is
Data in dispute shall be disclosed only if the individual s statement of disagi'
• included with the disclosed data• � BPpe�led pursuant to the
� The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
.�_ . . FOR OFFICE USE ONLY
ADDRESS OR I�EGAL: ,'� �� �a "�1- ' � ����' �i'� PID: ���'lI�' v�:J �f/ �`>C�'��
DE�CRIPTION OF WORR: �'`�`�� ���'��`
-------- - -------
----- --------------------------
ZONING RL�VIEW BY: DATE APPROVED: ���.� /��
BIIILDING REVIEW BY:
C�� DATE APPROVED: �� � �' �y
--------------------- ------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �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 ���✓�
Fire Department: wA�z-- Post Office: c,JT� School. District: o�'^�
Lot Area: �'O�C- Width: i✓lL- Depth: /��C
Survey Submitted: Yes� No Date of Survey: <l''/��Z`7�
Proposed Setbacks: � ��� �
Front (Lake) : S"Z� Right Side:
� fi-
Rear (Street) : ��/1- Left Side: `��
Adjacent Structures: �1-T�el+c�� Wetland: ���'�-
Building Height: Def . Hgt. , �L _ Peak Hgt.
Avg. Setback: Lot Coverag :
Existing Pr posed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 ' --
Hardcover Vari nce Re uired: Yes o Date of C uncil Approval:
Grading: Staf Approv 1. Dat : By: Coun il Approval. Date:
Septic: Staf Approva� Date BY=
Zoning Fi]�e: R solution Res ].ution Date:
RF�MARKS (in house) : ,
BUIZDING REVIEW CHECK LIST �
,
IIgC. �' �'j CONSTRIICTZON TYPE: �� �
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 Septic Water Connection
�Insulation Firepl.ace Sewer Connection
�Wall Board (`Mfsojry) ptherIrrigation
�Fina� g•
Other Wel� (State Permit)
Q�Electrical (State Permit)
-----------------------------------------------------
�F.titARR$ (IN HOIISE) :
-----------------------------------------------------
REVIEW BY OTI�EtS: DATE:
Access : Existing New
Access Approval: Date BY=
--------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
.: N s K .���1�
FRANK R. CARDARELLE =• ' F, ` Land Surveyor
(612) 941-3031 ��,�`�;��-� � Eden Prai rie, MN 55344
sYL't
��r tt�i�a��� �� ��r���
Survey For Connell sn,ith Book 345 Page 37 File
128 Chevy Chase Drive -- ����1
Orono, piN _�
�~w GIT� OF 4R�N0
,
,� ;jTE PLAN GRADING PLAN
� ��r <�.` �0�1ED
� � ` �'�'F� Wl7H REV!SIONS
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' o Denotes Iron Mon. found
I hereby ceNfy tlisl thl�1��Ws�nd corteet reprs�entetlon ol��urvey o}Ma boundrle�ot L�t 71 B l��-'k 2� Hi 11 owa i�nor
Hennepin Counly,Mlnne�ola end ihs IocaUon o dl bulidlnp�' ereon,and dl ��Ibls sn�achmeM�,II any on�eld land.
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Y ,, lst dayot October ,�e�_. �� ��
Surv� ed b m�on thl�
_ Frank R. Cardarelle
State Reg. No. 6508
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-�ommerits are for your ir�formation. Aii �,vark sha!! hA c'�ir::�
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CITY OF ORONO r ��LED IN O � `�
INSPECTION NOTICE � �11�SCHEDU�ED �h ��� � n
PERMIT NO. � ��� COMPLETED !.1 _ �_
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� 01 FOOTING 11 MECHANICAL RI 18IXCAV/GRADINOlFIWN�
y 02 FRAMING 13 MECHANICAL FINAL 19 LAi�SHORE/WETLANDS
Q 03 INSUlAT10N 24/25 WOOD BURNER/FlREPLACE 34 TREE REMOVAL
Z 04 D. 12 WATER HOOK-UP 17 SITE INSPECTION
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~ 07 DEM�SITE 27 SEPTiC MAINT. 21 COMPLAINT
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINO FINAL � 36 FOUNDATION REMOVAL
Q NER ONTRACTOR TO MEET YOU: YES NO
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Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr site:
inspector.
White Copy/inspecto s File Canary CopylSite Notice
DATE / TI�E
CITY OF ORONO CALLED IN D �7 �/- �-C '
INSPECTION NOT}C�E - scHE�u�Eo � ' ,�`�/ yj
PERMIT NO. (�/ ��� COMPLETED
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� 01�� 11 MECHANICAL RI 16 WELLTEST PUMP
02 FRAMING ' 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
O`"-II37id3t1tXCf10N 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 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
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLIOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNEHICONTRACTOR TO MEET YOU:_YES_NO
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❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContracto n si :
Inspector.
White Copyllnspector's Fi e Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED �6--�/'7—� /d :� D
PERMIT NO. �� ���o COMP�ETED '" - ' �`��( 6 U.o�
ADDRESS �a �` ��� �tCC.-a.-� /U/�
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� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNd
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Q 3 INSULA � 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4� 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTfiACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '— CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor sit •
Inspector.
White Copyllnspector's File Canary CopylSite Notice