HomeMy WebLinkAbout1995-007288 - addition/remodel PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �y a;
Crystal Bay, Minnesota 55323 Permit Number: I
(612) 473-7357 Date Issued: :
SITE ADDRESS:
�I 11 � 0 3,b b
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -
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APPLICANT/ RMITEE SIG URE ISSUED BY:SIGNATURE
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �S9?j GR.�IST�- p�-"�u= PID'
/Lc.-w�ro d CZ
DESCRIPTION OF WORR: AIOiO177d/��
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-------------------- ---- ----------- �
ZONING REVIEW BY:
DATE APPROVED: �"�Z `�S
BDII,DING REVIEW BY: DATB APPROVED: 7-12-�1 S
----------------------- -----------
FEES TO BE CHARGED• Misc. Fees Calculated By:
PERMIT Yes ✓" No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes i/' 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: /YI Post Office: ,�1 School. District: D
Lot Area: �'r 7/5 S �i Width: 5� Depth: �Y�•
Survey Submitted: Yes� No Date of Survey: 1- �'' g�
Proposed Setbacks : �
Front (�) : �g � Right Side: 1�, �
N A Left Side: 1�� '�'�
Rear (�') = '
Adja�ent Structures : � Wetland: /J/A
Building Height: Def . Hgt. p . {�- Peak Hgt. � • ��-
Avg. Setback: N�✓� Lot Coverage: 1�• �
Existing Proposed
Hardcover: 0-75 '
75-250 ' -
250-500 '
5oo—i000 � ��.5 Zz.y
Hardcover Variance Required: Yes No o� Date of Council Approva�:__
Grading: Staff Approval Date: N �"}- By: Council Approval. Date:_.
Septic: Staff Approval. Date: /���} By:
Zoning File: # 1�7 72- Resolution # : � y�J`'( Resolution Date: /��/`/��i
REMP,RKS (in house) :
BIIILDING REVIEW CHECR LIST
pgC: �.- 3 CONSTRIICTION TYPE: Y^J
Sq Footage $ Per Sq Ftg
Basement x -
lst Floor X -
2nd FJ.00r X -
Garage X -
x =
TOTAL
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Sstimated Construction Val�ue: $ `[�a�"
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Fil.ling
(Footing Mechanical Fire
�Framing Septic Water Connection
�Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
►�Final (Mfg.) Other
Other Well (State Permit)
CElectrical. (State Permit)
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RF.MARKS (IN HOUSE) :
-------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
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REMARRS (TO BE NOTED ON PERMIT) :
` ' CITY OF ORONO - BIIZZDING PERMIT APPLICATION ��
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Total Fee: $ ,Z-5 �• �� � Date Received:
Date P.pproved:
Entered By: t ::��' R � s���
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Permit n: /r�
AT.T• INFORMATION MIIST BE SIIBMITTSD IN FULL BEFORE PI�AN REVIEW WII�L B$ ST�,R�ED
(See Check-off List Enclosed)
----------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
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JOB SITE ADDRBSS: � � � � i' `�_�' J=Z�/ � �'� c � ZIP: �`� � .i � �-
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(work) ��f� 1�i ,�E> �
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N� OF OWNER: ��� �/� i� l� / ^ � . ��� �:� ��C' t`��'�� PHONE: (home) �'�5 ���i .�r���
hfATzzx� r��xEss: / ��t � �C ;�-/� �f-�' _ cz�: .�� ,i ����'"�����`�l�P: '':�C��
i i i �) ��( ����1� PHONS: �'<� l' � �'��
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CON2'�CTOR: 1t� �� ���G�L� ( i.(� 7 �C�i�/ [ �, . v
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MAII,ING ADDRESS: l �>-��� !'�'�, '���� _�'���� � CITY: �/��/,�,< 'v��; ,�,�F� ZIP: �����C'/
STAZ'S LICENSE: tt
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ARCHITECT�ENGINEER: � �/� >�'� 'L���� �:', ! .r��� PHONE:
�ILING A.DDF.BSS: CITY: ZIP:
;1p��: RBGISTRATION �
TYPE OF WORR: New Addition v' Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
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PROPOSED WORR (describe in detail) :� � �r 1 � � j i
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STORIES:�_^ _ SQ. FEST OF EACH FLOOR: � �� ! , , . i T
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NO. OF B$DROOMS: �� GARAG$ ST�LS: ATT. ' ',,.'.' DET.
