HomeMy WebLinkAbout1995-007021 - carport .� �'ERMIT
{ CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 -
Crystal Bay, Minnesota 55323 Permit Number: _:.: :_i __°_ .-..
(612) 473-7357 Date Issued: �-���-':'°�?�:_-
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: - . _. - -�.j�-: -�
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� f CITY OF ORONO - BIIZZDING PERbLIT APPLICATION �
r�" �� Date Received:
'�ot�l Fee: $ � � �
Date A��roveC:
, /
�ntered By: � `- I � Perr,tit ,;: � �' �
AT•7. INFORMATION MIIST BS SIIBMIT'�F�D IN FIILI' BEFORE PI,�N REVIEW WILL BB STARTED
( See Check-off List Enclosed)
--------------------------------
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� APP�ICANT IS: (circie one) OW"NER or CONTRACTOR
JOB SITE ADDRBSS: " ' '" , � ZIP:
� (wor:c)
. � �C � � � PHONE: (home)�f ` �,
NAML OF OWNF.R: � � '
. , . �_ CITY: , . � ',' �'` ��_ ZIP:
M�I,ING ADDR.ESS: �.� -' �
CONTRAC`i`OR:��_ �i '- C, PHON$: ���7_3 - � -� Y, �
?�,SI,ING ADDRESS: `_' �-���--
CITY: ZIP:
STATS LICpNSE: r
ARCHSTECT/ENGINEER:
PHONE:
�+'fPSLING ADDP.ESS:
CITY: ZIP:
.`��: RBGSSTRATION �
�;�
'*'YPE OF WORRs New Addition Accessory StruLand�Alteratione
Demo Re.*nodel/Alteration Renovate
� . . r�� ��t�� � � �� � i ' � -� �� �J�l�;-- ? �
PROPOSF.D WORR (describe in detail � t � �"'� `� -
STORIES: SQ. FEET OF EACH FLOOR:
�O. OF BEDROOMS: G�GS STAI.I�S: ATT. DET.
� '
_ � O c._.
F$TTMATED CONSZ'RIICT20N VAI�UATION (eaclnding Iand) : $ e
= hereby apply for a building permit and I acknowledge that the infor�atio�
above is complete and accurate; that the work will be in conformance w=`�a�h`
ordinances and codes of the City and with the State Building Co ee�it; anc
��nderstand this is not a permit and work is not to start without a p
��at the wor�c will be in accordance with the approved plan. .
�'�` n DAZB: ' Z►� "� 9 os_
APPLIC1�r7T'S SIGNATDRE:�����"� ��C�
� CgECR OFF LIST FOR ISSIIANCE OF PERM3TS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z�t Z� C^—��'` `�� PID:
DESCRIPTION OF WORR: CA'����T
-- ---
----------DATE---
-------------------- APPROVED: C9• 2' ciS`
ZONING REVIEW B`�:
BIIILDING REVIEW BY: DATE APPROVEI7: 6 " 2` 5 S
--------------------
--- ---------------
PEES TO BE CHARGED• Misc. Fees Ca�culate y:
PERMIT Yes �No
PLAN REVIEW Yes f�Ia SEWER CONNECTION
�/�Na WATER CONNECTION
STATE SURCHARGE `leS pp,gg FEE
INVESTIGATION FEE `�eS N� SITE INSPECTION
SAC Yes No
OTHER (specify)
:�Iumber of SAC Units ------------------------
-----------------------------
------------ �/1,_)�
ZONING CHECR LIST
Zoning District:
P st Off ' e: S ol i trict:
Fire Depart:�ent: �
Lot Area :
dth: Depth:
Survey Submitted: Yes No D�. Date of Survey:
�
Yria�� s �- °� �-�J�» �ti
Proposed Setbacks : Right Side- ��d ��' �
Front (L'�k'e) : N �a
Rear ( ��� ' �y�� % Left Side: N � �
Adjacent Structures : �
� �-F Wetland: � ��
Building Height: Def . Hgt. � • �
Peak Hgt.
Avg. Setback: Lot Co era e: _.----
Existin Pro ose
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Re uired: Yes No
ate of Coun il Approval :�_
Grading: Staff Appro al Date: BY'
Counci Approval Date :
Septic: Staff Appro aI. Date: By=
Zoning
File: # Reso tion � Res I.ution Date:
g�RgS (in house) : �
BIIILDING REVIEW CH�:CK LIST '�' .
