HomeMy WebLinkAbout1995-006828 - partial basement fin .�- ���.�MIT
�TY OF ORONO PERMIT TYPE:
27�0 Kelley Parkway- P.O. Box 66 Permit Number: `'<�7.`T=�.�� "�'
Crystal Bay, Minnesota 55323 - - - --
(61�)473-7357 Date Issued: - - -
SITE ADDRESS:
DESCRIPTION:
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CONTRACTOR: - - . -. =. -.r°.r=i� -� OWNER:
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A LI ANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE '`'�,' ���
� ' ' � CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total. Fee: $ �''7� .���.� Date Received:
Date Approved:
Entered By: � '�� . _
Permit�: (���',,(�
AT•T• INFORMATION MIIST BE SIIBMITTSD IN FIIL.L BEFORE PI�N REVIEW WILL B$ STAR�ED
(See Check-off List Enclosed)
----------------------
THE APPZICANT IS: (circle one) OWNER or ONTRACTOR
Jos sz� AnnxBss: /�50 ����ti �r��� �C 1�. �-. zzP: �53y�
(work) ��3 �" 19�.5
N1�ME OF OWNF�EZ' ��1h� �J" �sr�.�, PHONE: (home)�� - �17D
�iAILING z�nDx�ss: /� 5d f=�-c,h��, �rt.�IC. 17� cz�: � r��� Z1P: S'�`3`��
_
CONTRACTOR: �o o s �r��l� Psox$: 02� '.�.�C� C�
MAILING AnDx�ss: 395� ���S�An•r �I.�- - S cz�r: /'1�/,� /''��� _ zzP: s�9a�
� ,� J
STATS LICENSE: � �o<,�I!
ARCHITECT/ENGINEER: PHONE:
MATLING ADDRBSS: CIZR: ZIP:
N�: REGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORK (describe in detail) :
STORIES: SQ. FE$T OF EACS FLOOR:
NO. OF B$DROOMS: GARAGS STAI.I�S: ATT. DET.
0 C�
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ )s J��
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. �
APPLIGANT'S SIGNATIIRE: � DATE= � �� �
. �
�I
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323�Municipal Offices
•
� - � � On the North Sh,ore 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
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
qual.ification 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 iocal, state or
federal agencies to the extent necessary to process the permit or
Iicense.
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 priva��
data on yourself.
6. Y�ur full name is required to process this apglicatian or
permit.
First Middle Last
Address
City State Zip
Phone
I understand my rights as stated above.
Signature
BUILDING&Z0�11NG-473-7357 • ADMINISTRATIO\&FINA:�ICE-473-7358 • PUBLIC WORKS -473-7359
ASSESStti G
J • �
�.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of da�e- The righ secti�viduals on whom the data is
stored or to be stored shall be ss set forth ir► thLs
Subd. 2. Information r�d
to be given in�v��L An.individuel asked to
� su 1 private or confidential data concernina �8m� hin the collect ng state agencY,
PP Y uested
purpose and intended use of the req
tem; (b) whether he may refuse or is leg y
political subdivision, or statewide sys known consequence arising from his
required to supply the requested dat$; (�) �Y
u 1 in or refusing to supply private or confidedere.l law to receiae the data.1tThis.
S PP Y g state or investi ative data,
other persons or entities authorized by
requirement shall not apply when an indt�vla law enforcementuofficer. g
pursuant to section 13.B2, subdivision 5,
The commissioner of revenue ma Dle�� tgX re°und instr�ucti ns insteadhos
subdivision in the individuel income tax or r�w
on those orms. . --- - _
Subd. 3.
Access to �ata by in�vi�al- UPon request to a responsible
authority, an individual shall be informed Wh ublic prrvateeor c�nfident al.e Upon his
individuels, and whether it is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individual who is the subject of stored private or
individuals shall be shown the data witho of�hat da a• After an individual hes been
�e informed of the content end meaning the data need not be c�isclosed t�
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 individ�h hes been collected or created. e
� P rovide copies of p reouire the
responsible authority shall p ilin the
the individual subject oftrie actual�cos h of mak ng,l aert fYingy a�'d comp g
requesting person to pay -
copies. ssible with any reQuest
The responsible authority shall comply immediately, if po �
made pursuant to this subdivision, or within �8 e �f Simmediategtcompliance eisu not
excluding Saturdays, Sundays and legal holi ys,
ossible. If he cannot comply with the request within that time, he shall so in�orth the
P heve an additional five days within which to comply
individual, and may �d le al holidays.
