HomeMy WebLinkAbout1992-004753-plans not scanned(filed with permit) , , PERMI�
CITY OF ORONO • , �ERMIT TYPE: �;��T`�7��s�;
1335 Brown Rd. South • P.O. Box 66 Permit Number: :ii=;�.?�_;
Crystal Bay, Minnesota 55323 Date Issued: �.i y J :t,;�_�'�
(612) 473-7357
SITE ADDRESS:
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APPL AN ERMITEE SIGNATURE ISSUED 9Y:SIGNATURE ��Q��
` ` � CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICF. USE ONLY
ADDRESS OR LEGAL: ( 3(o O (=1z l..�'�T C�-} C R�G�=I� '"` pID=
DESCRIPTION OF WORR: IGt;�I��'J c.._�"L --
-------------------------------------------------------------------------------
ZONING REVIEW BY: ��� DATE APPROV$D:
BIIILDING REVI$W BY: DATB APPROVF.D: /U • 3 0'�i z-
FEBS TO BE CHARGF.D: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes �/ No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes Noc/ PARR FEE
SAC Yes No � SITE INSPECTION
Number of SAC IInits OTHER (specify)
---------------------------------------------------------
ZONING CHECR LIST Zonin District:
Fire Department: Post Office: School Di t ' ct:
Lot Area: Width: Depth:
Survey Submitted: Yes No Date of S rvey:
Proposed Setbacks
Front (Lake) : Rig t Si e:
Rear (Stree ) : Le t Si e:
Adjacent S ructur s: Wetland:
Buil.ding Heigh a Def. Hgt. Peak gt.
Avg. Setback: Lot Covera e:
Ex sting Propose
Hardcover: 0 75 '
75 250 '
25 -500 '
50 -1000 ' �
Hardcover Variance Re uir . Ye No Date of Council pproval:
Grading: Staff Approv 1. D te: By: Counci]. App oval Date:
Septic: Staff Approva D te: BY=
Zoning iJ.e:# Resol tion Resol.ution Date:
REMARR (in house) :
BIIILDING REVIEW CHECR LIST
IIgC: �FS' �L -j C�NSTF2IICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement X -
lst F�oor X -
2nd Floor X -
Garage X -
x =
TOTAL
8stimated Construction valne: $ �7 (�a o �
Inspections Required: Work Reqniring Separate Permits:
Site � Plumbing Grading/Fil].ing
—TFooting Mechanical Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�]. Board (Masonry) Lawn Irrigation
Fina 1 (Mf g.) Other
Other Well (State Permit)
�Electrical (State Permit)
-----------------------------------------------------------
REI�IARRS (IN HOIISE) :
-----------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
---------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
CITY OF ORONO - BUILDING PERMIT APPLICATION
-� t , `� c� Date Received:
Total ree: $ )� �
J Date Approved:
Entered By: � �/.1�'
� Permi t�: � � -5-�
AI.I. INFORMATION MIIST BS SIIBMITT� IN FIILL BEFORE PI.AN REVIEi�7 WILL B$ STARTED
(See Check-cff List Enclosed)
------------------------------------------ -�--------_ --------------------------
THE APPLICANT IS: (circle one) OWNER or�QNSRACTO�
• /; 1� �
JOB SITE ADDRSSS: l���O l�r�.,2�►���t l,�"T�� l� ti L� , �1��� �I D ZIP:
(work)
N� OF OWNER: �O�'1 V� � G�T � PHONE: (home) �f �/� ��� '��J
MATLING ADDR.ESS: ( 3 b� {=�'�n ch (�'e e���C- iQ� CITY: ���o n � ZIP=
CONTRACTOR: 1���a« �J �.e-�'le.�r PHorr�: �� a� 3�'7- �,�i j�_
MATLING ADDRESS: Il`1nIt7 ( � � �'� �l�_ /1�'�- CITY: ��; ��t i./ , :ti� ZIP: J�3� —
STATS LICENSE: � �7�o -��-(`�;';�
ARCHITECT/ENGINEER: PHONE:
MATLING ADDRBSS: CITY: ZIP:
N�ME: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alterationy� Renovate Land Alteration
PROPOSF.D WORR (describe in detail) : ��� � l:%G ��,f� T
�a'� y 5�,i=r
STORS$S: SQ. FEBT OF EACH FZOOR:
NO. OF BBDROOMS: C�RAGB STAZ.LS: ATT. r,%' DET.
ESTIMATED CONSTRIICTION VALIIATION (eaclnding land) : $ ��o�*�+ �>E`�
I hereby apply for a buil.ding 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; t:�at 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. . .
