HomeMy WebLinkAbout1994-006084 - interior remodel 4 � PEI�IVIIT
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� CITY OF ORONO PEl�MIT TYPE: },� ;�, �t j}�`�
2750 Kelley Parkway • P.O. Box 815 Permit Number: ;=;;=;;�„;;;;T
Orono, Minnesota 55356-0815 Date Issued: � �
(612) 473-7357 - ='':'' #r':`j�-'�'
SITE ADDRESS:
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DESCRIPTION:
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CONTRACTOR: OWNER: - �;r���� 7.�:�.�-�:. --
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APPLI ANT%PERMI E SIGNATURE ISSUED BY SIGNATURE �'-�
,
_ � ' CITY OF ORONO - BIIII.DING PERMIT APPLICATION
Total Fee: $ ���� `'�-3 Date Received:
' Date Approved:
Entered By:�l'f� —
Permit�: (,,d�,�/'
AI�.L INFORM2�TION MUST B$ SIIBMITTSD IN FULL BEFORE PLAN REVIEW WII,L B$ STARTED
(See Check-off List Enclosed)
THE APPLICANT IS: (circle one) WNE or CONTRACTOR
JOB SITE ADDRSSS: a5a5 �c� ( � r �VL zip: 5533 �
(work) �T7��J�`1���
N� OF OWNER: �,�/�11�.t��[S �" C���I �-Tr�va t� PHONE: (home) 4'7I-7�� �
.
MATLING ADDRESS:��.L�� CITY: [�%t[[.���jCO Ir ZIP: 5�53 3l
CONTRACTOR: �S �.0 PHONS:
MAILING ADDRSSS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: 1 �A,�� PHONE:
MATLING ADDRSSS: CITY: ZIP:
N�: RSGISZ�tATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration �/ Renovate Land Alteration
PROPOSF.D WORK (describe i.n detail) : I��O'�t.pi�� � �� `� a-�1� w�-U � �� � he.�
- ov� Vu t
STORI$S: SQ. FE$T OF EACH FLOOR: _
NO. OF BSDROOMS: GARAGS ST�LLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcludi.ng land) : $ � i�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 wil 1 be in accordance with the approved plan.
xppzzc�rrr�s szcrr�,�: DATE: �Q f��
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CITY of ORONO
Poat Office Box 66•Crystal Bay,Minneaota 55323•Municipal Offices
• �
� - � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we wou].d 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
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 I.ocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council. 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 full name is required to. process this application or
permit.
�
Q.r s � �"
First Middle Last
a 5 2��� �C�e,�.t.0 l�-v
Address
��Cc�ls�o r �-,�l �5 3 31
City State Zip
�7l-?� 3 (
Phone
I understand my rights as stated above.
Signature
BUILDING 8c ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING �
� �__.�. . '__..' _'_'"__._'.__' .. 1
�.p,4 RIGHTS OF SIIBJECTS OF DATA �
' ion L Type of date- The rights of individuals on whom the ciata is
SubdivLs
stored or to be stored shall be es set forth in this section. An.individuel asked to
_ _ Subd. 2. Informaticn re9ui�
to be given in�viduel.
� � su 1 rivate or confidentiel data concernina BmWi�n the collecting state ag n Y�
PP Y P uested v refuse or is legally
purpose and intended use of the req tem; (b) whether he ma„
political subdivision, or statewide sys �own consequence arising from his
the requested date; (c) any
required to supply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply p State or federal law to receive the data. This.
other persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an indt�vie 1a en orcementuofflcer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lart taX re°und lnstructionsuinsteadh�s
subdivision in the individuel income tax or r• e
on those orms. . - --- - � .
Subd. 3.
Aecess to data by individual• Upon request to a responsible
authority, an individual shall be informed whetbh�c Pr'vateeor confidential.e Upon his
individu8ls; and whether it is clessified as p � ublic data on
e to him and, if he desires, shall
further request, an individual who is the subject �f stored private orvidual hes been
individuels shall be shown the data withou�t anh��tg. �t�r an i��
6e informed of the centent and meaning t� �ta need not be �sclosed to
shown the prfvate date 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
e
pending or additional data on the indi of the h� been collected or create ' the
� responsible authority shaIl provide copies p o�ible authority may require
the individual subject oftrie actual•eo ts of malcing, certifying, and compiling the
requesting person to pay -
copies. ssible, with any request
The responsible authority shall comQly immediately, if po
made pursuant to this subdivision, or withinlag e �f Simmediate8tcomplience eisu not
excluding Saturdays, Sundays and legal hol ys,
ossible. If he cannot comply with the request within that time, he shall so inf`orth Lhe
P hs.ve an additional five daYs �'+�ithin which to comply
individual, and maY �d le al holidays•
request, excluding Saturdays, SundaYS g
Subd. 4. Proced�a'e �►hen data is not accurate or complete. An indi�id�� may
contest the accuracy or completeness�of public or private data concerning
himself. To
exercise this right, an individuel shall notif e T ��ibletauthorty shall w thin 130
describing the nature of the disagreemenL Z'h �° lete and attempt to
days either: (a) correct the data found to be inaccurate or incomp
notify past recipients of inaccurate or incomple t�e t�e esdthe datalto be correct
the individuel; or (b) notify the individuel tha eement is
Data in disPute shall be disclosed only if the individusl's statement of ��' to the
• included with the disclosed data. � 8�pe81ed pursuant
' The determination of the responsible authority to contested ceses.