request, excluding Saturdsys, SundaYs g
dtu�e when data is not acc�ate or complete. An individual maY
Subd. 4. P� himself. To
contest the accuracy or completeness of public or private data concerning
ht an individusl shall notify in writing the responsible authority
exercise this rig �
describing the nature of the disagreement. Th accura e ore n omplete and att pt to
days either: (a? correct the data found to be i
notify past recipients of inaccurate or incomple t he beI evesdthe datalto be correct
the individusl; or (b) notify the individual tha eement is
Data in dispute shall be discl ta d cn1Y if the individual's statement of �a� t to the
• included with the �sclosed da be 8Ppe8ied pursuan
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
CHECK OFF LIST FOR ISSIIANCE OF PERMITS
` � � FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ( ZS� ��-�''r�'� �� PID'
DESCRIPTION OF WORR: �f�Sa� ��''"`s�+ - ��r`�-
----------------------------
ZONING REVIEW BY: fv �,� DATE APPROVED:
BIIILDING REVIEW BY: DAT$ APPROVED: Z-L4-S�S'
----------------- -----------
FBES TO BE CHARGF.D: Misc. Fees Calculated By:
PERMIT Yes �No
PLAN REVIEW Yes �No SEWER CONNECTION
STATE SURCHARGE Yes �o WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
-------------------------------------------
ZONING CHECR Z�IST Zoning Distri t:
Fire Department: Post Office: Schoo]. D' trict:
,
Lot Area: Width: Tpepth:
Survey Submitted: esl No ate of Survey:
Proposed Setbacks :
Front (Lake) : Right Side:
Rear (Street : I Left Sidez
�
Adjacent St uctures: � We land:
Building Height. Def�l Hgt ! Peak Hgt.
i �
Avg. Setback: �Lot Coverage:
F.�xis ing ' roposed _
l� 1
Hardcover: 0 75 ' J
�
75 250 ' ;% ;
�
2 0-500 ' I
i
5 0-1000 ' 1 �� �
Hardcov r Varianc / equired: � Y s No Date of Counc�l Approval:_
Gradin : Staff Ap oval. Date: By: Council ;Approval. Date:
Septi�: Staff Approval Date BY=
Zoning Fi�e:# esolution #: Resolution Date:
REMARKS (in house) : ,
BIIILDING REVIEW CHECR LIST • - ,
IIgC: � ' � CONSTRIICTION TYPE: �l V�
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor X -
Garage X -
x =
TOTAL
$sti.mated Construction Value: $ � 5 ����y
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical. Fire
_�Framing Septic Water Connection
�Insulation Fireplace Sewer Connection
_�WaJ�I. Board (Masonry) Lawn Irrigation
�cFina 1 (Mf g.) Other
Other Wel 1 (State Permit)
�_Electrical (State Permit)
------------------------------------------------------
�LFMARRS (IN HOIISE) : -
---------------------------------------------------------
REVIEW BY OTH�RS: DATE:
Access: Existing New
Access Approva�: Date BY=
----------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
CITY OF ORONO CALLED IN =� — �T ECi � � �IS� i j,y�
INSPECTION NOTICE / ,, �� SCHEDULED ��' - J �=���� 1. 3c'��'Z
PERMIT NO. �F'�� COMPLETED /�, �C� -UV
ADDRESS /�� /'���.,7 c_�! �-`4.�_.��f� �1 -
�s� �
OWNER ���:-r',.�--�"�.�.�' CONTR. �� /,c� �`�>-�; ���c-�-��'
TELEPHONE NO. %��L " -� ���-�� ����
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADWG/FILLING
Q FRAMING . 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 IN ON 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Q
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMEN :
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W� �i RKSATISFACTORY:PROCEED ;� PROJECTCOMPLETE
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
❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
� :1Owner/Contract r si
Inspector.
White Copyllnspector's Fiie Canary CopylSite Notice
�
DAT�Q TIME
CITY OF ORONO CALLED IN � � / —�� � � �
INSPECTION N T �ry SCHEDULED ! ' � l U ; � v
PERMIT NO. X COMPLETED �� � S�\ 1 J`'��
ADDRESS /� ���� �0 �
OWNER ��-S�� CONTR. c�S - 2/ C�
TELEPHONE NO. ��� ' 3 3��
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 0 � AL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
J
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d Y WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
W
�/fJ CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. _ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
Cl INSPECTION REQl11RED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on sit .
Inspector. — ��--�
White Copyllnspector's File Canary Copy/Site Notice
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C11r,yj 0F OROND
OUILDING PLAN R&IM-
,WSPF-CTOR
CATE PERMIT No.
.�.��APFROVED- AS SLp rsTE
APPIRMED WITH AS NOTED
Fz- &-RESUMAiT
R --- — CO r- C T
NOTA P'PNOVD ' shall be d—A
re for your imcimation. All wor,A
�so. comments a -, Q2
tt%; cofmoilance with aiizoning& zoning o0ft
s. jiy noted in this reVtur
Mciudling items not speclfiCE
PLAN SST UIN SRE AT ALL TIMF"k
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P�om-vv mmoo"vv "L
MIL -0 1'�50 ,
CA,
R101ARD SCHWARZ ARCHITECTS
307 MANITOBA AVL SO( 114 1 %VAYZATA MINNESOTA 55391
(612) 476 — 6766