HomeMy WebLinkAbout1994-006463 - after fact deck PERMIT
C9TY OF ORONO PERMIT TYPE: ;=;�.:;; ::
2750 Kelley Parkway- P.O. Box 66 - �= ���`��" i'`
Permit Number: �����=�;�.�,:=`
Q Crystal Bay, Minnesota 55323 Datelssued: '���y;'�`�'�;=;'�_-;�'
(612)473-7357
SITE ADDRESS: ..
: j '�:% ._`��;°i�? !i?��i�.:�'—? a=�?�,���:.
:'�{..?
r•. . i:.l i t�r_.�7 i '" _ _
DESCRIPTION: [
. !-�FF„ i f;:('i. !`'_�f„�e�_.. 6 ��`i�i. .
`_'• . , —i i r -� _., �r ' � i'C� r:� i i�,•�'�.s � i�T�'� irC iri't 7i4�t!
!:�+�i', sF..,..�!'µ !'+:'1 ,4l1 � ; (='�� _. —HUI_.r .__!3€_�_°��_ �•si i �i VfSL7tt!
_:=i i i,C:(3,i"t+.—.i �+;�-:i�i' `s,��.`�:if� !_)�-.i.F:, ��;'titiC''"' +iC'Cri'�C
r`ii neT�•i 4+ e .t�..•a.. ��
`3!- _ (��f.^'•,._,�!—e�111'L . .` J.+..!UIVVVL�t 2'!'
i ;��' _ + : ,
i.s.{jE_-`�,-".'�.t'S;f=.�.],i_ti? ]:�-,�., !,:`�S iii vr.i.lit J"Tit}Y
'f�s'+���e}i)(f � s4
c....'.,.Et�i,�'��"'f �__���i—� lr'�1V1L�VV� T� n 17
�.%i iviit _..�.i ir
l.4i�f..t�.'t�i}\•V tt
f!7 f��4t I yr
��1 'Jilt .1.ai.J
3 e'1 i?!litt�t�}�� f1
Si•1J1V�•V�1V !i
i �' �i
�l.d I:Ltt u.�T+il
�r'%�'}i�tf�/t! �y
.L�'�J1#iV L'V�Y !f
�s� (
V i t7+Llt 1 1 r'i VV
L�1�tL1r1 tL J1t�JJ
f 11�..LL1!t M( '�S�'7 TI• /•L�iJ
nw�irli���! LL�V1 1V3 !11�fJf
i:4':'±1iL:1
1•!.' i L't�•7
REMARKS:
FEE SUMMARY: ;;�:�i�#�r�;-� j j::.�.�,.; - _:�°F �;s��}
',-::j:;'.. �'.`�T �r:�;�� . e_t�_� i�`�i:z l i—ii'?f_s`.» t'��: '� . °_��?
r'�nt f .-.�:.'T F.'�tyF • _; _. . i '•_a E.!.~s,E- i�.I"4 # f'"I[ L:�:��'.}. .� ._,__._.�_. �? �'f: (�:'1
�-,e-
�-L;�''»fi�j'€':�_' `.`• ' . _ i,�-��,;,� i-t+,�+ ;�;_'�-`=� _ _
_ i
�t�•'•'—+__,.�,.`s=�;::I.l i-i i': ------- :i�.•'.i Fi)E 1
. -',i.�}EL.;1.����_��; ;. 'x t:,iL _L
1'�ej'-;:`!, +.i���'s.. -'
CONTRACTOR: O���R: L.;_;sy`� j_����i r.��;���
3:=��:�+'`�;_� �•is`�� _�:='<�:3
__;-.�,;�:•
?N� �.�i����":�i G���� ���'���Y �°�#a���.:�:�3 �'�hi�1:�':�:Mr�;�.#� T�,:3 .��€��:� T�l� �Et�� ����`��3�'���t�.._,.,
:������:T�:���:x` ��t:� ?����;�:�_-: �'��i �:��:i �t..�... �:}�=i�l��: �P� °,=,�,:3�;:�' �;�w���- �__�{T4��::�. �I 7� ���:�.�.`��:r�'y �:r..
