HomeMy WebLinkAbout1994-006217 - addition ,� PERMIT
�CITY OF ORONO PERMIT TYPE:
2750 Kelle Parkwa • P.O. Box 815 ` "'�`�'-.'°�';��'��`
Y Y Permit Number: ,`,i;;-,�; ,
Orono, Minnesota 55356-0815 Date Issued: - � -
(612) 473-7357 ''-s'�,': -=:`:°�-�:"
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: -- �::��:=�I. �r ri?;�:. --
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� APPLICANT-PERMITEE SIG URE ISSUED BY:SIGNATURE
. CHECR OFF ZIST FOR ISSIIANCE OF PERMITS
� . . FOR OFFICE USE ONLY
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_ - -: :..___ ._ PID. `� �-- ;_._�:._.__. ...:�..__._--�-=---�--- -
ADDRES S OR LEGAL. Z�Z'l'�� 1�2��► ' ._.
DESCRIPTION OF WORR: //4iDO1 77�/`� - . _ _ . _
-------------------- - - --- ---------------- ---
. . . ` _ :
_ ...: _ - - ---.. . .__ __ -. ._
ZONING REVIEW BY: DATE `APPROVED. . �e "� Z X"'S_ -
. - - _ : . ;_ .....
.. . . _ _ ,,DATE APPROVED: • (�_" ��. 1'"� `/ -
BIIII,DING REVIEW BY: �
FESS TO BE CHARGF,D: Misc. Fees Calculated By:
. ✓
PLANIREVIEW __ Yes�No SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATER CONNECTION
INVESTIGATION FEE Yes No � P�K FEE `
SAC Yes No_� SITE INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECR LIST -----------------Zoning District---G 2 ���------------------
Fire Department:��J/(,o ��..c� Post Office: (.c�•4^�?i9-r�a- School District: � ���
Lot Area: Z + /a-GIZ-C S Width: ��2.rLe-G v��✓,�- Depth: `-"
Survey Submitted: Yes � No Date of Survey: 3--I �-( -�i�
Proposed Setbacks: �
�ron�t (Lake) : l !:� } Right Side:
R�ar (Street) : zs-r�� 3" Lef t Side: 3J � `
Adjacent Structures : �'�t�f� Wetland: /��/�'
Bui�ding Height: Def. Hgt. �.(L- _ Peak Hgt.
Avg. Setback: �d�-�-��W�- �92�� Lot Coverage: iV �%
Existing Proposed
Hardcover: 0-75 ' �• Z`� `��� �(� .
75-250 ' 2J�.�f4`�o Z�• �Z-�=-
aso—soo � 3• ��`f1� � �—
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approval:
Grading: Staff Approval Date: y Council Approva�. Date:
Septic: Staff Approval Date: B �
Resolution # : 3 i � 3 Resol.ution Date: � � z7�y y
Zoning File:# (5 3 � .
REMARKS (in house) :
BIIILDING REVIEW CHECK LIST . `
:-..- � :�"�. � ..->� -
.IIBC: �- � CONSTRIICTION ,TYP$: .�� - � � . ; .- - :
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_ Sq Footage _ _ �- $ Per Sq-Ftg �, - . � _
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Basement _ , - °� - _ _ _ -
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`lst`Fl.00r` _ x � _ - _ , -_s`
2nd_F�oor. x . _--- _ �_ _ _- �""� ��:
Garage x � . _ - = `-_
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TOTAI� _ ' (� ,, /���ri�+F-C_
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. _ Bsti_mated Construction Value: $ �Z���p o� -
, ,:. -.
Inspections Required: Work Reqniring Separate Permi.ts: _ _
Site ._ . �DPJ.umbing Grading/Filling
�Footing OCMechanical Fire
�Framing Septic Water Connection
_�Insulation �,Firep�ace Sewer Connection
_p�Wa�l Board �`(Masonry) Lawn Irrigation
P-Final (Mfg.) Other
Other Well (State Permit)
�E�ectrical (State Permit)
-----------------------------------------------------------
�F.MARiC$ (IN HOIISE) :
-----------------------------------------------------------
REVIEW BY OTHEFtS: DATE:
Access: Existing New
Access Approva3.: Date BY=
---------
REMARRS (TO BE NOTED ON PERMIT) : . ---- - �
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, ' ' , CITY OF ORONO - BIIII,DING PERMIT APPLICATION ""'
Total Fee: $ %'�/, �J C' Date Received: •-�,Z- 9�
Date Approved:
Entered By: � �'`/, Permit�: /��/�
AT.T• INFORMATION MIIST B$ SUBMITTSD IN FIILL BEFORE PLAN REVIEW WILL BB STAR�ED
(See Check-off List Enclosed)
-----------------------------------------------------------------------------
TSE APPZICANT IS: (circle one) OWNER r CONTRACTOR
JOB SITE ADDRSSS:,2.S.z S ��r'-!/� /�- v� ZIP: .S.S--��!
