HomeMy WebLinkAbout1995-007440 - detached garage � PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued: - ,
SITE ADDRESS:
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DESCRIPTION:
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CONTRACTOR: OWNER: '
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APP�ICANT�PERMITEE IGNATURE ISSUED BY:SIGNATURE ,����
�' �� CITY OF ORONO - BUILDING PER�LIT APPLICATION
•
Tou�al. Fee: $ � 702� �'1 Date Received:
i
Date Approved:
Entered By: � �1��� Permit tt: /`t�(/
ALL INFO�SATION MIIST B$ SIIBMITTED IN FDLL BEF�RE �'LAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
-------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRRSS: � � IJ����r��s�i���H N,�� ZIP: � S 3 S �
(work)
'Z��i-1 �R�� c� .�C ., ,.�► PHONE: (home) t/7 3 -S �"z�
NAME OF OWNER: -
MATLING ADDR.ESS: �Sl/�����c�a�,� ���<< CITY: �CM1�G- ZIP: 5 S 3 � c
CONTRACTOR: �'�L �.r�� s G��.�� _ PHON$:
MATI,ING ADDRSSS: CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGINEE�tt: PHONE:
MAILING ADDRBSS: CITY: ZIP:
N�: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Struczure �'( Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : � r� �� S `j�=�.--- Z /x �-�
STORIES: SQ. FEBT OF EACH �LOORt
NO. OF BgDROOMS: GARAG'S STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ > >�lz'
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the wor}c 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
�hat the work will be in accordance with the approved plan. •
APPLICANT'S SIGNATDRE: I`-�-•sf�� �c��.� DATE: /l% `/-5� i
_ � * ..
. � ��� � �
�
��� ���� ������� ��� CI'�Y of O�iON�
Y x 1:.
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�`'� � � Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal cea
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� �t' ` ,� �= 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
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 wil.l be used to determine your
qualification for the permit or Iicense reguested.
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
license.
4. If your requested permit or Iicense requires Councii action
Ito approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
E. Yc�ur full namP is required to process this apr-licatian or
permit.
���H A,�u L��� � L � �'"�,L.� ��L%'9 C—�,ti���_�n�
First Middle Last
�� N,�� �; ���,�� '.� < < <
Address
�.o J�JC- �.� i�c� ,�� iy ��� � �� �>
City State Zip
��� z -- �; � Z �)
Fhone
I understand my rights as stated above.
�4� �-r�� L-Z i-�;/7,� -
Signature T
BUILDING&ZONING—473-7357 • ADMINISTRATIO[Y&FINANCE —473-7358 • PUBLIC WORKS—473-7359
ASSESSIN G
.. � � .
�13.a4 R.IGH'�'� OF �gJgC�°S OF DATA
Subdivision 1. Type of dat�- 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 require
d to be given in����' An.individuel asked to
su 1 private or confidentiel data concernin�g tgmW hin the collecti g state agencY,
PP y uested
purpose and intended use of the re9 tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �o�„�n consequence arising from his
required to supply the requested dat8; (c) any
u 1 in or refusing to supply private or confidential data; and (d) the identity of
S PP Y g state or f ederal law to receive the data. This.
other persons or entities authorized by investi ative dats,
requirement shall not apply when an individual is esked to supply g
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav lart tgX re°und i�tructionsunsteadhos
subdivision in the individual income tax or Qc���
on those orms. - .
Subd. 3. Access t� data by in�vi�u�l- Upon request to a responsible
authority, an individual shall be informed whetbh�ec Pr vateeor confident al.e UPfln h�s
individuels, and whether it is classified as p � ublic data on
e to him end, if he desires, shall
further request, an individusl Who is the subject of stored private orViduel has been
individuals shall be shown the date witho of�hat da a• After an indi
�e informed of the content and meaning the data need not be �isclosed to
shown the private data and informed of its ut�or�action pursuant to this section is
him for six months thereafter unless a �Sp n request by
� endin or additional data on the individual h� gte or pu lic datarupoeated. The
� p g• require the
responsible authority shall provide copies of the p ilin the
the individuel subject oft�e actual.cos h of mak ng,l cert fyingyand 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 withi lida e �f Simmediategt ompliance eisu not
Sunde and legal ho Ys,
excluding Saturdays, YS
ossible. If he cannot comply with the request within that time, he shall so in�or h the
p have an additional five days v+►ithin which to comply
individual, and mgY 5��� �d legal holidays.