EM��������,�' �M;��I i�Ai�J�:�_�': ��►€� `��Tt�TE ���= �?Il��l���;�_t-T� ���I L�I�1�'� {_ � _,;,- ��#�#�����*��.�.�.,�.
� �
APP ATURE ISSUED BY:SIGNATURE !—�j .
� � � CITY OF ORONO — BDILDING PERMIT APPLICATION
To�:a� Fee: $ �-� `'��`�- �� Date Received:
Date Approved:
Entered By: '•�,/r`
Permit�: ��i�a�
AT•T• INFORMATION MIIST B$ SUBMITTSD IN FIII�L BEFORE PLAN REVIEW WILL B$ STAR�ED
(See Check-off List Enclosed)
------------------------------------------------------------- -
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: ��1 (' .7 ���'d„�1 /� '�lJl� ,�:r� � ` ZIP: ��-:j �� `/
(work)
� 1
� �.. �, ,,_�,� �< �� � PHONE: �home)Fr��'-�L��� L--
N� OF OWNER: , ,� �T�.'-� _
, . , ,
`�.t � �/iZy CITY: �.....IG l GL c K�` i?, :,�
MAILING ADDRESS: ��� ) ��t-r r 1 l��. �<f ZIP: � � } �`
�
CONTRACTOR: �� r l =�•� � l�--L` PHON$: � J � � 5��-' `�
�iAILING ADDRESS: CITY: ZIP:
STATS LIGENSE: �
� ` PHONE:
ARCHITECT/ENGINEER: �� � t`z % ,,' -
MATLING ADDRBSS: CITY: ZIP:
g�: RSGISTRATION �
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: GARAGS STAI.I.S: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ � ' � `�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 will be in ,�ccordance with the approved plan. �
� r�
/ - � �' "
'' ^ . . / , �i ._.. `+ ' j�,..
/
l. __
APPLICANT'S SI6IJATURE: �� � DATE:
1 , . .
_ �
e
' � ` �� � CITY of ORONO
x
� , �.
,�t'�,, ,., }f,
� � , .,- �';� .
t� A,"���=,t' Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
•
� _ o ,�. 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 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 wi3.1 be used to determine your
qualification for the permit or license 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 revzew pri�a��
data on yourself.
6. Your full name is required to process this applicatian o�
permit.
�` � �lr-� :��' �: -� /.�S f� �<< �
First Middle Last
� f� �� � ���`��� '� �� r � �,�f ''
Address
,l ,- -
� . _ ,
, -�--, � . �� -.- �
����� �� t . _ �-�� � i., � 1 �
City State Zip
' / / . • r~/
Phone
I understand my rights as stated above.
�'� _ , ,��;-� �.
;✓ ,
,, , :�
Signature
BUILDING&ZOIVING—473-7357 • ADMINISTRATION&.FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING '
.. . „ L
f
�
513.0.4 RIGSTS OF SIIB�TS �F DATA � � .
gubdivision L Type of data- The righ section.viduels on whom the data is .
stored or to be stored shell be es set forth in th�s . ���. An.individuel esked to
Subd. 2. Information required to be given in
� ' 1 rivate or confidentiel data concerning 8n'Wi�in the collect g state agencY,
supp y p
purpose and intended use of the requ em;d �b� Whether he may refuse or from his
political subdivision, or statewide sys �oWn consequence arising
required to supply the requested date; (c) any
in or refusing to supply private or confidede�al law ta�ceive he data.ItThis.
supply g state or f 1 �vestigative date,
other persons or entities authorized by
requirement shall not apply when an indt�vialaw en orcementuoff lcer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lace the notice re uired under this
ubdivision in the individuel income tax or ro ert tax re und u�structions instead o
s .
on those orms. • - --- - .
Subd. 3.
