HomeMy WebLinkAbout1991-003870 - kitchen remodel PERMIT
CIT�� OF ORON� PERMIT TYPE:
1335 B�own Rd. South • P.O. Box 66 Permit Number: E�;�I i�C}I i�l�a
Crystal Bay, Minnesota 55323 Date Issued: '-�°`-'�'`=''`'
(612) 473-7357 i�;'a j i�:_;;'f�,
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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ICAN , E �1!�FE SIGNATURE ISSUED BY SIGNATURE
���o �; ���� _
� , • CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRBSS OR LEGAL: ���� ,�/�I� C��.�e /(� ���• PID: Da - ��7- � 3 �� `� �CJU�'�`J
DESCRIPTION OF WORK: ���'c.Pis� ���'12G���
----------------------�-!�--------------------------------------
------------
ZONING REVIEW BY: /V DATE APPROVED:
BIIILDING REVIEW BY: DATE APPROVED: �'' �f" �1 �
FEES TO BE CHARG$D: � 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 Distric :
Fire Department: Post Office: School District:
Lot Area: 'dth: epth:
Survey Submitted: Yes o Date f Surv
Proposed Setbacks:
� Front (Lake) : Ri t Side:
Rear (Street) : L ft Side/
Adjacent Struct res : � Wetl d:
,
,
Building Height: D f. Hg P ak Hgt.
Avg. Setback: � L t Cov rage:
Exist ng Prop sed
!
i-T�r�Cp��or: �-75 %
75-2 0 '
250- 00 ' '
�`� �
500 �1000 ' �'
Hardcover Variance Regui . Y No D of Council Approval:
Grading• Staff Approval D te: By: Council Approval Date:
Septic. Staff Approval Date: By:
Zoning File:# Res lution #: Resolution Date:
REMARRS (in house) :
BIIILDING REVIEW CHECR LIST •
• ,
DBC: g`1� /` �3 CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg � �- -
Basement X =
lst Floor X -
2nd Floor X -
Garage X -
x =
TOTAL
$stimated Construction value: $ 3� C�c��
�
Inspections Required: Work Requiring Separate Permits:
Site �Plumbing Grading/Filling
ooting Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
Final (Mfg. ) Well State Permit
Other �Electrical (State Permit)
REMARRS (IN HOOSE) :
-------------------------------------------------------------------------- �
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY�
--------------------------------------------------------------------
R$MARRS (TO BE NOTED ON PERMIT) :
, CITY OF ORONO - BUILDING PERMIT APPLICATION �
� � ^ �
/ � �
/ -,�
Total Fee: $ � ��1 ��f - Date Received: �x ;�� }
�' -
--- Date Approved: �� �
Entered By: �' -�` `> ,-��
Permit#: �) �� ����'
AT•T• INFORMATION MITST BE SIIBMITTED IN FIILL BEFORE PLAN REVI�W WILL B$ STARTED
(See Check-off List Enclosed )
THE APPLICANT IS: (circle one) OWNER or CONTRACTO
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JOB SITE ADDRESS: ��CS !^��G$� �'+G�N��/�L.,� Z IP� S��� /
(work)
NAME OF OWNER: TN�GL��'r'� �A�-�S t-f" PHONE: (home) � � 6�-3
MAILING ADDRESS: �6�5 G�c� �,c,���� cz�: G�����f zzP: ,5'.�3,/
CONTRACTOR:�� ��'b���"`d"� PHONE: 8Zi'3- 3az�
MAILING ADDRESS : ,S� � ��cw�3 /H'� �d CITY: ZIP: S�S`!"��/
TYP$ OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�— Renovate Land Alteration
PROPOSED WORR (describe in detail) : /�L� � �� ��,�ig. �J/,vyl �.eet t �4�G7 �rN��f_
__1�__�����.
STORIES: SQ. FEET OF EACH FLOOR: �/e� )'"" � S � _
.
NO. OF B$DROOMS: GARAGE STALLS: ATT. DET.
�
ESTIlrlATED CONSTRDCTION VALIIATION (egcluding land) : $ / � _
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 ' not to start without a permit; and
that the work will be in accordance with e approved plan.
�PPLICANT'S SIGNATORE: DATE: �/ �I
f.. � �'�;�m�.ir
t '�.�1�`h �..
.� �� �� �. � - �- Ci�'��' O� o��N�
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=' � Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
•
� - � ,�: On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would 3ike 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 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
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�a��
data on yourself.
6. Your ful.l name is required to process this application or
permit.
.
�ft�Y ,�E� J�.s,�,Qsk � .
First Middle Last
,.Sr35�� ' �'�£ �
Address
��►�,,� �,� ss�19
City State Zip
82 3 - �v�29
Phone
I understand my right stated above.