provisions of the administrative procedure act relating
� • CHECK OFF LIST FOR ISSDANCE OF PERMITS _ _
" ;. _. FOR OFFICE .USE ONLY ,
..�- -` � ' .. . . . . , . ^'C ..9.`''Y tir�� 'a ../..i `�. ..-_ _ ...
�. - s.. .. .. . - �1i-�"~ PID• , ,�.._....,�.. _ ...... ,w.�..... -
�ADDRESS OR LEGAL: � ' � -
_,., :. _. ,._ �.: , . ,.., . _ .
-- . .. ., - - - _ ^ -- - ��-
_�: . . . . . , _. .._ . : - �. :: :
- .
D$SCRIPTION OF WORK: 1 N��L�c�2 ��-r��-- � .
----=------ -= -- - --- -- --- -- -- --- -- -- - - - - ---
. . . . -
-----. :� �.. .. w�..._ :DATE 'APPROVED: �- � �
-_.__..
4:
ZOIIING REVIEW .:BY: '-
-- . ._.
. _ . . :. _ _ . . .., ,_;.� ,�,-:...., �.,..,:. _ - ., . .
: . . _. _ . - -
._ . , . _ _ � - -
- . _ _:. ,-
. - :',�,;,
BIIILDING REVIEW BY: � ._ _ �- v-DATS �APPROVED: �j�`f b: .,��.s� . ' . . _ .
--------------------- -------------
FSSS TO BE CHARGED: � � Misc. Fees Calculated Bye :
PERMIT Yes
�pp . . -
PLAN REVIEW . _. ___...Yes No SEWER CONNECTION - �
STATE SURCHARGE � Yes�No WATER CONNECTION
INVESTIGATION FEE Yes No�� PARR FEE � �
SAC Yes No�� SITE INSPECTION �
Number of SAC IInits OTHER (specify)
� ----------------------------g---------.
------------ .....,,
ZONING CHECR I+IST Zonin D strict.
Fire Department: Post Office: Scho,ol Dist ict:
Lot Area: Width: Depth�
� -
Survey Submitt d• Yes No Date of Syirvey: `
;
,'
Proposed Setba k : �
Front (L e) Right Sic�e:
Rear (St eet) : Left Si : �f
,
Adjacent Struc ures: Wet and:
Bui].ding Heig t: De . Hgt. eak Hgt.
,
Avg. Setback• ` L t Co rage:
istin Prop se�---•- --_____.
Hardcover: 0 75' ' .
75 250' � '
r
250 500 ' . %
500- 000' ,�
Hardcover riance Requ�.re : Yes N � Date of Council Approval:
Grading: S aff Approval te: By: Council Ap roval Date:
Septic: St ff Approval D e: BY�
Zoning Fil :# - Resolution . � Resolut on Date:
REMARtCS (in house) : � .
_;. . . .. _
;�:: . : _ ._� . , _ _ . .
BOILDING REVIEW CHECR LIST. : , � . • .
_ ., _ ., .'_ t .- z „� .`r..�a �-'�� _ ./c- � r� '' y"y+-�`�"tLy,:
yIIBC: �''`-� - - .CONSTRIICTIOH TYPE '" �:� * �r�y-= `` �'�f .
