HomeMy WebLinkAbout1992-004858 - repair accessory str PERMIT
'.°�'Tl� �F ORONO PERMIT TYPE: �;�_!3�C;It.��::
>35 Brown Rd. South • P.O. Box 66 Permit Number: `-'`-'°�����=
�:;rystal Bay, Minnesota 55323 Date Issued: ���`��`r���_��=
!�;12)�473-7357
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t ^,�'��iCANT/PERMITEESIGNATURE ISSUEDBY:SIGNATURE i
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CITY OF ORONO - BUILDING PERMIT APPLICATION
� ;
Total Fee: $ ` Date Received: �' /p�`z--
Date Approved:
Entered By: � ''
�} Permit�: �' •
ALL INFORMATION MIIST BE SIIBMITTSD IN FII�L BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
TSE APPLICANT IS: (circle one) OWN or CONTRACTOR
'J zIP: �`��'z a �i i
JOB SITE ADDRSSS: _�j ��j `� �t�YV i._.C��� 1 11'� �
(work) F1'�7�- "�S`l �
N�ME OF OWNER: ?�,�;<. y^-�' �"��t� i-3i'�2>l: PHONE: (home)� �; -;,';y i,
MAILING ADDRESS: .�_�'� I-l� :a_r:�� ,J��e CITY:� )K��?tia-�l�- ZIP: ,`-� � J'`y 1
CONTRACTOR: C�i t� .� �E' �'_ PHONE: � � �"._ 3`- Z-/ ,
MAII,ING ADDR.ESS: �rt-�ri.-� CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGINEER: PHONE:
MATZING ADDRBSS: CITY: ZIP:
NAML: RSGISTRATION tt
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORR (describe in detail) : �� t'��=; , t; �,i�-"A�`�� F^�✓� t��7�n��.
-� r�P,� r �
STORIES: SQ. FEBT OF EACH FZOOR:
NO. OF BEDROOMS: GARAGE STAIS,S: ATT. DET. ��
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ �('�C�.l�
I hereby appiy 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: ,,.,�,�T '����v-�� DATE: � �G' .
� •
- " CHECX OFF LIST FOR ISSIIANCE OF PLRMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: `�'����;�c.;v �uw PID:
DESCRIPTION OF WORR: �� p;r�, � t�i,y f-�
------------------------ --
ZONING REVIEW BY: DATE APPROVED: 12• �f- �i Z
BIIILDING REVIEW BY: DATE APPROVED: /2-S' - S �—
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes v 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)
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ZONING CHECR LIST Zoning District: �/�-�Q
Fire Department: Post Office: �,�,�4+�'L+��� Schoo� District: �,1LtrrJ�
Lot Area: I°�,356.S��yS /�CIlx3 Width: l.SD � Depth: I Z y.Z.3'
—,--
Survey Submitted : Yes�j _ No Date of Survey: 5��6 - ��
Proposed Setbacks :
Front ('�xke-) : �o y ' -� Right Side : N 7. YS �
Rear (�'��t) : S. ( � Left Side: ,) �Zo '�-
Adjacent Structures: SS� Wetland: /✓�I`�
Building Height: Def . Hgt. Pea Hgt.
Avg. Setback: Lot over ge:
Exist ng P opos d
Hardcover: 0-75 ' ,
75-250 '
250-500 '
500-1000 '
Hardcover Variance equired: Yes o D te of Counci Approval :
Grading: Staff App oval Date: By: Council A proval. Date:
Septic: Staff App oval Date: Y�
Zoning File: # Re o uti n # : Resolut� on Date:
RF.MARKS (in ho se) : ,
• j .
BIIII�DING REVIEW CHECR LIST � �
IIgC: $K /y�-� CONSTRIICTION TYPE: "��.
Sq Footage $ Per Sq Ftg
Basement X =
lst FJ.00r X -
2nd Fl.00r X =
Garage X -
x =
TOTAL
$stimated Construction Value: $ /, OoO �
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/Fil�ing
Footing Mechanical Fire
� Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�l Board (Masonry) Lawn Irrigation
�Finaz (Mfg.) Other
Other Well (State Permit)
Electrical (State Permit)
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REMARRS (IN HOIISE) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval. : Date By=
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REMARRS (TO BE NOTED ON PERMIT) : �G ANS /t/UT �/L(�v�/1l� - C.o����ej'`�S /�'I A�
BE �f ���✓a ,� .�e 4�.�.�r -rn f�,.�s �,v,5��c.��.v
�3.4�w/rc+�Y�n� '�.s�.� .
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• �1j.eM
!-4b � Is'i. '�
�=������ CITY of OR011\T�
�...Y ,��.. � ¢
,� � � Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
0 '��
. � _ � 7'".�`h 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 like to inform you that your request for a permit or
I.icense from the City of Orono or any of its departments may require
you to furnish certain private or confidential information.
You are notified that:
l. The information you furnish wi3.I 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 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
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 �o rev�ew pri�a�e
data on yourself.
6. Your full name is required to process this applica�ian or
permit.
��i� �l��� � �l � �� �'.l'� �� �� �1
First Middle Last
��1 � � �1`�n.�l-C�:,� ��' l' -
Address
�-�"- '� ti '? t�'�1'� �'ln� ,. �5��3 �� �
City State Zip
�l �� � ' 3-� �f �
Phone
I understand my rights as stated above.
