HomeMy WebLinkAbout1995-007241 - add/remodel 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:
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: ` � OWNER:
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PLIC �T�PERMITEE SIGNA E ISSUED BY:SIGNATURE
A � • CITY OF ORONO - BDIZDING PERrLZT APPLICATION
��� � ' ��� Date Received:
Total Fee: $ ,
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Date Approved:
Entered By: � ;�!V� . .
Permit�: , �L//
ALL INFORMATION MIIST BE SIIBMITTSD IN FIILI� BEFORE PIaAN REVIEW WI7�I, B$ STARTED
(See Check-off List Enclosed)
THE APPLICANT IS: (circle one) OWNER or ONTRACTO
JOB SITE ADDRSSS: �J`� � � u�� I ZIP: ��� � �
(work)
27�ME OF OWNER- �-�� �v �` �5�1�'1'�- PHONE: (home) L� 7 f ����d
MAIZING ADDRESS: �� � �,. . � � I CITY: �rGti�- ZIP: S�3�I /
CONTRACTOR: ��..� cv►�.-�e �v- C�1 PHON$: l �� `�� S—� L
.�AII�ING ADDRESS: � L�l°' �`�t�Ct1� ���1� CITY: � ZIP: 5�7c��-�
�/ pr
STATS LICENSE: $ f� X
��RCHITECT/ENGINEER: �-� PHONE: �� � I � � S� Z.—
MATLING ADDRBSS: CITY: ZIP:
g�: RBGISTRATION A
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration�/ Renovate Land Alteration
PROPOSF,D WORR (describe in detail) : �.�•-�.r /��\`�"-���
STORIES: �� SQ. FEBT OF EACH FI,OOR:
NO. OF BSDROOMS: GARAGB ST�LS: ATT. DET.
� �
?STIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �i �G�
I hereby apply for a building permit and I acknowledge that the information
�bove is complete and accurate; that the work will be in conformance with the
,rdinances and codes of the City and with the State Building Code; that I
��nderstand this is not a permit and work is not to start without a permit; and
`:�at the work will be in accor nce with the approved plan. .�
. ���
APPLICANT S SIGNATURE: DATE:
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C ITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � 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 Iike to inform you that your request for a permit or
license f rom 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 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 �.ocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Counci3. 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. Your fulZ nam� is required to process this applicatian o�
permit.
� �'�
� � flaw���
First Middle Last
S� �-
Address
`.�_ s�3 �
City State Zip
G��1 1--O S'� Z
Phone
I understand my rights as stated above.
Si e
BUILDING&ZONING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 � PUBLIC WORKS—473-7359
ASSESSING
- , . ,
�- .
�.04 RIGHTS OF SIIBJECTS OF DATA �
Subdivision L Z�Ipe of data- The rights of individuals on whom the data is
stored or to be stored shell be as set forth in this section.
gubd, 2. Information required to be g��� ����' An.individual asked to
� � supply private or confidentiel data concerning BmWit�h�in the collect g state agency,
purpose and intended use of the requested da
(b) whether he ma� refuse or is legally
political subdivision, or statewide system; �own consequence arising from his
required to supply the requested date; (c) eny
supplying or refusing to supply private or confidentiel data; and (d) the identity of
other persons or entities authorized by state or federal law to receive the data. This.
when an individuel is asked to supply investigative data,
requirement shall not apply to a law enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lace the no�cae��ructio�nsteadhos
subdivision in the individual income tax or ro ert tax re
-on those orms. . � _ --- -- -
Subd. 3.
Access tc data bY in���L Upon request to a responsible '
authority, an individuel shall be informed whether h��ateeor confident al.e Upon his
individuaLs; and whether it is classified as public, p ublic data on
turther request, an individual whc is the subject of se tr�e�mrl�ae if he desires, shall
individuels shall be shown the dat8 withou�f an�y��g. �ter an individual has been
�e i n f o r m e d o f the content and meaning t� �t a n e e d not be disclosed to
shown the privaie dats and informed of its meaning, u��t to this section is
him for six months thereafter unless e dispute or action p
, � pending or additionel data on the indi f�h h�ateeor p blic datarupon request by
responsible authority shall provide copies P
the individual subject of the data. The respcnsible authority may require the
requesting person to pay the actual costs of making, certifying, and compiling the
copies. immediately, if pcssible, with any request
The responsible authority shall comply ' of the date of the request,
made pursuant to this subdivis�a le with uda e if�immediate complisnce is not
excluding Saturdays, Sundays � �'
possible. If he cannot comply with the request within that time, he shall so inform the
have en additional five daYs within which to comply with the
individual, and maY S�� �d legal holidays.
request, excluding Saturdays, YS
Subd. 4. Procefia'e when data is aot acccu�nte or complete. An ind�mdu�. To
contest the accuracy or completeness of public or private data concerning
ht an individust shall notify in writing the respcnsible authority
exercise this rig + nsible authority sha]1 within 3 0
describing the nature of the disagreement. The respo
days either: (s) correct the data foundincom lete dataeincludingrec p'ents name tby
notify psst recipients of inaccurate or P
the individuel, cr {b) notify the individuel Lhat he believes the data to be correct.
