HomeMy WebLinkAbout1992-004204 - redo kitchen PERMIT
� CIfiY OF ORONO PERMIT TYPE: �;t;1��;�;u;;
1335 Brown Rd. South • P.O. Box 66 Permit Number: �_j!.f�-.:`!_!�
Crystal Bay, Minnesota 55323 Date Issued: _f._�:�����•:''=�:�;
(612) 473-7357
SITE ADDRESS:
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APPLICANT%PE EE SIGNATURE ISSUE BY:SIGNATURE
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, CITY OF ORONO - BUILDING PERM.IT APPLIGATION
Total Fee: $
/' 3� ' � � Date Received:
Date Approved:
Entered By: � � permit�: � Z U ��
AT•T• INFORMATION MIIST BE SIIBMITTSD IN FULL BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Enclosed)
THE A.PPLICANT IS: (circle one) OWNER o CONTRACTOR r
JOB SITE ADDRBSS:-���'-f����l�L�' 9/�� ! ZIP:
(work)
x.�r� oF owNBz: ,�/ �.tr� G�(!''C.r �c�G �l S P_ PHorrE: (home)
MAILING ADDRESS: �C�� 7 �(�(�� C'vi� _ CITY: �j�(�} 17("�' ZIP:
CONTRACTOR: l C7/�� �(Jl �'7 PHON$: P1 "l CI ` � �r� c�
MAILING ADDR.SSS: ( 3 C ICGt�U (O�� CITY: Y/ISJ� � ZIP: ��-3�
STATS LICENSE: �
ARCHITECT/ENGINEER:�����-feS � PH�NE: �� 7 — �7'7' �7'"
MAILING ADDR$SS: CITY:���S ZIP:
NAME: �T�(/� L K�{2U U K REGISTR.ATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate �� Land Alteration
PROPOSED WORK (describe in detail) : J'�Q� �� ��!�f1v
STORI$S: SQ. FEST OF EACH FLOORt
NO. OF BSDROOMS: GARAGE ST�LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ /'�'/�ik,0��
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 will be in accordance with the approved plan. � •
APPLICANT'S SIGNATIIRE: ' DA�E: � � �--
J.
I4 �
�� CITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 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 would Iike to inform you that your reguest 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 iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�at�
data on yourself.
E. Your full name is required to process this appl.ication or
permit.
���1� �- S��/�� ��� �S��
First Middle Last
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Add ess
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City State Zip
�`��- 7 7��-.-
� Phone
, I understand my rights as stated above.
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; Signature �
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSING
�.p.� RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of data- 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 gi�� 1T1���' An.individuel asked to
� � supply private or confidentiel data concera a tgmwi�t�hin the collect g state agency,
purpose and intended use cf the requeste
political subdivision, or statewide system;
(b) whether he may refuse or is legally
required to supply the requested date; (c) any known consequence arising from his
supplying or refusing to supply private or confidentiel date; and (d) the identity of
other persons or entities authorized by state or federal law to recenveste at ve da e
requirement shall not apply when an individual is 8sked to supply g
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue o� rolert tax re�und instructionsunsteadhos
subdivision in the individuel income tax
on those orms. . _-- -
Subd. 3. Access to �ata by in�vi�usl- UPon request to e responsible "
authority, an individusl shall be informed whether h r vateeor confident al.e Upon his
individuels, and whether it is classified as public, p
further request, an individuel who is the subject of se to himrlande if he desires shall
individuals shall be shown the data withou�fan�y ��g. After an individual has been
�e informed of the content and meaning t h e data need not be c�isclosed to
shown the private data and informed of its meani n g,
him for six months thereafter unless a dispute or action pursuant to this section is
, � pending or additional data on the indi of the hr veteeor p bI c datarupon request by
responsible authority shall provide copie P uire the
the individuel subject ofthe actual�cos h of mak ng,l cert fyingy and compiling the
requesting person to pay _
copies. ssible, with any request
The responsible authority shall comQly immediately, if po
made pursuant to this subdivision, oe �th lidays,�f Simmediateatc mpliance eisu not
excluding Saturdays, Sundays and 1 g
possible. If he cannot comply with the request within�i��ntl�ch toh omplynw�th the
individuel, and may have an additional five days
request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Proced�e �►hen ��o f ublic o�p ivate dat1a lconcerning himself• To
contest the accuracy or completeness p
exercise this right, an individual shall notify in writing the responsible authority
describing the nature of the disagree a to beTnacciu�pa e or fn omplete and att mpt to
days either: (s) correct the data f oun
notify past recipients of inaccurate orV au�P�t hea believesdthe datalto be correct
the individual; or (b) notify the indi
Data in dispute shall be disclosed only if the individusl's statement of disagreement is
• included with the disclosed data. Q�ed �u�t to the
' The determination of the responsible authority may be aPP P
provisions of the administrative procedure act relating to contested cases• .
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� . ' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
' FOR OFFICE USE ONLY
AL'DR$SS OR LEGAL: pID=
DESCRIPTION OF_WORRt_
------------- ---- - ----------------------_-�-- -----------1 ------
ZONING REVIEW BY: DATE APPROVED � r I
BIIILDING REVIEW BY:-��JD DAT$ APPROVED: S �
------------------
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:
Building Height: Def. Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval. Date:
Septic: Staff Approval Date: BY=
Zoning File:# Resolution # : Resolution Date:
REMARRS (in house) : �
BUII�DING REVIEW CHECR LIST ' • .
IIgC: �- 3 � ( � S CONSTRIICTION TYPE:� •
Sq Footage $ Per Sq Ftg
Basement x =
lst Fl.00r X -
2nd Floor X =
Garage X -
x =
TOTAL
Estimated Construction Value: $ ,��, (D ��
Inspections Required: Work Requiring Separate Permi.ts:
Site Plumbing Grading/Fi17�ing
ooting Mechanica� Fire
raming Septic Water Connection
Insulation Fireplace Sewer Connection
a�� Board (Masonry) Lawn Irrigation
Fina 1 (Mf g.) Other
Other Well (State Permit)
Electrical (State Permit)
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REMARRS (IN HOQSE) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
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REMARRS (TO BE NOTED ON PERMIT) :
r�::�
�
� DATE�^ TIME
CITY OF ORONO CALLED IN �-�✓/ -� � ��'� �l
INSPECTION NOTICE scHEou�Eo �3- i-3 `{�,1 � : �T�z.n.�•
PERMIT NO.�2� COMPLETED � _�,�
ADDRESS ��"a7 �-� L/� P�.t% �'---
OWNER ��Cz C�'1 I S CONTR. � � �
TELEPHONE NO. �'�`�'/T��n vL..
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q G 11 MECHANICALFINAL 18EXCAVIGRADINGIFILLING
`03 INSULATION'� 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETfTURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEEO C PROJECTCOMPLETE
W �l CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
0 STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73rJ7
OwnerlCont r o ite:
Inspector. �..
White Copyllnspector's ile Canary Copy/Site Notice