HomeMy WebLinkAbout1993-005187 - deck addition � PEI�MIT
CITY OF ORONO , PE�RMIT TYPE: /
2750 Kelle Parkwa • P.O. Box 815 ' �::`��_`';�"t�
y y Permit Number: ;-�fr;,
Orono, Minnesota 55356-0815 _ ' ��:''� _
(612) 473-7357 Date Issued: ;;�,;-�_;_;;__a::;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT%P RMITEE SIGNATURE ISSUED BY:SIGNATURE ����
, CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ _ '' Date Received:
Date Approved:
Entered By: (�!; permit#: � � �
AT•T• INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Encl.osed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS:�S�-� ��NUJbO�� �vrc• ZIP=��� �
(work) rj��- �,1'�i
NAME OF OWNER: 1 �V����\Vi � � ��l��V PHONE: (home)��`-��-1
MAILING ADDRESS 2�0� ��NU�O(C�� �'TVC• CITY: VV JT�CI���T' ZIP: 5�3�`
CONTRACTOR: (��1NC�(�� PHONE:
MAII�ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: �W �vr��� PHO�=
MAILING ADDRESS: CITY: ZIP:
Np,My: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure� riove
Demo Remodel/Alteration Renovate Land lteration
PROPOSED WORR (describe in detail) : �� ��i�til c�� P� �L�C�G
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: 6ARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $
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:�/t �--�'- DATE:
�
CITY of O�iON�
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 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 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 local , s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii actiar.
to approve, some information may become public.
S. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required �o process this application or
permit.
��,1)�TC� � ���S l ����N�
First Middle Last
���"J ���NV�C�OG7- � f��� �
Address
������-- 'M� �53� 1
City State p
�(n�� g-�� - ��1�
Phone
I understand my rights as stated above.
�
Signature
BUILDING&ZONING—473-7357 • ADM['.�ISTRATION&FINANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G
513.04 RIGH'Z5 OF SIIB�CTS OF DATA
Subdivision L Z� of ��- 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 in���L An.individuel asked to
� � supply private or confidentiel data concera a gmwi hin the collecti g state gency,
purpose and intended use of the requeste
political subdivision, or statewide system; (b) whether he may refuse or is legally
required to supply the requested dat8; (c) any known consequence arising from his
supplying or refusing to supply private or confidential data; and (d) the identity of
other persons or entities authorized by Svidual iseaskedlto supplyinvest gat ve data,
requirement shall not apply when an indi
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma rolert taX re�und instructionsu�ateaahos
subdivision in the individusl income tax •r
on those orms. . --- -
Subd. 3. Access to �ata bY in���• Upon request to a responsible �
suthority, an individual shall be informad�h b���hPfrvateeor confident alre UPon �
individuals, and whether it is classifie P ublic data on
further request, an individusl who is the subject of SQ to himriande if he desires, shall
individuals shall be shown the data withou�t an�y ��tg. After an individual hes been
�e informed of the content and meaning the data need not be �sclosed to
shown the private data and informed of its meaning, �nuant to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the indivif�h h�ateQor publi t datarupong equest by
responsible authority shall provide copies o P require the
the individual subject oft�e actusl•co ts of mak ng,l cert fyingy and compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comQly
tnade pursuant to this subdivision, or with lide e,�f Simmediateatcompliance eisu not
excluding Saturdays, Sundays and legal YS
possible. If he cannot comply with the re9five �thin�i��nt�ch to�omplynw�h the
individuel, and rnaY ha�e er► additional Y'S
request, excluding Saturdays, SundaYS and legal holidays.
Subd. 4. Proced�e �►hen data is not accurate or complete. An individuel may
contest the accuracy or completeness of Pnoti � inrwri eng tthe�responslb e au hor ty
exercise this right, an individuel shall Y
describing the nature of the disagreementbeTnaccura e or incomplete and at mpt to
days either: (a) correct the data found t�
notify past recipients of inaccurate or incamP�t he believesdthe datalto be correcty
the individuel; or (b) notify the individu
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the disclosed data. ealed pursuant to the
" The determination of the responsible suthority may be app
provisions of the administrative procedure act relating to contested cases.
� �
'�
, CHECR OFF LIST FOR ISSDANCE OF PTRMITS
' , FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � ;S Q c� f�U�1 W c�O�O� PID:
DESCRIPTION OF WORR: �Q C �k
------------------ -----------------------------------------------------
--T---
ZONING REVIEW BY: � 1JL�^N- DATE APPROVED: 5"- Z�o - `13
BOILDING REVIEW BY: �,Y� C� DATE APPROVED: S -�--`7�
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: � 2- ��-
Fire Department: /l�ocr� Post Office: �„��y�•g-r� School District: �tr-o�v�4
�
Lot Area: ��,3�2 �, -�rt � Width: %`(� ( Depth: � 3 5 � Av-P
�T
Survey Submitted: Yes � No Date of Survey: G - z T - s�
Proposed Setbacks:
Front (Lake) : SfS� ± Ri ght Side: N {�4- S��
Rear (Street) : (60 � + Lef t Side:_�5 � � N
Adjacent Structures : �77x}-Gf9-�� Wetland: /I��f!�
Building Height: Def . Hgt. (� ' �C Peak Hgt.