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the disclosed daia• ealed ursuant to the
' The determination of the responsible authority may be aPP P
provisions oi the administrative procedure act relating to contested cases.
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CHECR OFF LIST FOR ISSIIANCE OF PERMITS
' � � FOR OFFICE USE ONLY
ADDRESS OR LEGAL: '3S��S ��� p�''A"� PID:
C
DESCRIPTION OF WORK: �V CI�J K �Tc-�-�e^�
--------------------------------
ZONING REVIEW BY: /U �/q- DATS APPROVED:
BIIILDING REVIEW BY: �J���- DATS APPROVED: Q 'I � ' S �
------------------ -------
FEES TO BE CHARGF.D: Misc. Fees Calculated By:
PERMIT Yes �No
PLAN REVIEW Yes��/�No SEWER CONNECTION
STATE SURCHARGE Yes v No WATER CONNECTION
INVESTIGATION FEE Yes No PARR FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
-------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Degartment: Post Office: Schoo istrict:
Lot Area: Width: Depth:
Survey Submitte Yes No D e of urvey:
Proposed Setba k :
Front (La e) • ight S de:
Rear (St eet : Left S de:
Adjacen Stru tures: Wetl nd:
Buil�ding He' ght: f. Hgt. P ak Hgt.
Avg. Setbac : Lot Cov rage:
Existing Prop sed
Hardcover: 0-75 '
5-250 '
50-500 '
5 0-1000 '
Hardcov r Variance R uir d: Yes Date of Council A rova�:
Grading: Staff Approv I. D te: By: Council Appro al Date:
Septic Staff Approva D te: $Y=
Zaning FiJ.e:# Resoluti #: Resol.ution D te:
REMARRS (in house) : -
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BIIII,DING REVIEW CHECR LIST �- . . ,
OBC: � '3 CONSTRIICTION TYP�: VN
y
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x = _
2nd Floor x =
Garage ` X -
X =
TOTAL
Estimated Construction value: $ 2-�? c�°�
.
Inspections Required: Work Requiring Separate Permits:
Site ` �CP].umbing Grading/FiJ.].ing
Footing MechanicaJ. Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
WaI�Z Board (Masonry) Lawn Irrigation
inal (Mfg.) Other
Other Wel Z (State Permit)
Electrical (State Permit)
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REMARRS (IN HOIISB) :
-----------------------------------------------------------------------
REVIEW BY OTSERS: DATE:
Access: Existing New
Access Approval: Date BY=
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�F.NIARR$ (Tp BE NOTED ON PERMIT) : �
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�11A4E _ ---- PERMIT NO. ..��.W�-
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t" APPROVEG G"v CORREGTION9 �+S MOTED ��TRY
r. .�" iVJT AQPROV' — CQ�2RECT & RESUBMIT _______. , __
Ihese Cornme�'.3 �re f r your in5ormastian. �II work sheli��liT',�I6 {�G� --
�r. tui� cor»t�liance �vi� i t�pilC.ai�3� C�:�bBing 6� rosdt�g d��AY�C> __-_�
:Wt�+narts irvclud�n� �s not sQettticefty ncrted in this �
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GENERAL CONTP,ACTORS
JEFF DAN6ERf;Y
P.O.BOX 245•SPRiNG PARK, (v11Nf�ItSpTq b53$e�
DATE TIME
CITY OF ORONO CALLED IN �I-S�—9�.�
INSPECTION NOTICE���� SCHEDULED `> " G� �� •`�d
PERMIT NO. COMPLETED
ADDRESS 3���' t ��
OWNER /�/L�,L,Q-(l.L*�' CONTR. f�('�� �-�'1/�.,c�s
TELEPHONE NO. �7 I — C�,3 � �2,
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLWG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 4 WALL B�� 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� �� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. - pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR `1 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContrac n s't :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
D TE TIME
CITY OF ORONO CALLED IN ��- � � /�% 4��'
INSPECTION NOTIC SCHEDULED ?��1=�5 1 O : 00
PERMIT NO. o co �rE� '� �
ADDRESS ���g --1-V L A-�'-�
OWNER Lk��L-Sa7�1 CONTR. A N�V�`I
TELEPHONENO. `t� � — V S 3 �-
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z ALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractop�i s e
inspector. �
White Copylinspector's File Canary Copy/Site Notice