HomeMy WebLinkAbout1995-006770 - shed . PERMIT
CITY OF ORONO PERMIT TYPE: _ _ ._
� 2750 Kelley Parkway- P.O. Box 66 Permit Number: ?_���;;=:";{'����'y���
Crystal Bay, Minnesota 55323 � � � _ _
(612) 473-7357 Date Issued: _ _ _
SITE ADDRESS:
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DESCRIPTION:
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APPLICANT/PERMI E IGNATURE ISSUED BY:SIGNATURE �'� �-
• � ' � CITY OF ORONO UIL�� PE APPLICATION
� -� ������ Date Received:
Total Fee: $ _=j "> -��
Date Approved:
Entered By: �('�`� -
�JAN 1 ,� 1995 Permit�: ���7L�
r�.. r
AT•T• INFORMATION MUST BE SIIBMITTED IN FIILI� BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) O��iNER or CONTRACTOR
JOB SITE ADDRBSS: `� O , �' �'� �e- N ZIP: e����or`� �o
(work)
NAME OF OWNER: C�js,�EN �-�[��'�r� PHONE: (home)���' ���-7'
MAILING ADDRESS: 7 ��� C:� C�r�'L✓�. �✓vd� , CITY:��t��t '�/�c� �fV ZIP: �S�7rr� �
CONTRACTOR: ��� 1.� PH��'
MAILING ADDRESS: ��rrr�- CITY: ZIP:
STATE LICENSE: �
ARCHITECT/ENGINEER: ���-17" PHONE:
^ CITY: ZIP:
1`5t�'fiLiii� :,�i.J�D.:��vC� J<i�/�)�- .
p�g: R.EGISTRATION #
TYPE OF WORR: New �` Addition Accessory Structure� biove
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : �%Z �� �� � c:s /0 r f.�� � ���+�C __
STORIES:�_ SQ. FEET OF EACH FLOOR: `�e�-
NO. OF BEDROOMS: C� GARIIGE STALLS: ATT. '- DET. —
ESTIMATED CONSTRIICTION VALIIATION (egcluding land) : $ '���Q�
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 wil 1 be in accordance with the approved plan.
APPLICANT'S SIGNATORE: �'�. DATE: ,Ny, I ( �
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'y "��� C ITY of ORONO
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� _ � � 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 3ike 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 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 snared with other Iocal , s�ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii actior.
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your fu3.I na:ne is required to process this application or
permit.
�� /
�cc.��l� � f 1'E-1� C..�f� ��0 !�
First Middle Last
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Address
�, � .=o �� � ,�'� n/ .��s y z "3
City State Zlp
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Phone
I understand my rights as stated above.
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� � �L� �'
ignature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FI�ANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
� � � •
�.� �Gg� pg SIIg.7ECTS OF DATA
Subdivision L Type of data- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be given indiv��" An.individual esked to
� � su ly private or confidentisl data concernina 8mwi hin the collect ng state gency,
PP uested
purpose and intended use of the req
political subdivision, or statewide system; (b) whether he ma� refuse or is leg y
re uired to supply the requested dat8; (c) any known consequence arising from his
9 rivate or confidentiel data; and (d) the identity of
supplying or ref using to supply p
other persons or entities authorized by staau��e8skedito supplyeinvest gat ve data,
requirement shall not apply when an indiv
pursuant to section 13.82, subdivision 5, to a law enforesment officer.
The commissioner of revenue ma ole�t taX re�und instructionsunsteadhos
subdivision in the individuel income tax or r
on those orms. . - -- .
