HomeMy WebLinkAbout1994-005998 - replace existing windows PERMIT
I CITY OF ORONO PE�iMIT TYPE:
2750 i�elley Parkway • P.O. Box 815 Permit Number: `���=�=�'�r'°�='�
' ��rono, Minnesota 55356-0815 Date Issued: '''-'��'�'��s'-'
(612) 473-7357 =�5�+ :t:;;:,•'��s.
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE '
CITY OF ORONO - BIIILDING PERMIT APPLICATION
T���al Fee: $ �`� , -�J=j Date Received: �-/�G�%�
Date Approved:
Entered By: � ,�'`y j
Permit�: �����
ALL INFORMATION MIIST BE SDBMITT� IN FUL.L BEFORE PI,AN REVIEW WILL B$ STARZ*ED
(See Check-off List Enclosed)
THE APPLICANT IS: (circle one) OWNER r CONTRACTOR
• ,._ .... ,
' ZIP: �_�.�
Jos sz� xnnxsss: ; ��'1 ; . -
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(work).��t� JJ_ �.
N� OF OWNER: ��' ; ; ' �' j PHONE: (home) ';�~ � � --�
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MAIZING ADDRESS: . CITY: �-/� d ZIP:
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CONTRACTOR: � f �;��,� � � ,`C-� ti " � J � , PHONS: �
MAILING ADDRESS: Y,'';J 1%� j„=,����J� 1 CITY: �. , � ,�; � , � ,� ZIP:
STATS I.ICENSE: � ' '� ' .
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ARCHITECT/ENGINEEEt: � PHONE:
MAILING ADDRBSS: CITY: ZIP:
N��: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Struczure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSF.D WORR (describe in detail) : ;,'�� � � I ,�� �,� � 1�i '
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STORIES: � SQ. FEBT OF EACH FI,OOR: '�� %,r� _" ' �J� �.-. �✓1I d � ....� i_=��
NO. OF BEDROOMS: � G�GS STAI.LS: ATT.� DET.
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ESTIMATED CONSTRIICTION VALIIATION (eacluding Ia.nd) : $ ` /�J
I hereby apply for a building permit and I acknowl.edge that the information
above is compI.ete and accurate; that t ork will be in conformance with the
ordinances and codes of the Ci an wi h the State Building Code; that I
understand this is not a perm ' a w rk ' s not to start without a permit; and
that the work will be in ac rdan h e approved plan. •
A.PPLICANT'S SIGNA DATE: � ✓
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CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Sh.ore of Lake Minnetonka
DATA PRNACY 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 �ocal, state or
federal agencies to the extent necessary to process the permit or
l.icense.
4. If your requested permit or Iicense requires Councii action
to approve, some inf ormation may become public.
5. You have certain rights under M.S. 13.04 to review privat�
data on yourself.
6. Your full name is required to process this applicatian or
permit.
, ._ .� �
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First Middle Last
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Address
, ° r �
City State Zip
Phone
I understand m right st ed above.
gnature
BUILDING&ZONING-473-7357 • ADMINISTRATION&.FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
(
�.� �G� Og �gJp,CTS OF DATA
Subdivision L Type of da�8- The righ secti�viduals on whom the data is
stored or to be stored shall be as set forth u► th�s An.individual asked to
Subd. 2. Information re9�
to be given in�ivi�usl.
� su 1 rivate or confidential data concernina �8m�hin the collect g state agency,
PP Y P
purpose and intended use of the requested �b� Whether he ma� refuse or is legally
political subdivision, or statewide system;
1 the requested dat8; (c) any known consequence arising from his
required to supp y rivate or confidentiel data; end (d) the identity of
supplying or refusing to supply p State or federal law to receive the data. This.
other persons or entities autWhen anbndividual is esked to supply investigative data,
requirement shall not apply
pursuant to section 13.82, subdivision 5, to a law enforcement officer. under this
The commissioner of revenue ma
lace the notice re uired
subdivision in the individuel income tax or Rro erty tax re und instructions instea o
on those orms. � - — - .
Subd. 3. Access to �ata by
����. Upon request to a responsible
authority, an individuel shall be informed whe b�c Pr vateeor confidentia.l.e Upon his
individuals, and whether it is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individuel who is the subject of stored private or
individuels shall be shown the date witho of�hat da a• 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� ��uant to this section is
him for six months thereafter unless a dispute or action p
rivate or public data upon request by
endin or additional data on the individuel has been collected or created. T e
• P g• rovide copies of the g require the
responsible authority shall p The res onsible authority may ilin the
the individual subject oftrie actual.costs of making, certifying, and comp g
requesting person to pay -
copies. y if ssible, with any re9uest
The responsible authority shall comQly immediatel , Po
mg�e pursuant to this subdivision, or withinlag e �f Simmediateatcompliance eisu not
excluding Saturdays, SundaYs and legal hol y5,
� within which to comply with the
ossible. If he cannot comply with the requese within that time, he shall so inform t e
p heve an additional fi YS
individusl, and mgY �d le al holidays.
