HomeMy WebLinkAbout1995-006834 - addition PERMIT
' �;ITI( OF ORONO PERMIT TYPE: -
2750 Kelley Parkway- P.O. Box 66 ��r�=: -
Crystal Bay, Minnesota 55323 PermitNumber: ';��'��-.>-;..-�._;.ry�
(612) 473-7357 Date Issued: . -
SITE ADDRESS:
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FEE SUMMARY:
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APPL ANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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, CHECR OFF LIST FOR ISSDANCE OF PERMITS
- ' ' ' FOR OFFICE USE ONLY
ADDR$SS OR LEGAL: ���-� �� E�- � I �'�E ���� PID:
DESCRIPTION OF WORR: A Q D i n o�
--------- --------------------------
------------------- ---�( ------�--------- --
ZONING REVIEW BY: �c„�, C�l DATE APPROVED: �--2�-4 5
BIIILDING RL�VIEW BY: DATE APPROVED: 2-Z..�-S S
----------- ------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ � —
PLAN REVIEW Yes �� SEWER CONNECTION
STATE SURCHARGE Yes o 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 2- /�-
Fire Department: � Post Office• (N School District: �(
Lot Area: �S oo� � t% Width: Depth:
Survey Submitted: Yes X No Date of Survey:
Proposed Setbacks : .
Front (Lake) : ,1//f� Right Side: �
Rear (Street) : -]o` Left Side: N�� _
Adjacent Structures : �4�u�� Wetland: /il��
Buil.ding Height: Def . Hgt. �. (L Peak Hgt. 0 , k
Avg. Setback• /��� Lot Coverage: L(•3 �°
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 ' 25•�� o Z'�•�`'7a
500-1000 '
Hardcover Variance Required: Yes No oL Date of Council Approval:
Grading: Staff Approval Date: i✓�f� By: Council Approval Date:
Septic: Staf f Approval Date: /�/f� BY=
Zoning File:# /g£�7 Resolution # : 3SZ� Resol.ution Date: 2-c3-�i5�
REMARKS (in house) : ,
BIIILDING RE�7IEW CHECR LIST � � . ,
IIgC. � -3 CONSTRIICTION TYPE: �� �
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor x �( . 2 = c�,b o� -" °
2nd Fl.00r X -
Garage X -
x =
TOTAL
o�
Esti_mated Construction Value: $ � �O�v
Inspections Required: Work Requiring Separate Permi.ts:
Site Plumbing Grading/Fi�J�ing
Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
��'inal (Mfg.) Other
Other Well (State Permit}
�Electrical (State Permit)
-----------------------------------------------------
REMARRS (IN HOIISE) :
------------------------------------------------------
REVIEW BY OTHFRS: DATE:
Access: Existing New
Access Approval: Date BY=
----------------------------------------------------
�2F.IKARK$ (TO BE NOTED ON PERMIT) :
�ra�. CITY OF ORONO - BIIIZDING PERMIT APPZICATION
Total Fee• $ � �� � ` Date Received:
Date Approved:
Entered By: ' - - = ;; „ _;' .
Permit�: ��-�
ALL INFORMATION MIIST BE SIIBMITTSD IN FULL BEFOR.E PI,AN REVIEW WIZS� B$ STAIt�ED
(See Check-off List Enclosed)
-------------------------- ----------------------------------------
T� APPLICANT IS: (circle one) ER r ONTRACTOR
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JOB SITE ADDRSSS: �� � � � r� � �- 7 �L ZIP: �� � / 1
(work)
/� �� �� / �
�. � � 1�� PHONE: (home) l �'� " �� �
N�ME OF OWATER: rl
- � �a� ���;,..,�� ���=��z�: � ; ►�-�-EiV��� i�� ZZP: s�3� � .
MATLING ADDRESS.
CONTRACTOR: / C �- {-� PHONE:
MAII,ING ADDRESS: CITY: ZIP:
STA2B LIC:ENSE: �
ARCHITECT/ENGINEER: ���_'-+-- PH�NE-
MAILING ADDR$SS: CITY: ZIP:
N�: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration ���- Renovate Land Alteration
PROPOSED WORR (describe in detail) : �� ��'�1���S �1 �"1`- 1 o S c,�z f Ga'�
l��c lc �j�r�r� �l'� �+-�s� � � �:j �T�i � �r� � ��?� i s' �i wc�' >7R�civ,��
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STORI$S: SQ. FEBT OF EAC$ FLOOR: {
NO. OF BgDROOMS: GARAGE STAI.LS: ATT. DET.