Subd. 3. Access to �ata by individusl• Upon request to e responsible
authority, an individual shall be informed�h b���hPf vateeor confident al.e Upon his
individusls, and whether it is classified P ublic data on
lurther request, an individuel who is the subject of Se to himrlande if he desires, shall
individuels shall be shown the date witho ofan�y ��tg, After an individual hes been
�e ir�fo:mec� of the content snd meaning `h� �t� need not be disclosed to
shown the private date and informed of its meaning, ��uant to this section is
him for six months thereafter unless a dispute or action p
� ending or additional data on the individuel h� a e or pu 1 c datarupon request by
' p require the
responsible authority shall provide copies of t e p
the individuel subject oft�e actusl.co ts of mak ng,l cert fyingy and �ompiling the
requesting person to pey -
copies. ssible, with any request
The responsible authority shall comply immedistely, if po
made pursuant to this subdivision, or withi lida e �f Simmediateatcompliance e��,su not
excluding Saturdays, Sundays end legal ho ys�
ossible. If he cannot comply with the request within that time, he shall so inf�orth the
p within which to comply
individual, and may heve �Sundays e.nd Iegaldho1idaY5•
request, excluding Saturdays,
te or complete. An individual may
Subd 4. Procediu'e �►hen data is not accura �mself. To
contest the accuracy or comple u��Pnot fy inrwr ting tthe�responslble ��n 130
exercise this right, an lndivid
describing the nature of the disagreement. The responsible authol t �a attempt to
days either: (a) corrtSe of ineccurate ordincomplete datae including recipients nemed by
notify past recipien
the individual3 or (b) notify the individ�h in�tv,aueleslstatemen tof disg�'eementcis
Data in dispute shall be disclosed only if
• included with the disclosed data. be BPpe�led pursuant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
� CEECK OFF LIST FOR ISSIIANCE OF PF.RMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ,3�U QI�o �5�� � PID:
D$SCRIPTION OF WORK: �����= 5�v�
------------------------------
------ ----�-----------------
ZONING REVIE�1 BY' ��.� DATE APPROVED: /- 2 S�S S
�(� � DATE APPROVED: � - 2-5 -�S
BIIILDING REVIEW BY: l�(�-- _.
--------- --------
FEES TO BE CH�RGED- Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �o � SEWER CONiVECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No � . PARK FEE
SAC Yes No �� SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------
ZONING CHE�K LIST Zoning District: (L-S
Nan�P
Fire Department: (��Na�wTr2�1�V-P�st Office : � Schoo� District: MTpc�
Lot Area: /1��L Width: — Depth: —
Survey Submitted: Yes No pc Date of Survey: s�►-� Pc.�,J
Pro osed Setbacks :
P Fs-�x� (Lake) : f/o i� � +' Right Side: S�` ±
ge�� ( Street) : 7Z.� � Left Side: So� '�
Adjacent Structures : ,�g' Wetland: /J/!'�
BuiJ�ding Height: Def . Hgt. � •k- Peak Hgt. —
Avg. Setback: 0 •� Lot Coverage: D•«
Existing Proposed
Hardcover: 0-75 '
75-250 ' ���� ��
250-500 '
500-1000 '
Hardcover Variance Recuired : Yes No �( Date of Council Approval :
Grading: Staff Approval Date: � By:; � Counci� Approval Date:
, /
Septic: Staff Approval Date: � BY=
Zoning File• � R o�u�ion # � Resolution Date :__
' � �,
RL'MARRS (in house) : � �
BUIZDING REVIEW CHECR LIST
IIBC: /N - ( CONSTRIICTION TYPE; X� �
- - - - �
- Sq Footage $ Per Sq Ftg ` .. _ ..
-----_ - ,. t ._.,„
- Basement ._._ __ _- - - - -X- � _ �. _,,_ . --
lst F�oor _ _ __ - -
X _ _---- __ _ -
2nd Floor , _ __ - - , � ' - _, .�_
x
_ Garage X - _ _ . _ ,- ,
x. _ _ . _ - -
TOTAL
Sstimated Construction Value: $ 2`1 Do�
Inspections Rem�;red: Work Reqniring Separate Permits:
Site P�umbing Grading/Fil.�ing
Footing Mechanica� Fire
Framing Septic Water Connection
Insulation Firep�ace Sewer Connection
Wa�.J� Board (Masonry) Lawn Irrigation
�Fina 1 (Mf g.) Other
Other We�1 (State Permit)
E�ectrical. ( State Permit)
------------------------------------------------------------------
REMARRS (IN HOIISE) : ONU/ (=�n�A� ZN���✓ ���/�� - NO � 3o.c�o Sr�rr.