request, excluding Saturdays,
Subd. 4. Proced�u'e �►hen data is not acctu'ate 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 responsible authority
exercise this rig �
describing the nature of the disagreement. Tnac�P°�orenComplete and att pt to
days either: (a? correct the data found t� be
notify past recipients of inaccurate or incomp�t he believes�the dataito be correct
the individusl; or (b) notify the individual eement is
Data in dispute shall be disclosed only if the individual's statement of �8� to the
• included with the disclosed data. � BPPe�1ed pursuant
� The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
` CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
AJ�DRESS OR LEGAL: 3S I-11�CI<(3C�IZ�( 1-���-L PID:
DESGRIPTION OF WORR: O CT- C�A�'A6 c:
----��------------ -
------------------� �
ZONING REVIEW BY�� _ DATE APPROVED. 10 - 11- `�S
BOILDING REVIEW BY: d DAT$ APPROVED. (� II �tS
------------------ ---------
FEES TO BE CHARGED� 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 District:
Fire Department: L� Post Office: C.(.,, School District: o2o�vo
Lot Area: Z�Oy� Width: S -1 Depth: 2��
Survey Submitted: Yes�_ No Date of Survey: on� ���-�= ��- ►Z'S�
Proposed Setbacks :
Front (Lake) : ���� � _ Right Side: lo� �
I Rear (Street) : t 0� (�� Lef t Side: 55 �
Adjacent Structures : �5 � Wetland: NIG4
Building Height: Def . Hgt. c�,K Peak Hgt. C9 • I�
Avg. Setback: � �R Lot Coverage: �2�S�o
Existing Proposed
Hardcover: 0-75 '
75-250 '
N�
250-500 '
500-1000 '
Hardcover Variance Required: Yes No �C Date of Council Approval:
Grading: Staf f Approval. Date: /��A By: Council Approval. Date:
Septi c: Staf f Approval Date: t'� �l� BY=
Zoning Fi]�e•# - Resolution # : — Resolution Date: "
REMARKS (in house) : ,
BQILDING REVIEW CHECR LIST _, ` _
DBC: U -I CONSTRIICTION Z'YPE: �f N �
Sq Footage $ Per Sq Ftg
Basement x =
lst F�oor x —
2nd Floor x =
Garage 2y X2c. _ �2y x �6 �5•?3 = � `�,`�� °_
x =
TOTAL
�
Esti_mated Construction Value: $ °�,��
Inspections Required: Work Requiring Separate Permits:
Site PJ.umbing Grading/Fil7.ing
XFooting Mechanical Fire
K Framing Septic Water Connection
�_Insulation Fireplace Sewer Connection
_�WaJ�I Board (Masonry) Lawn Irrigation
F Fina� (Mfg.) Other
Other We1J� (State Permit)
� Electrical (State Permit)
---------------------------------------------------------------------------
�F.MARKS (IN HOIISE) :
------------------------------------------------------------------------------
REVIEW BY OTHERSs DATE:
Access : Existing New
Access Approval: Date BY=
---------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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_ • . .3s �-fkck8E7irz�4 �,C[.
Plst of Sur�ey
for P,ichard 'a. '�a@rnan ,
of Lots 11 a.nd 12, Block ?, �a.ziel's Long La�ce Heights
_ . Hennepia Count;�, �finnesoia lUx�y St�So� Po2Gt�
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Certificate'o£..Survep: � � ;; :� _ , �" :
. _��' .::�-..:�5•Z.'hereby%certif'y"`that-this=is'a true and_correct _representation of a : . , •:w+ ��_�
�" � ��"` s'�"�ura.Pp of;t�boundaries-.o£;I�ots'11 and 12, Block 2, Llaniel's Lc�ng Lake ,
" ;Heights,�,and�'of'the_locatiori of all buildings, if any, theraon, and all t * : �;
� � s���viaible��encroachmenta� if;�any; from or on said land. This survey is made� '� �:;
-oiiZy;in 'connectioa.,with�e:`,mortgage loan now being placed on the property; :� } �•' �
� : r j��,�and aof liabi'Iity ie 'ass�imed:ezcapt to the� holder of such mortgage or anp ' , - � ��
• other iatereat-,acquired:try�reasen.of such mortgage. It is understood and . �
' ��agreed no�>ainn�aenta. have_been plac f r the e of establishing lot : '
, - linea or:;botiridary corners.' t ".,-�.
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., .,� r,-,. 4 1� ; - 'rfm. S. Kslley, Jr. R .o. 1.'42 >y
-�>. ; '.'-�,C` >, { , � , - :,Bruce R. Kelley R g. No. 5'713 � 'f ,
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Scal� Y 50 , , , .
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=:H�����s in����tir:g it�ms nv; ���tsC�::�S'y noted in tnts rev�
�4:, � ��'l�` {-'L�I\ �S� f lF3P �'.2i f i ��T Y��. 14�1'+�
�
DATE TIME
CITY OF ORONO CALLED IN i-�r�
INSPECTION NOTICE ,/ SCHEDULED %//E: /`%e, ';�
PERMIT NO. '��`7� COMPLETED � �
�'S �; '
ADDRESS � . -� _,c��,/.�° � <_f
OWNER �%�''��-�.�'�.s��...� CONTR.
,,
TELEPHONE NO. � 7 =' - .'?_`? =< ��
� DESCRIPTION �:��,z ._ `�_,
� 01 FOOTING ' 11 MECHANICALRI 18IXCAV/GRADING/FIWNQ
y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER H�OK-UP 17 SITE INSPECTION
Q
2 . t)5F 1f�AL_ 14 SEWER HOOK-UO 06 PROGRESS
J\ b7 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBiNG RI 23 SEPTIC FI�CL 35 HARD COVER REMOVAL
v 10 PLk1�ABINO FINAL / � 36 FOUNDATION REMOVAL
� 6�IVNER/CONTRACTOR TO MEET��YES=NO
-L'IIIGIMENTS: � -- '
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d �WORK SATISFACTORY:PROCEED ROJECT COMPLETE
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� L CORRECT WORK&PROCEED �; ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALI.FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
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