UgC: F�'P U- 1 CONSTRIICTION �E: ��
Sq Footage $ Per Sq Ftg
Basement x
lst Fl.00r X
2nd Floor X
Garage x
x —
TOTAL
Esti_mated Construction Value: $ .Z ��� �
Inspections Required' Work Requiring Separate Permits:
Site Pl.umbing Grading/Fil�ing
MechanicaJ. Fire
i�k'ooting Water Connection
�'raming Septic
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
inal. (Mfg.) Other
�ther Wel 1 (State Permit)
E�ectrical ( State Permit)
--------------------------------------
RF.MARR$ (IN HOIISE) :
----------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
--------------------------------------
REIrSARRS (TO BE NOTED ON PERMIT) :
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����� Ad 3 ��+' Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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�-`}' On the North Shore of Lake Minnetonka
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DATA PRNACY 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
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 ctata, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other �ocal , state or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or 3.icense reauires Councii action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review prica��
data on yourself.
6, Your full name is required to process this applicaticn o�
permit.
.� �-,-
First Middle Last
_ ��- �
Address
�-�c� � a���.5�--�
City State Zip
`�73 - 8'�.2�
P�one
I understand my rights as stated above.
Sign ture �
BUILDING&ZONItiG—473-73�7
• AD!HP•YISTRATION&FINANCE—473-7358 • PGBLIC WORKS —473-7359
ASSESSING
---- �
�.� �G� �g �g�ECTS OF DATA
Subdivision L 'rYPe
of data- The rights af individuals on whom the data is
stored or to be stored sha]1 be as set forth in this section. An.individual esked to
Subd. 2. Information r�d
to be giren in�vidusL
� rivate or confidentiel data concerning �amw hin the collect ng state gen Se
supply p
purpose and intended use of the requested da
' al subdivision, or statewide system; (b) whether he may refuse or is legally
politic (�) any known consequence arising from his
required to supply the requested datg,
1 in or refusing to supply private or con��iaederal ae�y to receive the date.1tThis_
supp y � investi ative data,
other pe:5ons or entities authorized by state
reauirement shP11 not apply when an individual is asked to supply g
pursuant to section 13.82, subdivuion 5, to a law enforcgment officer.
T
he commissioner of revenue mav plac� igx re2�und instr�u�teonsu nsieadhot
subdivision in the individual income tax or pro�er v
on those orms. � �-- .
t� �� by ����. Upon request to a responsible
Subd. 3. Access
uthorit an individual sha11 be lnformed whetbh�eC hp �g eeor confident al.e Upon his
a y' ublic data on
individugls, and whether it is classified as p �
e ta him and, if he desires, shall
further request, an Indivi�u� �ta without eny chsrgtored private or
individu$ls shall be shown the of that data• After an individual has been
6e informed of the content and mearung the datg need not be �sclosed to
shown the private data and informed of its meaning, �Muant to this section is
him for six months thereafter unless a disPute or action P �ta u n request by
'n or additional data on the individual h�g e or p blic ed °r �eated. The
, pendi g rovide copies of the pr refluire the
responsible authority shall p The res onsible authority may �in the
the individual subject oft�e BC��'costs of making, esrtifying, and comp g
requesting person to pay -
copies. y ssible, with any request
The responsible authority shall comoly immediates off he date of the request,
made pursuant to this subdivision, or within five �Y immediate compliance is not
excluding Saturdays, Sundays and legal holideys,
ible. If he cannot cflmply with the request within that time, he shall S iln�°=th the
P°� ��e an additional five days within which to comp y
individuel, and m8Y �d le al holidays•
request, exeluding Saturdays, SundeYs g
te or comPlete. An individual maY
Subd. 4. Procs�u'e �►hen data is not a��ivate data concerning himself. To
contest the accLu'acY ar comQleteness of public or p the responsible authority
exercise this right, en individu8l shall notify in writing
describing the nature of the disagreement. The respansible euthflrity shall within 30
� either: (a) correct the data found to be inac a Lge���ngPeCipients namedt by
�
notify past recipients of inac�urate ar incomplete ,
the individusl� or (b} notify the indiviaual t��iaual's statemen tof disagreementcis
Data in dispute shall be disclosed only if the indi �u�t to the
• included with the c�isclosed data. ealed p
� The determination of the responsible authority mo contes ed cases•
provisions of the administrative procedure act relating
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DAT� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /G 'f- 9 S l�:nv
PERMIT N0. �I�� � COMPLETED �o—S � /S w� 2�
ADDRESS Z9 Zo �D X s�
OWNER 5�'c�6(3S CONTR. s��^-°
TELEPHONE NO.
� DESCRIPTION
� O�FOOTING 11 MECHANICAL HI 18 EXCAV/GRADINC�a/F�LLING
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
� 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
2 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
F' 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 OEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d _ ORK SATISFACTORY:PROCEED = PROJECT COMPLETE
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W CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� 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
OwnerlContra on si .
Inspector.
White Copyllnspector's File Canary CopylSite Notice