HomeMy WebLinkAbout1993-005220 - deck � f PEI�MIT
GITY OF ORONO PERMIT TYPE: r;�}���y�;���,
2jr50 Kel�ey Parkway • P.O. Box 815 Permit Number: 5:��:����.���k
Orono, Minnesota 55356-0815 -
(612) 473-7357 Date Issued: >_3�:�!{��!�+�:�
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
'� ,�
� ` Date Received:
Total Fee: $ �� ��=,�
Date Approved:
Entered By: � � ,;
Permit�: � �
AI�L INFORMATION MIIST BE SIIBMITTSD IN FIII� BEFORE PI,AN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
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THE A.PPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: (S �v �c7 X �T- ZIP:
(work)
— -�
N� OF OWNER: `i c.�H^- } �UH� ��-A� PHONE: (home)
MAILING ADDR.ESS: �� �� ! v� S� CITY: ��/ZL�rv _ ZIP:
CONTR�CTOR: T �C%���z•� ����✓r � PHOIJ$: �7�- �-��i Ls
��iAILING ADDRSSS: ��'� ��-' ``"r�'C/4 (�G"�J CIZ'Y: L�.�i9 j ZIP: sS � � r
STATS LICENSE: � ��-�S �
ARCHITECT/ENGIN�: PHONE:
MAILING ADDRSSS: CITY: ZIP:
N�: R.BGIST`RATION tt
TYPE OF WORR: New Addition Accessory Structure Move
Demo_� Remodel/Alteration Renovate Land Alteration
PROPOSF.D WORK (describe in detail) : ���-�v✓� L'�-r' Dc`�� � ���_�>���
STORIES: �- SQ. FEBT OF EACH FI,OOR:
NO. OF B$DROOMS: GAR�,GE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �S7S
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 SIGNATORE: � /� DATE: � �-/ �1�
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
♦ '
ADDRESS OR I,EGAL: /SYa /�D� S% PID:
DESCRIPTION OF WORR: ��=�-t�
---------- ---,p--------------------------------
ZONING REVIEW BY:_ C���.�o C�N+�w._ DATE APPROVSD: Co' `{`S' �
BIIILDING RL�IEW BY: �Xr � DATS APPROVED: � - `{- `� 3
------------------- -
FEES TO BE CHARGED� Misc. Fees Cal.culated By:
PERMIT Yes ✓ No -
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No � PARR FEE
SAC � Yes No � SITE INSPECTION
Number of SAC IInits OTHER (specify)
---------------------------------------------------
ZONING CHEGK LIST Zoning � st ict:
�� , ,
Fire Department: os�t Off ' ce: S ' s�c :
�
Lot Area: i h: D pt
Survey Submitted. Yes� No Date of Survey:
`l� OI�.S Fi l.�C
Proposed Setbacks:
Front (Isa��) : N�A Right Side: /.�� � 't
Rear (S.t�-e�et-) : �30 � Lef t Side: N�/�
Adjacent Structures: /�n'�u�� Wetland: /✓�A-
Buil.ding Height: Def. Hg -. P ak Hgt.
Avg. Setback: L t Cov rage:
Exi 'ng Propo ed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Varia ce Requ' red: es o ate of Counci Approval:
Grading: Staff Approval Date By: Council A proval Date:
Septic: Staf Approval ate By:
Zoning File � R soJ.utio �: Resolut on Date:
RFl�iARKS ( " honse) : ,.
BIIILD.ING REVIEW CHECK LIST - - .
IIBC: �
(L-3 CONSTRIICTION TYP$: \%N ~ ' �
Sq Footage $ Per Sq Ftg
Basement X =
lst Floor X —
2nd Floor X =
Garage X -
x =
TOTAL
$stimated Construction Valne: $ 2S �5 �'�
Inspections Required: Work Reqairing Separate Permits:
Site � Plumbing Grading/Fi].].ing
�Footing Mechanical Fire
�Framing Septic Water Connection
InsuZation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
�CFinal (Mfg.) Other
Other Well (State Permit)
Electrical (State Permit)
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REMARRS (IN HOIISE) :
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REVIEH7 BY OTHF=RS: DATE:
Access: Existing ' New
Access Approval: Date BY=
------------------------------------------------------------------------
RF.MARRS (TO BE NOTED ON PERMIT) :
. �
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� �� : CITY Of OI�011\T�
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��'� � �-� :s Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
�` '``���::��
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� -. �. � ; 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 Iike 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 confidentia3 information.
You are notified that:
l. The information you furnish wi3.]. 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 Councii 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.
6. Your full name is required to process this applicatian or
permit.
�v v/�4<'� � � �/v�� y -
First Middle Last
/4�E%C c.V �'t T�c'�} /3 C,v�
Address
1,��4-�-z.�i�- ,r-� ,.� 5 _� '� /
City State Zip
�f � S - ��-�f`�> C�
Phone
I understand my rights as sta`ted above.
� %�� -.
Signature
BUILDING&ZONING—473-7357 • ADM[NISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
573.04 RIGH'T'S OF S��CTS OF DATA
Subdivision 1. Type of data- The righ secti n.lvidu8ls on whom the data is
stored or to be stored shall be as set forth in thLs
Subd. 2. Information require
d to be given �����' An.individual esked to
� su 1 rivate or confidential data concernin a�amwi hin the collecti g state agency,
PP Y P uested d
purpose and intended use of the req tem; (b) whether he may refuse or is legally
political subdivision, or statewide sys �c� any �oWn consequence arising from his
required to supply the requested date;
su lying or refusing to supply private or te orlfederal law to receive the data.1tThis.
PP
other persons or entities authorized by sta investi ative data,
requirement shall not apply when an individual is esked to supply g
pursuant to section 13.B2, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lert tax re�und instructionsui steadho5
subdivision in the individual income tax or r��
on those orms. - - -- - .
Subd. 3. Access
to �ata by individusl• UPon request to e responsible
authority, an individuel shall be informed whe b�c Pr vateeor confidential.e Upon his
individuals, and whether it is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individuel who is the subject of stored private or
individuels shall be shown the data withou�fan�y ��tg. After an individual has 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 e dispute or action p
� rivate or public data uPon request by
e
, pending or additional data on the ine i of the p� been collected or create ' the
responsible authority shall provide copi uire
the individual subject of th gc��'cos h of making,l eert fYing y s�a �ompiling the
requesting person to pay the - re uest
copies. immediately, if possible, with any 9
The responsible authority shall comQly
made pursuant to this subdivision, or withi lida e dif Simmediategtcompliance e��.su not
excluding Saturdays, Sundays and legal ho ys,
ossible. If he cannot comply with the request within that time, he shall sP lnw°h the
P have en additional five days within which to com ly
individuel, and maY �d le al holidays.
request, excluding Saturdays, SundaYS g
Subd. 4. Pt�ocec�e when data is not accura
te or completa An individuel may
contest the accuracy or comQleteness of public oinriWvra t�g tthe°re Ponsib e au hor ty
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 iete dataeincludingreec pients namedt by
notify past recipients of inaccurate or incompl �
the individuel; or {b) notify the individusl t��dual's statementof disagreementci
Data in dispute shall be disclosed only if the m
• included with the �isclosed data. � BPpe�led pursuant to the
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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CITY OF ORONO CALLED IN �i�Z� ��`'`^"
INSPECTION NOTICE SCHEDULED �3 � o
PERMITNO. 5��v COMPLETED 'V U
ADDRESS /S� T� � �-J
OWNER �'1�4—�--_ CONTR. � d" '���5
TELEPHONE NO. �'I � ' ` ��1 �l o
� D CR1P�0 N
FOOTING � 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
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 SEWEF HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAIfvT. 21 COMPLAINT
= 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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W� �WORK SATISFACTORY:PROCEED - pROJECT COMPLETE
W CORRECT WORK&PROCEED =" ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �_ pHOTO TAKEN
INSPECTOR WILL RETURN
I : CITATION ISSUED
C STOP ORDER POSTED.CALL INSPECTOR
u INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra o site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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APPROVED WITH C t� MO,
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