�
,�:�� �����.-` - -
Signature �
BUILDING&ZONItiG - 473-7357 • ADMINISTRAT101& FItiANCE - 373-7358 • PUI3[,IC��'nRKS - 473-7359
ASSESSING
513.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision 1. Type of date- The rights of individuals 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�vi�uel• An.individuel esked to
supply private or confidential data concer a a tgmwit�h�in the collecti g state agency,
purpose and intended use of the request
political subdivision, or statewide system;
(b) whether he may refuse or is legally
required to supply the requested dat8; (c) any known consequence arising from his
supplying or refusing to supQly private or confidential date; and (d) the identity of
other persons or entities authorized by svaau��e�kedlto supplyin est gat ve data
requirement shall not apply when an indi
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mg ropert tax re�und instructionsunsteadho5
subdivision in the individual income tax •r
on those orms. -
Subd. 3. Access to �ata bY in�►v�dual' UPon request to e responsible
authority, an individuel shall be informad�whe b�c'pr vateeor confident al.e Upon his
individusls, and whether it is classifie P ublic data on
further request, an individual who is the subject��ge to himrlande if he desires, shell
individugls shall be shown the data withou�fan�y t �ta. After an individual has been
�e informed of the content and meaning the data need not be c�isclosed to
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
, � pending or additional data on the indi oif the hri 8 eeor p bI c datarupongrequest by
responsible authority shall provide copies The res onsible authority may require the
the individual subject of the data• p
requesting person to pay the actusl costs of making, certifying, and compiling the
copies. immediately, if possible, with any requesi
The responsible authority shall comply
made pursuant to this subdivision, or �th lideys,�f Simmediateat ompliance eisu n t
excluding Saturdays, Sunc3ays and leg
possible. If he cannot comply with the request withi�i��ntl�ch toh omQlynw�th the
individuel, and may have sn additional five days
request, excluding Saturdays, SundaYs and legal holidays.
Subd. 4. Procedtu'e when data f ublic o�p ivate datla lconce nnng himseif•mTo
contest the accuracy or completeness P
exercise this right, ar► individuel shall notify in writing the responsible authori y
describing the nature of the disagree a t�beTnacctu�a e oren omplet and att mpt to
days either: (a) correct the data foun
notify past recigients of inaccurate or i�u�P�t he believesdthe dataito be correct
the individuel; or (b) notify the indiv
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the �isclosed data• ealed pursuant to the
" The determination of the responsible authority may be app
provisions of the administrative procedure act relating to contested cases.
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, ,,, ' Lots 4 , 5 and 6 , Block 1 4 , htINNL't'UNK11 1;T�U1�1 �, �accord�ing ,o tl�e
, ;, ° recorded plat ther�of � Ilenne
,;; . pin County, Minn��sota.
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GENERAL NGTES �
�=_--------
, � Denotes iron monument
_..._,: . -t� proposed top of foundation elevation =
Denotes cross chiseled in concrete Proposed basemeni floor elevation =
x 939.7 Denotes existing spot alevaf lon
� 939 Denotes proposed spot elevation Proposed garage floor elevation = �
�--- Donotes surface drainaqe ' E�CNCNMA�tK:
Dashed contour lines denotes propose.d features �
: .< Solid contour lines denotes exisfing featur��s
�,�,�. ,,,
�rj�j -��j ��O ���A7� I h�reby certity Ihdt fhis surva SCALF �'
a111 was pre a�pd Y, Dun or rtporf
. � D by m� or under my direct �uperyiiion ! ,� : ��,
R �t �,� and ihal I am a duly Reqi�4ered Land Surveyor
. _... �'�4�L' ���� unde� the low� of the Stale ol Minnesola. , ;:r'
'__'. ' BOUK f'AG E
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23�0 Oaniels Street �ic'(. , l /�-`:f � ,' ,, �'
Long Lake, Minnesota 55356 J �__r- '=�-- `•r�. �" �
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Ph: 475-1433 0 � '��i � " �" �
� � I /� FILE N0.
ATE _ REG. N0. / ��- �
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�i+�.'��.',�i�vferT:`�M'i.�:T71"��iZ:iF.���..........r_.. .s.r._.__
ATE TIME
CITY OF ORONO ca��Eo iN � �G �'�
INSPECTION NOTICE SCHEDULED 9/o f R '� l'� 3 0
P�RMIT NO. COMPLETED � �
ADDRESS 3 - '
OWNE �:� CONTR.
TELEPHONE NO. �7�-� 7=�`�?'
� DESCRIPTION �
W 01 FOOTING MECHANI L RI 16 WELLTEST PUMP
�
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETIANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP �34 TR � OVAL
Q 05 FINAL 13 METER SETlTURN ON 17C SITE INSPECTIO
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENT •
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W WORK SATISFACTORY:PROCEED i_, PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ! ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
l CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
I STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
"1 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra r site:
Inspector. -
White Copyllnspec r's File Canary CopylSite Notice
��
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � 3=3D
PERMIT NO. co LETED
ADDRESS � �7 �Ct►'� Ov� ('tJN�
OWNER CONTR.
TELEPHONE NO. -
� DESCRIPTION
lL 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
�
031NSULATION 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 �/ TE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
W 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 10 PLUMBING FINAL 23 SEPTIC FINAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
�
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d ❑WORK SATISFACTORY:PROCEED i PROJECT COMPLETE
W
� ❑CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
I_: CORRECT UNSAFE CONDITION WITHIN HOURS. i pHOTO TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �- CITATION ISSUED
INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor o site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice