HomeMy WebLinkAbout1993-005163 - 12x12 deck . PEI�MIT
C�ITY OF ORONO PEAMIT TYPE:
- 2750 Kelley Parkway • P.O. Box 815 Permit Number: ��t�������Je=
Orono, Minnesota 55356-0815 {'�r���'='
(612) 473-7357 Date Issued: _;c, . y�,:��;_;
SITE ADDRESS:
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CONTRACTOR: OWNER: - 'r��=�=� ���?i�k� -
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APPLICANTiPE iTEE SIGNATURE - ISSUED BY:SIGNATURE 4�1cf�/�
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` . • CITY OF ORONO - BUILDING PERMZT APPLICATION
Total Fee: $ �>.�� `/ 5 Date Received:
Date Approved:
Entered By: � '/..-
Permittt: �
AL.L INFORMATION MIIST BE SIIBMITTSD IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
2'HE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: � Z� � �KE.-> j!� ��Z= ZIP: ������
(work) ��1� 3t:�;C�
� N� oF owx�x: �c�y � �-i�7�L+� �: ►�,� PaorrE: (home) �]� -Z�-7�-
�3AILING ADDRESS: �"�ZL �F�K� �1� �''��� CITY: L`;(�;4 ��K� ZIP: ��3.`> �
CONTRI�CTOR: O(,t„) n,'E� PHONE:
.
�iAILING ADDRBSS: CITY: ZIP:
STATS I,ICENSE: �
ARCHITECT/ENGINEEFZ: � � ti E tZ PHONE:
MAILING ADDR.$SS: CITY: ZIP:
N�: REGISTRATION n
TYPE OF WORR: New Addition Accessory Structure� Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : � Z t �( l Zr LL:'�.c:� �,��:
STORIBS: SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: GARAGE STAI.LS: ATT. DET.
. `�✓4Y �
ESTIMATED CONSTRIICTION VALIIATION (eaciuding la.nd) : $ 1 �'�. ��
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work wil. l be in conformance with the
ordinances and codes of the City and with the State Buildinq 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.
APPLICANT'S SIGNAZ'URE: '�� � - DAZrE: � �jG v��
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��r���� CITY of ORONO
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_,,,�� r� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Officea
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� m +� � a On th,e North Shore of Lake Minnetonka
DATA PRNACY 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
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 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 publ.ic.
5. You have certain rights under M.S. 13.04 to review pricat�
data on yourself.
6. Yaur full name is required to process this apFlicatian or
permit.
LEG�1 �L1 CiCIt.'� �7RLl.' f���IV�
First Middle Last
C'1 Z�:'-- D ��kc; r� AU��
Address
�
1��,ti'�; L r�k� n1 �' .�:�_3.��
City State Zip
� 7� -Z4 ��
Phone
I understand my rights as stated above.
�i�^� C� c;�.�2C.�� J,` `�� ��
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&F(NANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
573.04 RIGH'I5 OF SIIBJECTS �F DATA
Subdivision 1. Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be g��� u'���'1' An.individusl asked to
" supply private or confidentiel data concernina tgmWi hin the collecti g state agency,
purpose and intended use of the requested
(b) whether he may refuse or is legally
political subdivision, or statewide system; known consequence arising from his
required to supply the requested dat8; (c) any
supplying or refusing to supply private or confidential data; end (d) the identity of
other persons or entities authorized by stat u��e@skedlto supply i nvest gat ve data,
requirement shall not apply when an individ
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma� olert� tax re�und instructionsui steadhos
subdivision in the individuel income tax •r r �
on those orms. . --
Subd. 3. Access to �ata bY ����' Upon request to a resp�nsible �
authority, an individual shall be informed whethen c��teeor confident al.e UPfln h�s
individuels, and whether it is classified as public, p ublic data on
further request, an individusl who is the subject of e to�mrl�aeif he desires, shall
indivi�uels shall be shown the date withou�f an�y ��tg. After an individuel hes been
�e informed of the content snd meaning the data need not be �isclosed to
shown the privete date and informed of its meaning, u�uant to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the individ�h h� ate or p bl c datarupongrequest by
responsible authority shall provide copies of P require the
the individuel subject oftrie actual•costs of mak ng,l c�rti yingy and compiling the
requesting person to pay -
copies. immediately, if possible, with any re9uest
The responsible authority shall comply s of the date of the request,
made pursuant to this subdivisi�nd le with lid ys,�f immediate compliance is not
excluding Saturdays, Sundays �
possible. If he cannot comply with the request withinNi�nt�ch toh omplynw�h the
individual, and may hsve an additional five dsy's
request, excluding Saturdays, Sunda3'S and Iegal holidays.