113�-�18ns �r ! S vF3�u* �� Uc� C{-E-�C�L �4-T�FC-L-l-2� ��i�rr� ��1�n�'f- �=��
_ OWrNe2 _�_��u..��.L�_2�s�s�� D �2��_�sc_�r/0--------------------
-��'`-�------� ----
REVIEW BY OT�f2S: DATE:
Access : Existing New
Access Approval : Date BY=
-------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
� � �.���..
.� �
``' �� F ON WORKSNEET �t _ �:�����-� �:_ . �
HARDCOV�R CALCULATI -
• SETBACK ZONE: �CIRCLE ONE)`�,, �-�5'i' %5-?�d' 250-500' S00-1000�
EXISTING HARDCOVER IN ZONE
--------------------------
�� a„ Hous< <1 � x .� �� _ � ! �' s,F,
� LENGTH WIDTH
X = ' S�F.
X = S. F�
x = S.F�
X = S.F�
B, GARAGE X = S�F�
C. DRIVEWAY X = S.F,
X = S� F�
D�. SIDEWALK X = S.F�
y, _ _ ..,_ S.F�
X = S.F.
E� ATIO/
�ECK
. ; _ X = S,F.
F� LANDSCAPE X = S�F,
AREAS
UNDERLAIN
BYX = S.F,
PLASTIC
SHEETING _
X - S.F�
X = S.F�
G� OTHER X = S�F�
TOTAI. HARDCOVER IN ZONE - S�F� �
, TOTAL PROPERTY AREA IN ZONE - � ��' ' " S�F� �
' � ! O
� � : g ', � . = x100 = � �
19
^-+' �e�♦
HARDCOVER CALCULATION WORKSNEET '
SETBACK ZONE: �CIRCLE ONE) 0-75' 75-250� 25�-5��' S00-I000�
EXISTING HARDCOVER IN ZONE .
--------------------------
A� HOUSE X = S�F�
LENGTH WIDTH
X = S�F�
X = S� F�
, �� X = ,
,� S�F�
X = S.F�
B. GARAGE X = S�F�
C� DRIVEWAY X = S�F,
X = S� F�
D� SIDEWALK X = S� F�
X = S�F�
X = S.F�
E� PATIO/
DECK
X = S.F�
F� LANDSCAPE X = S�F�
AREAS
UNDERLAIN
BY X = S�F�
PLASTIC
SHEETING
X = S,F,
X = S,F�
�. �' � ` _
, , , ' ' � G� OTHER v X ' � S� F,
i._i:,. -------------
TOTAL HARDCOVER IN ZONE — �_�� `� S� F� �A
TOTAL PROPERTY AREA IN ZONE — � '' J - S�F� �B
� e �� j
A �� '�.� - g ', x 100 = t, ,! ; o
.
20
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APPf�OVEG WIl'H CORRGi�TlO�ti� P+S NOTE�� ,'
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9'n+�ee Co►r►ments ara tor yeur iniormation. AI� WCN'k Shell br Ur�''R ;�
qf tuM otrtit�D�lBnoe with �ii a}�ic��e bulltfl & zonln� code ++�° " , ---______ �
��n�nts I�rcluding itams not sp�clflcally !ed in this rev► jl . -- - ---
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_ �TE, _� r TI�ME
CITY OF ORONO ca��E�irv "a � �> ��-� � �� �-�z�
INSPECTION NOTICE scHE�u�Eo % - � _S l v:c�%�l M
PERMIT NO. !` '��� �� coMP�ETE�
=� C� `�- � � . , , .� ,��
ADDRESS �-� �� -
,
OWNER �� � .-'F�� -� �,-�'�r'<, '�!� CONTR.
TELEPHONENO. �� �1 — X !;"�: =; ��i- !-,_'���`_'�."'�
� DESCRIPTION �� �� �-� t�
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
2 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ORK SATISFACTORY:PROCEED ,� PROJECT COMPLETE
W C CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. �_ PHOTOTAKEN
INSPEC�OR WILL RETURN
CITATION ISSUED
C STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the m ction 24 hours in advance.473-7357
OwnerlContract r site
Inspector. -�
White Copyllnspector's File Canary CopylSite Notice