EST�iATED CONSTRIICTION VALIIATION (eacluding Iand) : $
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
c�rdinances and codes of the City and with the State Building Code; that I
understand this is not a perm ' t and wo is t to start without a permit; and
that the work will be in acc dance w'th pproved plan. �
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R�PI,ICANT'S SIGNATDRE: C DATE: (J � `�
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� �' �`� 1 I�.$ �� CITY of ORONO
�:���,
�rs.��'����'
>�j;=x'�.. ,: � �':"�.���` Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� _ � � 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 woul.d 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 wi3.1 be used to determine your
qualification for the permit 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 �ocal , 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 �o review pri�at�
data on yourself.
6. Yrur full name is required to process this applicaticn o�
permit.
, �
,
''I �� n. �L6� ��'
Fi st Middle st
�� ; � � ��,,�n ��,� � :L� —
�
Address
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City State Zip
���. -��ca
Phone
I unders nd my ric� t a stated above.
_ (,
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSIN G
.�. �..
t
�.04 RIGHTS OF SIIB.TECTS OF DATA .
Subdivision 1. Tppe of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
gubd, Z, Information required to be given in���" An.individual asked to
� su ly private or confidential data concera a t8mw hin the c�llect ng state agency,
PP uest
purpose and intended use of the re9 tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �C� any �own consequence arising from his
required to supply the requested date;
supplying or refusing to supply private or confidential data; end (d) the identity o
other persons or entities authorized by state or federal law to receive the data. This.
1 when an individuel is asked to supply investigative data,
requirement shall not app y
pursuant to section 13.62, subdivision 5, to a law enforcement o icer.
The commissioner of revenue ma lace the notice reauired under this
subdivision in the individu8l income tax or ro ert tax re und instructions instead o
on those orms. . - -- - .
Subd. 3. Aecess to �ata by inffividusl• Upon request to e responsible
authority, an individusl shall be informed�he blic hPr vate or confident a1.e Upon his
individuals, and whether it is classified p � ublic data on
e to him and, if he desires, shall
further request, an individual who is the subject of stored private or
individuels shall be shown the data withou�t anh ��tg. After an individual hes been
�e informed of the content and meaning the data need not be �isclosed to
shown the private data and informed of its meaning, u�uant to this section is
him for six months thereafter unless a dispute or action p
� ending or additional data on the individu e h� ate or public dataruQonarequest by
• P reauire the
responsible authority shall provide coples The res onsible authority may
the individuel subject oftrie actual•eosts of making, certifying, and compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comply
made pursuant to this subdivision, or withi jlaa e �f Simmediateatcomplisnce ei�su n t
excluding Satur d ays, S u n d a y s a n d l e g a l h O �' with the
ossible. If he cannot comply with the request within that time, he s h a ll s o i n f o r m t h e
p within which to comply
individual, and gay h sve an a d d i t i o� le al d h l idaYS•
r e quest, excludin Saturdays, Sunda3'S g
Subd. 4. Procedure �►hen data is not aecura
te or complete. An in divi du a l m a y
contest the accuracy or comp le ten e s s o f p u blic oinr WT ting tthe�respons b e au h o r t y
exercise this rig h t, a n i n d i v i d u a l s h a ll n o t i f y
describing the nature of the disagreement. Th accura e ore n omplete and att pt to
days either: (a) correct the data found to be in
notify past recipients of inaccurate or incomple t he bel evesdthe datalto be correct
the individuel; or (b) notify the individual tha eement is
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the �isclosed date. be aQpe�ed pursuant to the
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
DATE�+ TIME
CITY OF ORONO CALLED IN JS
INSPECTION NOTICE SCHEDULED �5 <-�-
PERMIT NO.�87 COMP�ETED 1� �
ADDRESS � `�
OWNER CONTR.
TELEPHONE NO. '� 7-Z � �J ��1-
� DESCRIPTION _ � � p z�c�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q FINAL'� 14 SEWER HOOK-UP 06 PROGRESS
� EMO-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 OWNER/CONTRACTOR TO MEET YOU:_YES�NO
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� COMMENTS: -.yz�'L�l�1s,.
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� /VORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W C7 CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ;� PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '=' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
OwnerlContra o n si e
Inspector.
White Copyllnspector's File Canary CopylSite Notice
6a9371 �
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oC Lots 1 and 2 , 131ock 3 , Casco Ilcights
Ilci�ne�>in Cc�unty , Minncsota ,
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`l�his survey shows the location of an existinq house �s;;,.;.;,
on the abovc� described pro�>erty . It does not F�urport to
show any other improvement=s or encroachments . "" �'�
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o : I ron m��rkcr sct �j
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, I hereby certify that this survey ���as prepared b�- me or under m��direct super- �nrr_ 9-15-94
� 1 � ' 1 i ' visicin, and that f am a dulv rc�;ititcrrd Civil f�,n};inc�cr and L�ind Survcv��r imd��r - -------
thc la�vs ��f tl�c St��t�� ��f Mii�i��tic�t�t.
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,���,.� .�_,��.,�,��� . 94 - 346
Mark S. Gronbcrg Minn�sc�ta Lic�nst Numb�r 12755 ����;���
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