HomeMy WebLinkAbout1991-003876 - remodel master bath PERIiiIIT
CITY OF ORONO PERMIT TYPE:
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1335.3rown Rd. South • P.O. Box 66 PermitNumber: �!�?����=%�_
Cr stal Ba , Minnesota 55323 ;j;_:;z;�,i'�;�,
Y Y Date Issued:
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
� CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total F'ee : $ Date Received:
Date Approved:
Entered By: Permit#:
ALL INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIB'W WILL B$ STARTED
(See Check-off List Enclosed)
------------------------------- --- ---------------------------------------
THE APPLICANT IS: (circle one) OWNE or CONTRACTOR
JOB SITE ADDRESS: CJ �/'I C�� '�Q_) J C� - Z �-� . ZIP: ���� I
(work) �� '4' ��� �
� ���-�� � t1 � - �
NAME OF OWNER: ��� � (.�'iAG/�►�� C������, PHONE: (home) I��J � �-�L�L
MAILING ADDRESS: 7� I���,t � _�\ 2C�1'1 CITY: (,��zi�tl� ZIP: ��%�
CONTRACTOR: �� � PHONE:
MAILING ADDRESS: CITY: ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remode�/Alteration�_ Renovate Land Alteration
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PROPOSED woxx (aes�ri� in aetai�) : �'1C S��,�'�c1�-h Y'��'Yl���►"L�1�
I h�C�,+-ct�,� �, 2 {���,t�� �
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STORIES: SQ. FEET OF EACH FLOOR:
IdG. OF �BDROGI�iS: GARAGE STF�LLS: tiTT. LET.
ESTIMATED CONSTRIICTION VALIIATION (egcluding land) : $ �,���Ci• (`J�
I hereby apply for a building permit and 2 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 SIGNAZ'URE: ��I 1�1�:- ����1-�'�(,�i.-� DATE: J �- C
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� CITY of ORONO
Post Office Box 66•Crystal Bay,�Vlinnesota 55323•Municipal Offices
•
s • � � 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
I.icense 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 wi1.I. 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�atc
data on yourself.
6. Your full name is required to process this application or
permit.
��� M��� C�,ac.��f/��r
First Middle Last
�C1 ���1"�'lCt t�L2 �!�'E����'I
Address
C�U�Iz�� J'`/��, �S;�r� i
Cit� State Zip
4`��- C�:��-`�
Phone
I understand my rights as stated above.
" ����;�1'1C��- �rf��'�����.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
513.04 RIGH'I5 OF SIIBJECTS OF DATA
Subdivision 1. Type of data- The rights of individusls on whom the data is
stored or to be stored shall be es set forth in this section. An.individual esked to
Subd. 2. Information required
to be given in�ivi�uaL
� u 1 rivate or confidentiel data concerning �amWi hin the collectirng state agen Y�
S PP Y P uested da
purpose and intended use of the req tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �c� 8ny �oWn consequence arising from his
required to supply the requested date;
su 1 ing or refusing to supply private or confidential date; end (d) the identity o
PP Y state or federal law to receive the data. This.
other persons or entities authorized by 1 �nvestigative date,
requirement shall not apply when an indtola law en orcementuof flcer.
pursuant to section 13.62, subdivision 5,
The commissioner of revenue ma la�t taX re°und instructionsui steadhos
subdivision in the individual income tax or r� er
on those orms. - - --- - .