��,::_.�.: '-..� .. . .� �i.4= ..,:.� . ��_:-.��-•� - --�-�~ - s..._S.�Y+.,nt+r Sl��r������:
� , .. _. , .... . ..� .. -. . .. . . - .' . _
. �.. .�..�„�,n. . ._ '. .�„�...�._...r--"'1+-..^r--• -: �� +..dr.tN�.+Nt,:rr.r-...�:..+.�-��.:.��.+..- ,-•-.-„'r _ _
� .�:a'. . �- - .. � .. . _ ._. .. __ . �. . • _
._ ♦ �..�4a. '.� E..� .if
"' '. ': Sq Footage $ Per Sq Ftg ,. _ . _ . ; _ ���-'; � ��-u-�
x,•.T��! ,+�,. v� w,G�,'��� �
Basement � - - •---�-x -- -- _ - _ _:.;�, ,.. „ .�T-. t�.�� ....,
`lst�F�oor - - . .. . x -� _ . : � _ �{,��;:�'�. ,���-���=:
_ �,�,T .,�.=,..�r.r.,.�..
�2nd_Floor. - :x - - - ., r��. .�_ _ _- . _ L-,'���-��.-�. ��Z,�,�.
. _ . ; .: ::_ .:. . .
t,...._..__.. ._. _.._� .. . : _ .. . .<„ r
: .:_ _ .: .._: _: _ ,-,,. ;.:. �:
_..-Garage - . X . . . _ T= _ - .; _ f�_ -
. `-♦ s .:r_� .� �4S
. .. ..- . . . .. . .. . . - - X � ._._ ...�._ _ .._- .-.=+s� - . . .. ._... �:x: ' __ _
TOTAL .._ _ -• ,.. , - _ . ._ - _
_ _ .._ _ -
Bstimated Construction Value: . S � ffU7� , � _:`- :�:
- - -. -_--. ._ _ __
Inspections _Reqnired: Work Reqnirinq Separate Permi.ts: -. _ ..
Site �._.._ . _ _.. �Plumbing Grading/Fil].ing
Footing �Mechanical . Fire �
�Framing Septic -- - Water Connection _ _
�InsuJ.ation Fireplace Sewer Connection
�Wal�l Board (Masonry) I,awn Irrigation
Final (Mf g.) Other
Other We 11 (State Permit)
. �E�ectrical. (State Permit) .
---------------------------------------------------------------
REMARRS (IN HOIISE) :
---------------------------------------------------�----------
RSVIEW BY OTSLRS: DATE:
Access: Existing New
Access Approval: Date BY= �
---------- .
_ _ .._--- __ ___.___
RELKAR,RS (TO BE NOTED ON PERMIT) : .
.. • - • -. ��:.:;-. , , ,�:_ -
.
• - -
• ___ _ - -
. - - . _
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V DATE TIME
CITY OF ORONO CALLED IN �� ,• �d rn
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. ��� co LETED .l�,— �
ADDRESS � �' �"—�
OWNER ✓ CO TR. �"�h J�. u
TELEPHONE NO. !�� � � 4 S�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
,� 02 FRAMI 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
��„ COMMENTS:
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d ORK SATISFACTORY:PROCEED r ❑ PROJECT COMPLETE
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� CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
w
OO ❑CORRECT WORK,CAlL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTtON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i tion 24 hours in advance.473-7357
OwnerlCont sit
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
v
ATE TIME
CITY OF ORONO CALLED IN ��9�
INSPECTION NOTIC � SCHEDULED �-Z-Z/9� y�Z��Pd�.
PERMIT NO. COMPLETED u �/
ADDRESS
OWNER, / r��J CONTR.
TELEPHONE NO. "�'7I - '13 3/
� DESCRIPTION ,Lt
� OOTI ��Q,�,�/Y/ 11 MECHANICALRI 16WELLTESTPUMP
Q AMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET(TURN 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 INSTAIL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
��,, COMMENTS:
�
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2
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d �VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W
� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
❑INSPECT►ON REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr te:
Inspector. -
White Copyllnspector's File Canary Copy/Site Notice
--------,
I,I �i_ .(.� (�.�M � �,',
_- 4, ,d„ �.�,��: G,;,�,
: RS � � �
STAt �
8" MAX. RISER 9" M1N. TREAD SPECIAL NOTE ��, _
pRo�g S�pKE DETECT�RS 6'�" MiN. HEADROOM SEE ATTACI-�ED SHEET -_ _ `
FOR ENTIRE Bi3ILDING AT LEAST ONE HANDRAIL REQUIRED F�R �{qu� /Lq,�L _
GUARDRAIL OPEN SIDES CODE REQUIREMENTS � -�'
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BEDROOM WINDOWS i � u'��. _ � � _ -
�„y , r'"'�Rc7VEi3 R`3 SUBM���.�Et3
- - - -� F,- � � .��-- �---
FtRE E�CIT REQUiRED , — -- _ _, r� �*— _ � � >;'�<<' t:r_; �v�r±-a C�RF.�'?'a0!Y3 AS NO�'ED
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