HomeMy WebLinkAbout1996-008189 - remodel/change roof PERMIT
�IT��OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Fci:� ��T���=�
Crystal Bay, Minnesota 55323 Permit Number:
{�:'i�-� �;;`�i
(612) 473-7357 Date Issued: �=�r};^;�_j._��
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
'=�C:_r='�i�:r�TE F'��;�•i i i hEc;�t;I F��u �i j�i �i�Ei�:��i t:t�i__ f:c�T�TE? .
FEE SUMMARY:
l!`F-i�._l 1�tT I i_i� $�:, i lt_):i
L�J�'r'1�' �}'Fa ��1.`/ . �
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CONTRACTOR: — �::,����i ; E�;;-�. -- �_;� . ���:. OWNER:
.it�iv Y�t.I�.��.�;'�� ii�i�: 1�.i�'�17�; 1=�1�:� F�FiE.� �I�iai�
�=,�;��i �:��:i��it����k�;�F t;�� :�.4.�,.'_: �i�:-;�'i f;�:::� :��'
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t:r:i •�':a �.7��--4,�.7�; a�r=,--:�T=:�.t�.
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APPLI ANT'P ITEE SIGNATURE ISSUED BY:SIGNATURE � C..�_�
Total Fee: ��.�.��., DateReceived: ;' /;,
DateApproved:
Entered By: �/ Permit#: ,5�.i �l
CITY OF ORONO - BUILDING PERII�IIT APPLICATION
ALL IlVFOR.�'VIATION MLJST BE SUB�IITT'ED IN FULL BEFORE PLAI�i REVIEW WII,L
BE STARTED
-------------------------------------------------------------------------- -----_--�---------------------
THE �iPPLICA:�1T IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �3`-��:5 C �-A�Kr S-� Z�� :5 ��S �'
NA�ti1E OF OW�1ER: � I ��.�4 ��'i`e�- PHONTE: (home)�� �'' 2 � y7
\(work)
MAILII�TG ADDRESS: �i-�-(;y,� �: L��r ,f'f CITY: �J/'� ZIP: y S'��'�
CONTRACTOR: � �NL � ���,�Gr cO�S -.0 ��'_ PHONE: f-��� —;� /'7 C,
vIOBILE PH0�1E/PAGER: c�� �-Z�2..�—
MAILING ADDRESS: ��SU l.c>avA�' ��s��r,�CITY: .�¢ZIP: 3�;- :
STATE LICENSE: #��/:�� (}
ARCHTI'ECT/ENG�EER: PHO�1E:
MAILING ADDRESS: CITY: ZIP:
�J�V�; REGIST'RATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
Up�y���n�
PROPOSEDWORK(describeindetail): ��t'ss� c.�: ' r�� -�
C �F ' � ' ''� � �,���
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI.LS: ATT. DET.
EST�IATED CONSTRUCTION VALUATION(escluding land): $ ff, �e� �
I hereby apply for a building permit and I acknowledJe 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.
, �
�/ �
APPLICANT'S SIGNATURE: '' � �✓��,��%� _ / ��-�';�%'� �DATE: �—�� � ��
. � -
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGH'I'S OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be�ven individual. An individual asked to supply private or confidendal data conceming himself shall
be infortned of: (a) the purpose and intended use of the requested data within the collecdng'state agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown coasequence arising from his supplying or refusing to supply
priva[e or confidential data;and(d)[he idenary of other persons or encicies authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigaave data, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv tax refund
inscrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject
of stored data on individuals, and whe[her it is classified as public, private or co�denaal. Upon his funher request,an individual who is the subject
of stored priva[e or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the contenc
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this secdon is pending or addirional dara on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesring person to pay the actual costs of making, cettifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any reques[made pursuant to this subdivision,or within Five days of
the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is no[possible. If he cannot comply with the reques[
within that time,he shall so inform the individual,and may have an additional five days wi[hin which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himsetf. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreemen[.
The responsibfe authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipienrs of
inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authority may be appealed pursuant to the provisions of the adminisuative procedure act relacing to
contested cases.
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 determuie your qualification for the pemut or license 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, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
C�n, State Zip Phone
I understand my rights as stated above.
Signature
" CHECK OFF LIST FOR ISSUAI�iCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _ ,,: _.
PID:
DESCRIPT'ION OF WORK: i�.�:�,��` �4,•�'� C� �-kv=�t-U� �= ;�-�--��_
-----------------------------
ZONING REVIEW BY: DATE APPROVED: 1- �8•�b
BUII..DING REVIEW BY: DATE APPROVED: �-i 0• 9 G
----------------
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 v SITE INSPECITON
Number of SAC Units OTHER (specify)
--------------------
ZONING CHECK LIST Zoning District: G 2 -/R Shoreland District : `I�5
Fire Depar[ment: �Nt, L�iu% Post Office: (�onrc, (�t�K,C' School District: ��1t�d
Lot Area: Sq.ft. I I ��U t Acres , 2 S Width (/'2.� � Depth �l`/•�7
Survey Submitted: Yes o� No Date of Survey: �'3' `'�
Proposed Setbacks: F'/�.�N7 c
F-�e�t (Lake): fo�(� � -Pag�t Side: `i� +
��e-� (Street): �2� + Left Side: 32� �'
Adjacen[ Structures: 1�TCi4Gt�C� Wetland: N�I}
Building Height: Def. Hgt. d-� Peak H�t. -
Av�. Setback: N //a- Bluff Setback: /�(�9 L.ot Coverage: /�/U CI�r9h.cL.P
Existing Proposed
Hardcover: 0-75' /'1•�1 —
75-250'
250-500'
500-1OQ0'
Hardcover Variance Required: Yes No � Date of Council Approval: (o� Z y'�b
Grading: Staff Approval Date: /��/Q- By: Council Approval Date:
Septic: Staff Approval Date: N�/� BY�
Zoning File: # 214� Resolution: f# Resolution Date:
RF.MARKS (in house):
BUII.DPi 1G REVIEW CHECK LIST
UBC: �.' 3 CONSTRUCTION T'YPE: �!N
Sq Foota�e � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ g' Ooo 6-
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
D Insulation (Masonry) Other
_�Wall Board (Mfg.) Well (State Pemu[)
ic Final Grading/Filling K Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By�
REI�IARKS(TO BE NOTED ON PER.NIIT):
27 �
.
