HomeMy WebLinkAbout1992-004644 - change exist window -
" �ERMIT
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1335 Brown Rd. South • P.O. Box 66 ��i��������1�
Permit Number: {;;;��.,��
Crystal Bay, Minnesota 55323 Date Issued: ;�,���;;�,�i
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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A PL CANT PERMITEE SIG TU E ISSUED BY:SIGNATURE
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CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received:
Date Approved: "l"f$-S 2 Q'•v'
Entered By: � Permit�: � f r,�v�j
��/��� ��sP �
AT•T• INFORMATION MIIST BE SDBMITTED IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
-----------------------------------------. .__-__.��------------------------------
THE A.PPLICANT IS: (circle one) OWNER or CONTRACTO-_R-`_�\�,
JOB SITE ADDRSSS: �I I '�� ����_�1�'�- /\'� � ZIP: �a�� 1 I
(work)
N�ME OF OWNER: � � PHONE: (home) "'�
MA�I,ING ADDRESS: � � �� CITY: ZIP: ,,� � �
CONTRACTOR: �l/f 1 SO.v �Ow.s�/��o� ��-c PHOIJg: �S�- S�S^'C�['7
MAII,ING ADDR.ESS: G 511� ��/v�i' �`� eo`i'�CITY:T_�r�ce.Fi i�'��r�'r ZIP: �� �l�
STAZ'S I�ICENSE: � � �,�j a
ARCHITECT/ENGINEER: �/q,�/t PHONE:
MATLING ADDRSSS: CITY: ZIP:
NAME: RBGISTRATION n
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) : �o�c'_ ��5•�/i+., �v+�,�a� �� S�-��� ..��i
�� iWt�s� �'1/� v� !/� �!./ �/�/r� \.LQQ/_ GZ/7 l/V ��l�w...- ���_ �l�R<(
�3C 3 Z.r!v �fa� � .s�'►.a� q`� � ��,� q,si �� �a6lr ��!°
STORI$S: SQ. FEBT OF EACH FLOOR:
NO. OF BSDROOMS: GARAGE STALLS: ATT. DET.
ESTIIKATED CONSTRIICTIDN VALIIATION (eacluding land) : $ �6a
I hereby apply for a building permit and I acknowledge that the information
above is corr�plete 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:�'�i���� '(� DATE: � /��L-
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� �� �'� k `� CITY of ��0��
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�,�, ;,, � � *j Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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�'�"� ��j� �-;' 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 3.ike 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 confidentiaZ information.
You are notified that:
1. The information you furnish wiZl 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 Iicense.
3. The information may be shared with other ioca? , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Counci� action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 �o review pri�a�e
data on yourself.
E. Your full name is required to process this application or
permit.
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�l, :�' L/�-�l� � ,� � , � ,
First ;; . � iddle �, � Las�t `
� i / ';�� �' .���'l ; _(`� o k�. l���t� l 1/
Address
�� • , ,. / —;-- �
� G�(.�i�a,( � �I � 1 J `-'`� � � �
City State Zip
7 �� �- ���� � �.
Phone
I understand my rights as stated above.
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Sig a e
BUILDING& ZONING—473-7357 • ADM!!�'ISTRATION& F[NANCE —�373-7358 • PUBLIC WORKS —473-7359
ASSESSING
513.04 RIGHTS OF SIIB.7ECT5 OF DATA
Subdivision 1. Z`ype of ��- The rights of individuels on whom the data is
stored or to be stored shall be es set forth in this section.
Subd. 2. Information require
d to be given in�vi�ual- An.individual esked to
� supply private or confidentiel data concera a tBmWi hin the collect g state agen Y�
purpose and intended use of the requeste
political subdivision, or statewide system; (b) whether he ma� 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 dats; and (d) the identity o
other persons or entities authorized by stat u��e@skedlto supplyi nvest gat ve data,
requirement shall not apply when an individ
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mg rolert taX re°una instructe ns insteadhos
subdivision in the individu8l income tax •r � �
on those orms. -
Subd. 3.
Access to �ata by in�vidual- Upon request to e responsible
authority, an individuel shall be informed whether h?��gteeor c�nfidential.e Upon his
individuels, and whether it is classified as public, p ublic data on
further request, an individual who is the subjecc��e to�mriRvngaeif he desires, shall
individuals shall be shown the data withou�f��Y t �ta. After an individual hes been
6e informed of the content and meaning the data need not be �sclosed to
shown the private date and informed of its meaning,
him for six months thereafter unless a dispute or action pursuant to this section is
, pending or additional data on the individ�h h� a eeor publ ct datarupongrequest by
responsible authority shall provide copies of P uire the
the individuel subject of the data. The responsible�Qa�f onity�a� mpiling the
requesting person to pay the actual costs of making, Yi g�
copies. immediately, if possible, with any request
The responsible authority shall comply
mgde pursuant to this subdivision, or within five �f Slmmediateat ompliance eisu not
holi da
excluding Saturdays, Sundays and legal S'S�
ossible. If he cannot comply with the request within that time, he shall so in�orth the
p within which to comply
individual, and gay hsve an additio� ie al�h 1i�Y�•
request, excludin Saturdays, SundaYs g
Subd. 4. P��'e �►hen data is not accurate or complete. An individual may
contest the accuracy or completeness of Pnot f � inr writ ng tthe�responslb e au hor ty
exereise tYus right, an individual shall Y
describing the nature of the disagreementbeTnacciu�pa elor incomplete and att pt to
days either: (a) correct the data found to
notify past recipients of inaccurate or inu�P�t he believesdthe datalto be correct
the individual; or (b) notify the individ
Data in dispute shall be disclosed only if the indiv�dusl's statement of disagreement is
• included with the disclosed data• be aQpealed pcu'suant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
�
9ATE TIME
CITY OF ORONO CALLED IN '3 `�-=
INSPECTION NOTIC//E . scHEou�E� /rU '���� -�Z �
PERMIT NO. ���"�`� COMPLETED k k
� �
ADDRESS �'� `� a��� �l �����'
OWNER ����-�_ �� CONTR.��r��
TELEPHONE NO. ��� ���U �/�
� DESCRIPTION �` ' �'- % � r� ' '
� 01 FOOTING 11 MECHANICAL RI 16 ELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
Z 04 D. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL �� 13 METER SET/TURN ON 17 SITE INSPECTION
� —SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW �WORK SATISFACTORY:PROCEED �OJECT COMPLETE
� C CORRECT WORK&PROCEED �L ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,`_ pHOTOTAKEN
INSPECTOR WILL RETl1RN
� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr site: _
Inspector.
White Copyllnspecto s File Canary CopylSite Notice