request, excluding Saturdays, SundaYS g
Subd. 4. Procefiu'e when data is not accura
te or complete. An individuel maY
contest the accuracy or completeness of public oinr Wr ting tthe�responslb e au hor ty
exercise this right, an individuel shall notify
describing the nature of the disagreement. Tnacc�u�a e oren omplet and att pt to
days either: (a) correct the data f ound to be i
notify past recipients of inaccurate or incomp�t he bel e esdthe datalto be correct
the individuel; or (b) notify the individual t eement is
Date in dispute shall be discl t ed only if the individual's statement of �a� t to the
• included with the disclosed da a ealed pursuan
' The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases•
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
Ai:DRESS OR LEGAL: /�1 Z� L�ohntS YOrNr PID:
D$SGRIPTION OF WORR: q C����"� W rn+���
---------------------------------
ZONING REVIEW BY: /`�Ll� DATE APPROVED:
BIIILDING REVIEW BY: DATE APPROVED: y-7'y 7
---------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r/ 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 (specify)
-------------------------------------------
ZONING CHECR LIST Zoning District: /
Fire Departm nt: Post Offic : choo� District:
Lot Area: Wi th: De th:
Survey Submi t d: Yes o Date of Survey:
Proposed Set a s:
Front ( ak ) : Righ Side:
Rear ( tre t) : Left Side:
Adjace t St uctures: W tland:
Buil.ding He ght: Def . Hg . Peak Hgt.
Avg. Setbac : Lot verage:
Exist ng Pr posed
Hardcover: 0-75 '
7 -250 '
25 -500 '
500 1000 '
Hardcover ariance Req ir d: Yes o Date of Cou cil Approva�:
Grading: S aff Approval D te: / By: Council Approva� Date:
Septic: St ff Approval D e: By=
Zoning File�:� Resolution # : Resolut`ion Date:
REMARRS (in house) :
�� ,
BIIII,DING REVIEW CHECR LIST
IIgC: �I " � C�NSTRIICTION TYPE: ,L� �
�
Sq Footage $ Per Sq Ftg
Basement x -
lst F7�oor X -
2nd Floor X -
Garage X -
x =
TOTAL
•o
$stimated Construction Value: $ 2,7�v �
Inspections Required: Work Requiring Separate Permits:
Site � PZumbing Grading/Filling
Footing Mechanical Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
WaJ.I Board (Masonry) Lawn Irrigation
Q�FinaJ. (Mfg.) Other
Other Wel 1 (State Permit)
Electrical (State Permit)
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REMARRS (IN HOIISE) :
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REVIEW BY OTHEFZS: DATE:
Access : Existing New
Access Approval: Date BY=
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jLF.MARKS (TO BE NOTED ON PERMIT) :
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� �� � DATE TIME
CITY OF ORONO � CALLED IN
INSPECTION �CFc��� SCHEDULED
PERMIT NO. G OMPLET D
ADDRESS � c�
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OWNER " CONTR.
TELEPHONE N0.
� DESCRIPTION �Nr _ c� v�-�j
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
3 y4-�WAL`BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q � 0� 5 FIN� 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS.
INSPECTOR WiLL RETURN � PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
C INSPECTION REQU�RED.CALL TO ARRANGE ACCESS.
Call for t t inspec ' urs in advance.473-73
OwnerlContr r o t .
Inspector. �
White Copy/lnspecior's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO �j� cA��Eo iN ��- � "`% �� ��� «�'-,
INSPECTION NOTICE l�� SCHEDULED `1 �i i �`j 3. ��- . '��,
PERMIT NO. � COMPLETEDj� `—/ '� �� —�� ��
ADDRESS � ���C-` /'-�_`�=�� �' ' � /c�
OWNER �'��.-��:ct��,-, CONT . ��E:� ; ,,�.� ��
TELEPHONE NO. � �� " i�' %��� `� y�� - /�
� DESCRIPTION . l-�'��"i iL��„%: C-�<-k,`
�
� 01 FOQIL[�lG___ 11 MECHANICAL RI 16 WELL TEST PUMP
�2 F�RA�MING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
"'' 03 INSULATION / 24125 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 O6 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W'�❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �; PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
OwnedContractqro,n siie:
Inspector. �'�� -
Wh'ite Copyllnspector's File Canary CopylSite Nofice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TIC SCHEDULED
PERMIT NO. 1 MPL
ADDRESS T� �C) �, ' ,�e'N � . ��,
OWN ER CONTR.
TELEPHONE N0.
� DESCRIPTION _1 �%� N cl��� ��
lu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
5 FI L 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r-, pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '.-' CITATION ISSUED
p INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for t 24 hours in advance.473-7357
OwnerlCont ctor te:
Inspecto -
White Copy/lnspector's File Canary Copy/Site Notice