�STIHATED CONSTRQCTION VALIIATION (eacluding Iand) : $ �/ �%�-�'� �
= 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 will be in accordance with the approved plan. �
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APPLICANT'S SIGNATIIRE: /�, L� t,tt� '� iti �" y";'� `'�_=� DATE/�-, - ?
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�y i � � Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
;
05 .�� � fi.{; �
`" �" "' '� On the North Shore of Lake Minnetonka
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DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of
data" , we would like 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:
1. The information you furnish wil.I 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
license.
4. If your requested permit or Iicense requires Counci� action
to approve, some information may become public.
5. You have certain rights nnder M.S. 13.04 to review pri�a��
data on yourself.
6. Yaur full name is required to process this applica�icn or
permit.
� � ��
� � � �� <� ��Il � � �, ���
�>/.�d) 1(�� ' C l C'
First Mi` dle Last
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� -� t% �JC�� �� �� `> j ,�
Address
'1 ,;� t, �- �- `i f��' ��i S `�' ,'I `"� �� �/ �'�
City State Zip
; �< 7 — `� "� � _��,� ��-...
Phone
I understand my rights as stated above.
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,L,�- �� F L �
ignature ;
BUILDING&ZONING—473-7357 • ADMINISTRATION&FIN.1tiCE—�73-7358 • PUBLIC WORKS —473-7359
ASSESSING
.. .
�.� �Gg� pg �IIgJgC1'S OF DATA
Sub
division L Type of da�- The rights of ind�viduels on whom the data is
stored or to be stored shall be es set forth in this section. An.individuel asked to
to be given in�ivi�uaL
Subd. 2. Information reQ�� himself shall be informed of: (a) the
supply private or confioential data concerning
ur ose and intended use of the requested data within the collecting state agency,
P P tem; (b) whether he ma� refuse or lfromhis
political subdivision, or statewide sys �oWn consequence arising
the requested dat8; (c) any
required to supply rivate or confidentisl data; and (d) the identity o
supplying or refusing to supply p investigative data,
�• state or federal law to receive the data. This.
other persons or enti�ies authorized by
requirement shall not apply when an individual is asked to supply
pursuant to section 13.8?, subdivision �, to a law enforcement officer.
The
commissioner of revenue mav Place tgX re°und i�tauctionsu nsteadhos
subdivision in the individual income tax or propert
on those orms.
Subd. 3. Access
to �ata bY ����' UP°n request to a responsible
orit an individusl shall be informed whet�c h r ygteeor confident al.e Upon his
auth y, ublic data on
- individuels, and whether it is classified as Pu � P
e to him end, if he desires, shall
further request, an individuel �t8 Without any chargtored private or
individuals shall be shown the of that data. After an individual has been
�e informed of the content and meaning the data 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 datg u n request by
or additional data on the individual hes g een�r pu��c ed °r �eg�ed. The
, pending reauire the
responsible authority shall provide copies of the pr �d compiling the
the individual subject of the c��'co � of mpa�ng�l �Qrt fyingy may
requesting person to pay the a _
y if ssible, with any request
copies. immediatel , Pa
The responsible authority shell comply
e ursuant to this subdivision, or within five �f Simmediateatcomplisnce e��.su not
mad p �d le al holideys,
excluding Saturdays, S�aaYs g with the
ssible. If he cannot comply with the request within that time, he shall so inform t e
P° �Ve sn additional five days within which to comply
individual, and may end le al holidays.