Sign r
BUILDING&ZOIYING—473-7357 • ADMINISTRAT[ON&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
573.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision 1. Type of date- 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 requvred
to be given in���' An.individuel asked to
� su 1 private or confidentiel data concernina �gm� hin the collecti g state agency,
PP Y
purpose and intended use �f the requested
political subdivision, or statewide system;
(b) whether he ma� refuse or is legally
re uired to supply the requested dat8; (c) any known consequence arising from his
q rivate or confidentiel dats; end (d) the identity of
supplying or refusing to supply P state or federal law to receive the data. This_
other persons or entities authorized by 1 investigative data,
requirement shall not apply when en individual is asked to supp y
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ms lert tgX re�und instructions insteadhos
subdivision in the individual income tax or r• v
on those orms. . - -- - _
Subd. 3.
Acces� tc data by individusl- UPon request to e responsible
authority, an individuel shall be informed�h b�� hPf vateeor confident al.e Upon his
individuals, and whether it is classified p � ublic data on
further request, an individusl who is the subject of e t�e�mrl��e if he desires, shall ,
individuals shall be shown the dat8 with� of�hat da a• After an individual h�s been
�e informed of the content and meaning the data need not be disclosed 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
rivate or public data upon request by
ending or additional data on the indivif�h hes been collected or created. e
' p rovide copies o P require the
responsible authority shall p ilin the
the individual subject of �te gc��•�o� of mak ng,i aert f3'ingy a�'d �omp g
requesting person to pay t -
copies. if ssible, with any request
The responsible authority shall comply immediately, Po
mac3e pursuant to this subdivision, or within five days of the date of the request,
excluding Saturdays, Sundays and legal holidays, if immediahe shall so nfo m the
possible. If he eannot comply with the request withi�i��ntwhich to comply with the
individual, and may have en additio� le al�hol daYS•
request, excluding Saturdays, SundaYS g
Subd. 4. Procediu'e �►hen data is not accurate or complete. An individuel may
contest the accuracy or comQleteness of public or private data concerning himself. To
in writing the responsible authority
exercise this right, an individual shall notify �ible authority shall within 30
describing the nature of the disagreement. The respo
days either: (a) correct the data found to be lete datae including ree�Pi�� nam dt by
notify past recipients of inaccurate or incomp
the individuel; or (b) notify the individual that he believes the data to b eementcis
Data in dispute shall be disclosed only if the individuels statement of disagr
• included with the �sclosed data. ealed pursuar►t to the
' The determination of the responsible authority may be app
provisions of the administrative procedure act relating to contested cases•
� p DATE TIME
CITY OF ORONO CALLED IN ` l�
INSPECTION NOTI�/E�7 SCHEDULED g—/� �/ .`� C?
PERMIT N0. ,�U /U COMPLETED _T �
ADDRESS �� ��
OWNER ;f'� CONTR.
TELEPHONE NO. ���.� —. '��� �I
� DESCRIPTION
� 01 FOOTING ti MECHANICALRI 16WELLTESTPUMP
02 FRAMI Si,,, 11 MECHANICAL FINAL 18 EXCAVlGRADINGIFILLING
y 03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 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
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING 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 inspection 24 hours in advance.47�73�J7
OwnerlContractor on e:
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
� DATE TIME
CITY OF ORONO CALLED IN q _�I 9�
INSPECTION NOTICE SCHEDULED y l� l��
PERMIT NO. � ��� COMPLETED I� �'L
ADDRESS ��� �--������%��X_�L� C.�
OWNER �ah.Gti�t.�PN CONTR.��`�-
TELEPHONE NO. ��`� - =-3 :�� �
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q2 FRAMIN .� 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SET/TURN 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
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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Q O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL WSPECTOR CITATION ISSUED
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra or pf�site:
Inspector. �U
White Copy/inspect r's File Canary CopylSite Notice
? � C� DAT TIME �
CITY OF ORONO �✓� CALLED IN ��9�
INSPECTION NOTICE SCHEDULED /a1.3/9� /�7 : 3c�
PERMIT NO.�"3� � 3 � COMPLETED _� �
ADDRESS �S ��
OWNER �..��E.si��/v CONTR. rs�
TELEPHONE N0. ' ��
� DESCRIPTION�����s���C�
� 01 FOOTING 11 MEC NICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25'WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 LL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 5 FINA 13 METER SETlTURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBIN I 15 SEPTIC INSTALL. 22 FOLLOW-UP
J PLUMBING FIN � 23 SEPTIC FINAL
� OW RICONTRACTOR TO MEET YOU: ✓YES_NO �i7Y+-a—%L�2,t,Lu�y-LuzL�-Gr�,
� COMMENTS:
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� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORAFiY
0 BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR =� CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contrac ite:
Inspector. -
White Copyllnspector's File Canary CopylSite Notice
� � � � � T1�lC�1! � �� �����m����� �� �i�ED . . . .
tD�N
Approved Addresses Shali Be Dispiayed, -
Plainly Visible And Legible From The
Street Fronting The Property
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i DATE ����I PERMIT NO.
i APP`�0`:,;�r �,� SU3p,liTT-�
� AP�'RO'ti'Ev `,°�;i-i-�i CO;REC7i0NS AS �OTED
% j NOT AFr�;^VcD — Cv}�1R�CT & RESUBP�;?IT
�se commen?s ere for your irformation. Afi �vork shali be ne;
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APPROV�7 4l';TFi C�:R���TiONS AS NOTEp
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