HomeMy WebLinkAbout1991-003990 - remodel interior �F1Z1���T
CITY OF ORONO ,, � PERMIT TYPE: r,��-� 7r:.;.-.
1335 Brown Rd. South • P.O. Box 66 a ���'-��"`�'j�`�`�`
ermit Number: ��������'-,��
Cr stal Ba , Minnesota 55323 S�•„fj?i}I;'�i
Y Y Date Issued:
(612) 473-7357
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APPLICANT/PERMITEE StGNATURE ISSUED BY:SIGNATURE �� ��.
CITY OF bRONO -�,BIII_T�ING PERMIT APPLICATION
'?'otal Fee: $ �'� �- � � Date Received:
Date Approved:
Entered By: ��� .
.� 1 �'
"' Permit#: �'�'
AT•T• INFORMATION MDST BE SIIBMITTED IN FULL BSFORE PLP,N REVIEW WILL BE STARTED
---------------------------------------------------------------
THE APPI�ICANT IS: (circle one) ER .,�r CONTRACTOR
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JOB SITE ADDRESS: I `t � t t-�z:•�_�v���`� "� 1� �•, _ ZIP: �� �� �
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(work) ��`�J c-,`� �-`�
N�ME OF OWNER: �—�'•�``�r_i �'`'�- C�•.�c �5 ��2 ti•5 r%�. PHONE: (home) '`�7( � l �Z �
MAII�ING ADDRESS: `"�r� �t=- CITYS l:t:'<<•�Z,-�.�Ct ZIP: 5 R�nc
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CONTRACTOR: "�'/� PHONE:
°�iAILING ADDRESS: CITY: ZIP'
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration_� Renovate Land Alteration
��'` �
PROPOSED WORR (describe in detail) : Y�w��.:c., � = 7'.C-� �,vcrw
STORIES: '� SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS:� GARAG$ STALI,S: ATT. .�' DET.
�/ ,
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ "7� ��
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 Fermit and work is not to start without a �ermit; and
that the work will be in accordance with the aF�roved plan.
A,PPLICANT'S SIGNATQRE: `= � -c..-�,...�.,� DATE: l C�'c l �� �
�
(Please fill out the reverse side of this form)
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r_ - . _��:a� �ITY o� �RUI\TO
.A Post Office Box 66•Ctystal Bay,Minnesota 55323•Municipal Offices
_� _ `'-...
� ' On fhe North Shore of Lake Minnetonka
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DATA__PRIVACY ADVI_SORY
In accordance with M.S. 15.165, "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:
l. The information you furnish will 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 Iocal , state or
federal agencies to the extent necessary to process the permit or
�icense.
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. 15.165 to review private
data on yourself.
6. Your full name, and date of birth are required to process
this application or permit.
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First Middle Last
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Address �
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City State ZiP
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Phone
I understand my rights as stated above.
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Signature
BU[LIIING&ZONING—473-i 35 i • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473•7359
ASSESSIIG
CHSCR OFF LIST FOR ISSIIANCE OF P�2MITS
FG� OFFICE USE ONLY
ADDRESS OR LEGAL: P�'
DESCRIPTI ON OF WORR: '(^ V� � l� ���`�
------- ---------------------------------------------------
Z ONING REVIEW BY: � DATE APPROVED: �C, `�-Q I
BIIILDING REVIEW BY: � .�/Ow`LI ___ DATE APPROVED: �(� - 7'� �
--------------------
FEES TO BE CHARG�: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SIIRCHARGE Yes� No WATER CONNECTION
INVESTIGATION FEE Yes No� PARK FEE
SAC Yes No� SITE INSPECTION
Number of SAC Units OTI��,R (s�ecify)
--------------------------------------------------------- -
�nuru� ru�uCg �IgT Zoning Dist�ic�:
Fire DeAar�ment: Post Of�ice: Sc:�ool Dist�ict:
Lot Area: Width: Depth:
Survey Submitted: Yes No Da�e or Survev:
Pro�osed Setbac?cs :
rront (Lake ) : Rignt Side :
Rear ( Street ) : Lert Side:
Adjacen�. Structures We��zzd:
Building Height: Def. Ii t. p��k �Q�•
Avg. Setback: Lot Cove�age :
Exi y � ng Pr sed
� / �
Hardcover: 0-7 5 ���J " �
75-250 ' -
250-500 '
500-I000 '
Hardcover Variance Required: Yes No Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff ApprovaZ Date: BY�
Zoning File - � Resolution ;- Resolution Date:
REMARKS (in house) :
_ . _.__._ . _ -� -,
BIIII.DING RL�TIEW CHLCR LIST ,
IIBC_ �3 �j �j CONSTRIICTION TYPE:T.V'1 V
Sq Footage $ Per Sq Ftg
Base�e^t X
lst Floor X
2nd Floor X
Garage X =
x
TOTAL
$stimated Construction Value: $ ''Tv��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Mechanical Fire
ooting � • Water Connection
Framing Sep..ic
Fireplace Sewer Connection
Insulaticn (Masonry) Otner
Wall Board �Mfg, � Well State Permit
Final ^lectrical (State Permit)
---Oth2r----------------------------------------------------------------------•
�_MARKS (IN HOIISE) :
--------------------------------------
�tE'VIEW BY OTHERS: DATE:
Access : Exis�inQ New
-----Access_Approvai---Date------------------�v-------------------------------•
R$MARKS (TO B$ NOZ'BD ON PERMIT) :
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DATE TIME
CITY OF ORONO CALLED IN ���,
INSPECTION NOTI E SCHEDULED -L�`'l--c _3p
PERMIT N0. �-1�b COMPLETED << �
ADDRESS e%+ s �� �
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION
� Ot FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� �SULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 4 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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d �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL WSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr o ite:
Inspector.
White Copy/lnspecto s File Canary CopylSite Notice