request, excluding Saturdays, Sund�Ys g lete. An individuel mgY
Subd. 4. Proced�se �'►hen �ata is not accurate or comP �mself. To
or completeness of public or private data concerning
contest the accuracy in WTiting the responsible authority
exercise this right, an individual shall notify �ible authority shall within 30
describing the nature of the disagreement. The respo
dg � either: (a) correct the data f ound to be in�e agtae including reC Pi�� nam dt by
5
notify past recipients of inaccurate or incomp e �
the individual; 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 disagr
• included with the disclosed data• � 8ppealed pursuant to the
� The determination of the responsible authority may
provisions of the administrative procedure act relating t� contested cases•
Sketc.'1 �f I'r��i�:�'<3 Iic>>>;� �lcld;.ti.c�n �'c�r:
Din Ft<�.dfotd _ . _ �l'i4,��� �
� , 12�16 F,�st 90Lh Stre�t �'�
`,�y ��'� rr
Inver Grove IIeiyhts, HN 55Q77 ���,11�
�R .�_
DELMAR H. SCHWANZ
LAND SURVEYORS.INC.
Rpi�t�nd UnMr Lris ol Tt»StN�W Mln�wot�
14750 SOUTH ROBERT TRAiI ROSEMOUNT, MINNESOTA 55068 812/423-1769
SURVEYOR'S CERTIFICATE
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Scale: 1 inch = 30 feet /ZLOC�( 3:,
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��� Description: "
Lot 11,
Block 3, NAVIIRRF. IiEIGIITS. � �
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- I hereby certify th�t thls survey,pl�n,or roport waa
prepued by me or under rtry direct supeniaion�nd �
�� thet I �m �duly Fegistered Und Survsyor under /��,;� �7 �
the I�ws of the State of Minnesota. �' � / �����
i
, Delmar F�. Schwanz
09-09-94 Mlnn�sot� R�9istration No. Ed25 [
' Datsd
D TE TIME
CITY OF ORONO CALLED IN � �
INSPECTION NOTICE �. SCHEDULED �//[.�/5� /`/ ' 3 0
PERMIT NO. �t ��� � � COMPLETED
ADDRESS �S '�
OWNER CONTR.
TELEPHONE NO. "t'7 / - � � CnC�
� DESCRIPTION �L/1' Q,yv,��t�
l� 01 FO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� BEFORECOVERING
PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. C pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next spection 24 hours in advance.473-73�J7
Owner/Con�rdLf�n it :
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Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO�IC� SCHEDULED fl��"-�(�
PERMIT NO. `l,�-�=� coMP ETEo
ADDRESS � �
OWNER CONTR.
TELEPHONE NO.
��SCRIPTION
� 0 OOTING 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 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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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W� �WORK SATISFACTORY:PROCEED C; PROJECT COMPLETE
W C CORRECTI/t�ORK 8 PROCEED i ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WI�L RETURN
❑STOP ORDER POSTED.CAL�INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac r o-n�site:
Inspector. �U
White Copyllnspector's File Canary CopylSite Notice
ATE TIME
CITY OF ORONO CALLED IN /G' =� '
INSPECTION NOTICE ,., scHE�u�Eo � " '��E %� -C;;�
PERMIT NO. '�fi �7 �/ COMPLETED �.�_
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ADDRESS �-�=3�-i '��`:;��' ��-= u ��-
OWNER ��-���o �'�.���P , CONTR. -�'r���
TELEPHONE NO. '�r�7 �-('1��r�C?
� DESCRIPTION _�r��_ti;,?-� �_-
� `01 FOOTING �`�:» ;_�.�t�C�11 MECHANICAL RI 18 IXCAV/GFiADINd/FIWNQ
y 02 FRAMING `"f�t: ��-��;Z3 MECHANICAL FINAL 19 LAI�SHORENVETLANDS
Q 031NSULATION��'��-l� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. .� 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 74 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO-�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Z 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITH�N HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN -
❑STOP ORDER POSTED.CALL INSPECTOR
L� CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr n t :
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White Copyllnspector's File Canary Copy/Site Notice
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