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�'OR S�M�K.G OLTt�TO(Z :�,,►� o�rMrr r�. — -
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A�'�.�VED V+iITH C(5t;i�'�"iA�iB AS NOT.Ep
.;� NO� A�OVEU — COt�i�.Gr & RESU�;MIT
�resQ c�n�ex�rn;s zre tor yo�rr Ir�tcrrmatkan. AH work shetf�e 1�5119�f
L'l� � � � ;��;.,�,_ }��J ` ;�: �M .car�w;�+b�:� w�m �1, �-i� ovai�ii+� i� zarw� .i��r
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�►�i,�.� 7��+s �ti�r+ *s�i '.rt's �fif'"c AT �ti.L 11ih�it
DATE TIME
CITY OF ORONO CALLED IN % � '" �'�
INSPECTION NOTICE SCHEDULED '� � %�� •'O
PERMIT N0. ` j COMPLETED �_ �__
ADDRESS _"� _:��,� _;- <.�-�.<_- :f�,� l�_
! /-�% 'i'/
OWNER /� > .� CONTR. -
TELEPHONE NO. -. ' ' � , _, - �
� DESCRIPTION _ _ - < < .-
� 01 FOOTINd v 11 MECHANICAL RI 18IXCAV/ORADINCa/FIWNG
� Q2 FRAMING � 13 MECHANICAL FINAL 19 LAl�SHORElWETLANDS
�SULATION D�(� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Q WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
= OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
�` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOFi TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED
W � PROJECT COMPI.ETE
� � ORRECT WORK 8�PROCEED " ISSUE CERTIFICATE OF OCCUPANCY
W
OO CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN `
❑STOP ORDER POSTEO.CALL INSPECTOR '= CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for e x 'n pection 24 hours in advance.473-7357
OwnerlContrac o on it :
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
688484
CERTIFICATE OF SURVEY FOR
DIANE PEREZ
IN LOT 2, BLOCK 8, BAYSIDE ADDITION TO LAKE MINNETONKA
HENNEPIN COUNTY, MINNESOTA
.•(s3,.2�
k��' EAST LA�E STREET �
.16 ,..,
.' •(931.3)
• EAST 66.29 -
i.b�' e.2 ••�.�� —1
, , ', � �',
� � ,� , � �;�' ,:�� .
�� ,���:'�-' -�----- 200'---l�---->)
. � ,;�� o,N
EXISTING..•' �--,-��931.71• ��
(932.3)•• � E. I�neof'l.ot2, �
YARD B�N �.o � a�o�k e,ea,,,�e.-�� I
� Adl.foL�c.M�k4.
_ , a�, � EXISTING �'
O�/ 69*' - `^ � I
0
qz'_4 � HOUSE � ` �
Con foui'l;n i l � m
T ^'� � � I
;�/� 28.1
� •t -- �;.r5 ��� I
� � (931�.7)'', -:f'� N °
�� o,� . � - ^h �.
N� �, (931.2)•- ,z.o �� � =' I
^, �. Oo I
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/ ` � `+, Z�-• -..��e r
� 1 i
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� /, �� -4 +or- I
V A t -24.4d
� v 6± WE57' -• 18 t — — — — — — — ___�r���� ..�_
�f � e � '-929 4 Contour Line• .,,,�
M � ��� �
� � CiTY OF ORONO
N F �, I , oC SITE PLAN GRADING PLAN `
p � e � �e�A�'I-gaVED - 2oor, �w���. !
� !r '9 I � AP�R�VE� �A�";"��-� ��VlSION� �
q� �' ; ❑ DfS�1�P ����
j BY
�C��TE_..�^s�--�1-��-4� -------
LEGAL DESCRIPTION OF PREMISES : R��� ���
That art of Lot 2 Bloc ���
p , k 8, Bayside Addition to
Lake Minnetonka, lying West of the East 200.00 feet.
o : denotes iron marker
(931.9) : denotes existing spot elevation, mean sea level datum
Bearings shown are based upon an assumed datum. ...
This survey intends to show the boundaries of the above described property,
and the locotion of an existing house and yard barn thereon. It does not
purport to show any othet improvements or encroachments.
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I hereby certify that this survey was prepared by me or under my direct super- �A� 5-3-96
� � � � � � � vision, and that I am a duly registered Civil Engineer and Land Surveyor under
"i the laws of the State of Minnesota. scA�E �"=30,
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Mark S. Cronberg Minnesota License Number 2755 )og No. 96-I¢7
i-147
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