Avg. Setback: /���}" Lot Coverage: ��f
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 ' ZZ`7�
500-1000 '
Hardcover Variance Required: Yes No�C Date of Council Approval:
;-'1
Grading: Staff Approvat� � Date: 'By:_�,,�ouncil' Approval Date:
�
; � � �
Septi c: Staf f Approva�l. Date: B � j� '
i �� � i !
Zoning Fi�e: # ' Resolu�ion #: i c— --R solution Date:
� �, � i
REMARRS (in house)�: � �
� � .
i�
,,
%
j,
BUILDING REVIEW CHECR LIST ,
DBC: �� f� - � CONSTRIICTION TYPE: ��
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
c7�Lf� '-��ld x g.oa � _
TOTAL
00
$stimated Construction value: $ 3 .�C7 —
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Fil.ling
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�l Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Well� (State Permit)
Electrica� (State Permit)
------------------------------------------------------------------------------
REMARRS (IN HOIISE) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date By:
------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
� • �r�an`� 1 G�o�
� HARDCOVFR C'�LCUL�TION WORKSNEFT
SETBACK ZONE: �CIRCLE ONE) �—�5' 75-250� 25�-5�0' S00-1000�
EXISTING HARDCOVER IN ZONE
--------------------------
A� HOUSE X = S�F�
� LENGTH WIDTH
.. +�. x . _ � ..:�� S�F�
_ r'
X = Y S. F�
� � X = , S�F�
� X � _ ' S� F�
B� GARAGE X = S�F�
`�� _ ;� '� ._
C. DRIVEYJAY X S.F�
- — �, '
�.� X �-� ',.�' _ � a S� F�
D� . SIDEWALK X = S�F�
X = S� F�
X = �''� S.F,
E� �ATIOI
ECK � ` ,`•` ��
X _ = S.F.
F. LANDSCAPE X = S�F�
AREAS
UNDERLAIN �- � � '� = S.F�
BY X � � --
PLASTIC �
SHEETING
X = S�F�
X = S.F�
G� OTHER X = S�F�
TOTAL HARDCOVER IN ZONE — � S.F� Q
TOTAL PROPERTY AREA IN ZONE — I,�. OO� S�F� �B
�� � B I � "�. �
• � '�_ � x 100 - ,`` o
a - -
19
�
HARDCOVFR CALCULATION WORKSHEET '
SETBACK ZONE: �CIRCLE ONE) 0-75' 75-250` 250-500' S00-1000�
EXISTING HARDCOVER IN ZONE
--------------------------
A. HOUSE X = S�F�
LEN6TH 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 X = S�F�
TOTAL HARDCOVER IN ZONE - S.F� D
TOTAL PROPERTY AREA IN ZONE - S�F� a
a : B X loo = %
2 0 ';;:
4��
� . r
_Phone: GReenwood 3-8352 , ��
� � ARLEIGH C. SMITH
OR01�0 �a
, �-
' � Registered Professional Engineer and Land Surveyor
16215 Wayzaia Boulevazd �' Wayzafa, Minnesota
� '11� PLAT OF SURVEY
- OF PROPEFtTY OF �•� S• �a��s Rt. I �:�ayz?t�? '��.nn. .
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CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY _
I hereby certify that on V�►�i� �9 , 19�b I hereby certify that o*+ ✓ U N� �� , "lg �6
I made a survey of the p�i location of the I surveyed the property described above and that '
building on the above described property and that the above plat is a conect representation of said -
the location of said building is correctly shown on survey. ,r�s
the above plat. � t
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � _���
PERMIT NO. -����I COMPLE ED
ADDRESS o
OWNER CO R.
TELEPHONE NO.
� DESCRIPTION _ CL�
lti �OOTING 11 MECHANICAL RI 16 WELLTEST PUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGlFILLING
H
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SET(iURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
`� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP �
� 10 P�UMBiNG FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY;PROCEED L PROJECT COMPLETE
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� (1 CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑ CORRECTUNSAFECONDITION WITHIN HOURS. ,`- pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR L CITATION ISSUED
❑ INSPECTION REQUfRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra r o site:
Inspector. Vv
White Copylinspector s File Canary CopylSite Notice