,� -
:� ��' �
APPI,ICANT'S SIGNATURE: ;%1�e�' � � ,- t°�`" DATE: /r. _. .3�-- f.Z
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�'"'M, �'`''` Post Office Box 66•Crystal Bay, Minnesota a5323•Municipal Offices
•
� . � � On the North Shore of Lake Minnetoraka
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
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 Iicense requested.
2. You may refuse to supply data, but refusal may reguire 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 Counci� action
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review pri�a�e
data on yourself.
6. Your fuZl name is required to process this application or
permit.
' � �.� d�L�,�
f� ►�a �;� ; � Er�.��
First Middle Last
� '� '��1 v � i�k� ,� �� N��---
Address
�!. �'G t� ;"�IV" _5�' "�'�`/
City State Zlp
j �, I �-.� _��' '7- ,� �{ 1 j� --
Phone
I understand my rights as stated above.
;-�
.i� � , %�
Signature /
'
BUILDINC&ZOVING—473-7357 • ADMINISTRATION&FINANCE—373-7358 • PUBLIC WORKS—473-7359
ASSESSING
_ -- - - - .
�,3.0.4 � RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
gubd, Z, Information required to be g�r� u'���1' An.individual esked to
� supply private or confidential data �u�tea a amWithin the collecting state gency,
purpose and intended use of the req
political subdivision, or statewide system;
(b) whether he may refuse or is legally
required to suQply the requested da t� orcc nf det al data;e�andc(d)athenidenUty a
supplying or refusing to supply priva e
other persons or entities authorized by state or federal law to rice�est gat ve data,
requirement shall not apply when an individual is asked to supp y
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue og pco�ertV tax re�und instQucte ns insteadho�
subdivision in the individual income tax
on those orms. . - — -
Subd. 3. Access to �e.ta bp in�vi�uel- Upon request to a responsible "
authority, an individual shall be infor ead�h b���hP=ygte or eonfidentialre UP°n �
individuels, and W►hether it is classif P ublic data on
further request, an individuel who is the subject��ge to himrlandeif he desires, shall
individuels shall be shown the data withou�fan�y t �t8. �ter an individual has been
�e informed of the content and meaning the �ta need not be �isclosed to
shown the private data and informed of its meaning, u�uant to this section is
him for six months thereafter unless a disQute or action p
, � pending or additional data on the individuel has been �buc�tarupongr q est by
responsible authority shall provide copies of the private or p require the
the individual subject ofthe actual�costs of making,i cert fS'ingy a�'d compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comply a{ the date of the reqvest,
made pursuant to this subdivision, or within five days
excluding Saturdays, Sundays and lege ��wg'ltS�.nl�h$t tim 8he shall so nfo m the
possible. If he cannot comply with the 9 within which to comply with the
individuel, and may hsve an additional five days
request, exeluding Saturdays, SundaYS end legal holidays-
Subd. 4. Procedia'e when data is not accurate or complete. An individuel maY
contest the accuracy or completeness of public or private data concerning himself. To
ht an individual shall notify in writing the respcnsible authority
exercise this rig ,
describing the nature of the disagreem to beTna cui'pa e orin omplete and att pt to
days either: (a) correct the data found
notify past recipients of inaccurate or inac�o1mP�t he belie esdthe datalto be correct
the individuel; or (b) notify the indivi
Data in dispute shall be disclosed only if the individual's statement of disagreement �.s
• included with the disclosed data. � BPPe�ed pursuent to the
� The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
�
DATE ) TIME
CITY OF ORONO CALLED IN �� Cl� �`-- �• �v �
INSPECTION NOTICE SCHEDULED � '�V�`��— l��ov Ctiri
PERMIT NO. ���.3 COMPLETED I'1(� �t� < <=�J
� �
ADDRESS I�3��G l�/1�n �'—�1 /�L� �
OWNER �, CONTR.� =��'��
TELEPHONENO. ���47 ' ��`� ` ��
� DESCRIPTION f� l'Yc-=E-Z(-c?�-
ltr OyEA6�G 11 MECHANICALRI 16WELLTESTPUMP
Q02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 TION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 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
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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W �7 CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. , ; pHOTOTAKEN
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.473-7357
OwnerlContract r on ' e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CI fY OF ORONO ✓ CALLED IN ' �'9 �
INSPECTION NOTICE � SCHEDULED /o!.-/ � �
PERMIT NO. �17 5 � COMPLETED q �
ADDRESS �� �'D �/�2�2 �� �,���- �/�
OWNER � ��.�- CONTR. � � � ���
TELEPHONE NO. ��7 ',�S��J
� DESCRIPTION �C-C�2n���-
� 01 FOOTING 11 MECHANICAL RI 16 WEIL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 F AL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINA� 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPT�C FINAL
� OWNERICONTRACTOH 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
C STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
Ci INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor o site: _
Inspector.
White Copyllnspector's File Canary CopylSite Notice