t� �� by ����L Upon request to a responsible
Subd. 3. Access
authority, an individual shall be informed whetbh�c h r vateeor confident al.e Upon his
individuels, and whether it is classified as p � P ublic data on
e to him end, if he desires, shall
further request, an individuel who is the subject oi stored private orvidual has been
individuels shall be shown the data witho of�hat da a• After an indi
�e informed of the content snd meaning the data need not be �isclosed to
shown the private data snd informed of its meaning, u�uant to this section is
him for six months thereafter unless a dispute or action p
� endin or additional data on the individuel hes a e or publi�datgruponareq est by
� p g. require the
responsible authority shall provide copies The hresponsible aut�rgy maY �in the
the individuel subject oft�e actual.costs of making, certif n , and comp g
requesting person to pay -
copies. y if ssible, with any request
The responsible authority shall comQly immediatel , Po
made ursuant to this subdivision, or within ag e �f Slmmediategtcompliance eisu not
� and le al holi ys,
excluding Saturdays, S�ag�with thegequest within that time, he shall so in�orth the
possible. If he cannot comply within which to comply
individual, and may have an additio� i���o day�.
request, excluding Saturdays, SundaYS g
Subd. 4. Proced�u'e when data is not accurate or complete. An individuel may
- ublic or private data concerning himself. To
contest the accuracy or completeness cf P in writing the responsible authority
exercise this right, an individuel shall notify �ible authority shall within 30
describing the nature of the disagreement. The respo lete and attempt to
days either: (a? correct inaccurate ordincomplete datae including recipients named by
notify past recipients of
the individual; or (b) notify the individual that he believes the data to beementcis
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the �isclosed data• �ible authority may be aQPeeled pursuant to the
' The determination of the respo to contested cases• •
provisions of the administrative procedure act relating
�lo �erv�a�.1� ee�.
�
� C1TY OF ORONO �
BUILDIN RMiT PLAN REVIEVV
��� MSt�E�GTOR -
DATE FcRMfT tti0.
.� APPROVED AS SUBIViITTED
� APPROVED WITH CORRECTiONS AS NOTED
Q � % � [� NOT APPROVED — COKRECT & RES�JS�niT
Thest commenta are for your irformation. AI! evork shall be done
� � tn fuil compHance w►th all applicable buiiding & zoning code re•
S � pUI►Cments includlnR items not specifically noted in ,his reviel�
�L I KEEF? THIS PI.AN SET ON SITE AT ALL TIMES.
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�. l`�eW NI��'' �11�1 �
~ CHECR OFF LIST FOR ISSIIANCE OF PERMITS
" FOR OFFICE USE ONLY
ADDRBSS OR I,EGAL: PID=
DESCRIPTION OF WORK: �
---------------------------- ------------------------------------------------
ZONING REVIEW BY: N DATE APPROVED:
BIIII�DING REVIEW BY: b . v DATE APPROVED: /�
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 I.IST 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
gardco��er: Q-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) :
BIIILDING REVIEW CHECR LIST Y
/ � . � ,
IIgC: �-3 �j �j CONSTRIICTION TYPE. �i�✓
� ~ - Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X - .
2nd Floor X -
Garage X -
x =
TOTAL
Bsti.mated Construction Value: $ 3 �" �
I spections Required: Work Requiring Separate Permits:
�Site Plumbing Grading/Filling
Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
R$MARKS (IN HODSE) :
-------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY�
------------------------------------------------------------
RSMARRS (TO BE NOTSD ON PERMIT) :
pD\ DATE TIME
CITY OF ORONO � CALLED IN
INSPECTION NOTiC SCHEDULED � ��
PERMIT NO. c MP ETED � �(
�
ADDRESS �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BUFNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK•UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON �ITE 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
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMEN S:
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GW WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
C CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL�NSPECTOR C CITATION ISSUED
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra o ite:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice
� DATE TIME
CITY OF ORONO CALLED IN ` 9 —
INSPECTION NOTICEn /n SCHEDULED '/ a ' �
PERMIT N0. ,_,��/ `F� COMPLETED u lL
ADDRESS Q� ��%Y�n-oC��
OWNER CONTR. �'
TELEPHONE N0. �7 7�� �`�``3 '�
� DESCRIPTION — � �Q�-�-G�-�.�
l� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLiNG
�
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 5 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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d �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.47�73�J7
OwnerlContrac o ite:
Inspector.
White Copylinspector's Fite Canary Copy/Site Notice