Subd. 4. Proced�u'e �►hen �ata is not acetu'ate pr complete. An individual may
contest the accuracy or comQleteness of pno� °inrlwri�tthe°reSPonslb e au hor ty
exercise this right, an individual shall Y
describing the nature of the disagreeme otbeTnBcciu�a e or incomplete and atte pt 30
days either: (a? correct the data found t
notify past recipients of inaccurate or ia�P�t he believesdthe datalto be correct
the individuel; or (b) notify the indivi
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the �isclosed data. � BpPe�e� p�uant 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
• ,A
ADDRESS OR LEGAL: �ZC7 pA 1107�A PID:
DESCRIPTION OF WORR: CI�
------------------- - ------------------------------------�--+ -----------------
ZONING REVIEW BY: DATE APPROVED: �--�-L`-Q,�
BIIII,DING REVIEW BY: � DATE APPROVED: � "��•-� 3
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: Post Office: School. District:
Lot Area: Width: Depth:
Survey Submitted: Yes No Date of Survey: �
Proposed Setbacks:
Front (Lake) : Right Side:
Rear (Street) : Left Side:
Adjacent Structures : Wetland:
Bui�ding Height: Def . Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-7�' ° .
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No Date of Council Approva�:
Grading: Staff Approval. Date: By: Council Approval Date:
Septi c: Staf f Approval. Date: By=
Zoning File: # Reso�ution #� : Reso�.ution Date:
REMARRS (in house) :
BIIILDING REVIEW CHECR LIST . , �
pgC:� i`'��� t`� CJ g CONSTRIICTI ON TYPE: �- '
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor _ x =
2nd Fl.00r x =
Garage X =
x =
TOTAL
$stimated Construction Value: $ � q��
In�p ections Required: Work Requiring Separate Permits:
T ite � Plumbing Grading/FilJ�ing
�Footing Mechanical. Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
�a�I. Board (Masonry) Lawn Irrigation
inal (Mfg.) Other
Other WeI 1 (State Permit)
El.ectrical (State Permit)
---------------� ----------------------------------------------------
REMARRS (IN HOIISE) :
-------------------------------------------------------------------------------
REVIEW BY OT�tS: DATE:
Access: Existing New
Access Approval: Date BY=
-----------------------------------------------------------------------------
(TO B OTED ON P IT) :
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Lech E Gawron
920 Dakota Ave
Long Lake, MN 55356
473-2474
12'
1'-6" 8'-11� 1'-7�
1'-6"
4'-6"
2x6 JOISTS
0 24" O.C.
12'
4'-6"
2-2X10 BEAM
1'-6"
Lech E Gawron
920 Dakota Ave
, Long Lake, MN 55356
473-2474
2X6 DECKING 2X6 FASCIA
2-2x10 BEAM
4X4 POST 2X6 JOISTS
2X6 TREAD
11 1/4"
2�-5�
SIDE WALK
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6 1/2• CRADE
2X4 BLOCK
2X12 STRINGER
3'-6"
8'0 (MIN) FOOTING
6'
Lech E Cawron
920 Dakota Ave
Long Lake, MN 55.756
473-2474
2x6
2x4
3'
2x4
2x2
2x2
2x6
5'—3" 3' 3'—9"
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Lech E Gawron
920 Dakota Ave
Long Lake, MN 55356
473-2474
6"
3'
3'
Lech E Gawron
920 Dakota Ave
Long Lake, MN 55356
473-2474
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D� AT,���3 TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE . scHE�u�Eo "�b �%�'�
PERMIT NO. �/ �-j COMPLETED T �
ADDRESS �1`�U C ' �� ���-�-
OWNER .-����t r�`�-E� _CONTR. —
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TELEPHONE NO. r
� DESCRIPTION �����
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORENVET�ANDS
� 04 D. 12 WATER HOOK-UP 34 TREE REMOVAL
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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
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINA� 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d ORK SATISFACTORY:PROCEED
W� � u PROJECTCOMPLETE
W L, CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, PHOTOTAKEN
INSPECTOR WILL REfURN
C STOP ORDER POSTED.CALL INSPECTOR '-' CITATION ISSUED
O INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr r p�site:
Inspector. v
White Copy/lnspect r's File Ca�ary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED - O- 3 -���
PERMIT NO. -�/ � OMPLETED
ADDRESS �
OWNER f � CONTR.
TELEPHONE NO.
� DESCRIPTION � ��
��OTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE FEMOVAL
Q 05 FINAL 13 METER SET(TURN QN 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ORKSATISFACTORY:PROCEEO f� PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED i; ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. � pNOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
' GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContract o si e
Inspector. --
White Copyllnspector's File Canary CopylSite Notice