(wo rk)-S-Z�5�,�' �
NAME OF OWNER: ��i9.�;�1' � % i?�y�,� PHONE: (home)`7;7�1��,�
MAILING ADDRESS: �.f.2S s�a/Tv �'`.t CITY: �cf. s�� ZIP: _�",5��/
/
CONTRACTOR: '��� PHONS: ^
MAILING ADDRESS: `— CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGINEER: - PHONE:
MATLING ADDRSSS: CITY: ZIP:
N�: RBGISTRATION �
TYPE OF WORR: New Addition � Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORR (describe in detail) ;,�dd H�'w ��`���y.C�o�_�,���a�� �
� �,
STORIES: / SQ. FEST OF EACH FLOOR: ..�
NO. OF BSDROOMS: GARAG$ STAI.LS: ATT. DET.
�
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ ���,S.�o 00
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 will be in accordance with the approved plan.
A.PPLICANT`S SIGNATORE: / � �^ DATE: .�,Z^ l�
i��
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� - � � 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
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 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 to review pricatL
data on yourself.
6. Your full name is required to process this applicatian or
permit.
�
��.,�cc/s ��.�.,.,�.�' ��o c�,ec�
First Middle Lastf.
.2.,�'-2.S .k,'/ ��z
Address
./�X'c t si v.< i�ifi �'-�'v��/
City � State Zip
�- ?� - ���: ,
Phone �
I understand my rights as stated above.
;' '' /
�,
Signatu e
BUILDING&ZOIYING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING -
,� .
- ,
�.04 RIGSTS OF SUBJECTS OF DATA � �
Subdivision L �iPe
of data. The rights of individuels on whom the data is .
stored or to be stored shall be as set forth in this section.
-- to be given in���l' An.individual asked to
Subd. 2. Informaticn r�d
� ' su 1 private or confidentiel data concernina BmWi�in t� collect g st te agency,
Pp y v refuse or is legally
purpose and intended use of the requested �b� Whether he ma�
political subdivision, or statewide system;
the requested date; (c) any known consequence arising from his
required to supply rivate cr confidentiel date; end (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 �vesti ative data,
requirement shall not apply when an individual is asked to supply g
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mg rolert t8X re und instructionsuinsteadhos
subdivision in the individuel income tax �r
on those orms. . - - --- � - .
Subd. 3.
Aecess to data by in�ivi�• UPon request to a responsible
authority, an fndividuel shall be informeda h ubLc, pr vateeor e�nfident al.e Upon his
individusls, and whether it is elassified p ublic data on
further request, en individuel who is the subject of � to himrlande if he desires, shall
individuels shall be shown the data withou�fan�y��tg. After an individuel h�s been
�e informed of the content and meaning the data need not be disclosed to
shown the private date and intormed of its uian�Ba��on p��'su�t to this section is
him for six months thereafter unless e �SP �
� ending or additional data on the individuel has been cou�c�tarupongrequest by
' p require the
responsible authority shall provide copies of the private or p �in the
the individuel subject oft�e actual�costs of ma�lcing,lcertl Yingye�d �omp g
requesting person to pay -
copies. ssible with any request
The responsible authority shall comply immediately, if po :
mac3e pursuant to this subdivision, or within five days af the date of the request,
excluding Saturdays, SundaYs and legal holidays, if immediate compliance is not
ossible. If he cannot comply with the request within that time, he shall so in�or h the
P have an additionel �ve daYS Within which to comply
individual, and maY �d le al holidays•
requPst, exeluding Saturdays, SundaYs g
Subd. 4. Procedtu'e when data is not accu�'8te or complete. An individusl may
rivate data concerning himself. To
contest the accuracy or completeness�of public or p the respensible authority
exercise this right, an individual shall notify in writing
describing the nature of the disagreement. Tnac�P°�oren omQleie and at pt to
days either: (e) correct the data found to be
notify past recipients of inaecurate or incomp�t he bel e esdthe datalto be correcty
the individusl; or (b) notify the in�viduel t eement is
Data in dispute shall be dis�ia d only if the individual's statement of disagr
• included with the �isclosed � aQpe�1ed pursuant to the
" The determination of the responsible authority may
provisions of the administrative Qrocedure act relating to contested cases.
pATE TIME
CITY OF ORONO CALLED W � �//�
INSPECTION NOTICE�7 SCHEDULED - J'f D � • � � x
PERMIT NO. �- / COMPLETED � �_
ADDRESS � `^ -� �S-�s)
OWNER � /' CONTR.
TELEPHONE NO. %_�C� � �G�� l�
� DES�RIPTION ,��/J�Z����
� BJ�OOTING�j 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
� 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 SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� �WORKSATISFACTORY:PROCEED f, PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑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.47�73rJ7
OwnerlContra o s �
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
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