Access t� �ata bY in���'L �Pon request to a responsible
uthorit , an individuel shall be informed whetbh�ec h r vateeor eonfident al.e UPon his
a y ublic data on
individusls, and whether it is classified as P •1 �
data without any charge to him and, if he desires, shell
turther request, an individual who is the subject of stored private or��u� � been
individuels shall be shown the of that data. After an ind�
6e informed of the content and meaning t� �t8 need not be disclosed to
shown the private dsta snd informed of Its u�e�8ction pui'suant to this section is
him for six months thereafter unless a �P n request by
' din or additional data on the individuel h� 8teeor Public datarupoeated. The
, pen g uire the
responsible authority shall provide copies The hresPonsible authority maY re4�ln the
the individusl subjeet oft�e actuel costs of making, certifying, and comp g
requesting person to pay -
copies. y if ssible, with any request
The responsible authority she]l comply immediatel , P°
ade ursuant to this subdivision, or within five days af the date of the request,
holideys, uance is not
m p g��ys and legal if immediate comp '
excluding Saturdays, y�ith the request within that time, he shall so inf�orth the
possible. If he eannot comply within which to comply
individuel, and may have sr► additio�d le a��o��.
request, exeluding Saturdays, SundaYS g
te or complete. An individ�g� may
Subd. 4. Proced�u'e when data is not acc�a ivate data concerning himself. To
contest the accuracy or completeness�of public or p the responsible authority
exercise this right, en individual sha11 notify in writing
describin the nature of the disagreemenL The responsible authority shall within 30
da either: (a) correct the data found te be inaccurate or incomplete and attempt to
YS lete data, including recipients named by
notify past recipients of inaecurate or incomp eement is
the individuel; or (b) notify the individual in�v duel'slstatem n of disagr correc .
Data in d ispu te s h a l l b e d i s c l o s e d o n l y i f t h e
• included with the disclosed data. � 8ppe�led pursuant �o the
' The determination o f t h e r e s p o n s i b l e a u t h o rit y to conteste d cas e s• '
provisions of the administrative procedure act relating
� `. CHECK OFF LIST FOR ISSIIANCE OF PERMITS
' FOR OFFICE USE ONLY
A�DRBSS OR LEGAL: I/2� �'� L��VD/9 /4 Vt _PID:
DESCRIPTION OF WORR: ����- s �� ��GK
----=-------------------------------------- -
ZONING REVIEW BY: DATE APPROVSD �'t ' Z 3 'S`/
BIIILDING REVIEW BY: DATE APPROVED: '� "Z 3``7 �
-------------------- -
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes '� No SEWER CONNECTION
STATE SURCHARGE Yes f 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: G/�/Q
Fire Department: /U � Post Office: /��� Schoo� District: ���-
Lot Area: ���- Width: r�'���'� Depth: —
Survey Submitted: Yes� No Date of Survey: 1(�-(0• 53
Proposed Setbacks: , Zi -
Front (�e) : ( �� Right Side:
Rear (S�.°e�et) : -I.O � Lef t Side: S� �
Adjacent Structures: /��"77��LJ� Wetland: i✓��
Building Height: Def . Hgt. �1//� Peak Hgt. /�104-
Avg. Setback: /��A" Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 ' 33'�'°�o
500-1000 '
Hardcover Variance Required: Yes No Date of Council Approval:
Grading: Staff Approval. Date: By: Council Approval Date:
Septic: Staff Approval Date: BY=
Zoning File:# !&` Resolution #: 333 g Resol.ution Date:
REMARKS (in house) :
BQILDING REVIEW CHECR LIST .� �,
�C' �` 3 CONSTRIICTION TYPE: �//v ,
Sq Footage $ Per Sq Ftg
Basement X
lst Fl.00r X
2nd Fl.00r X
Garage X =
x
TOTAL
$stimated Construction Value: $ 2, 5�o
s�•.-
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/Fil.�ing
Mechanical. Fire
�CF'ooting Water Connection
Framing Septic
Insulation Fireplace Sewer Connection
�Wa�I. Board (Masonry) Lawn Irrigation
Final Other
--7�' (Mfg.)
_L Wel 1 (State Permit)
Other
Electrical (State Permit
----------------------
---------------------- �
REMARKS (IN HOIISE) - �/4 NV.n� O r� /� .$/75� U c� f}F� 77�! � /=��
l/�� /�f .: i S Co ��e - w � �0 u `L° h�t/�
------�-�-z---------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
By:
Access Approval: Date __________________
-----------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT N0. Gr�� 3 COMPLETED S-LS-SY `'7�.SS�
ADDRESS //Z� "��'�'��'''�
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 W�OD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
_ �INAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEM�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
� 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Q OWNEH/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS: ��-
�
W
�
�
J
O
a
�
O
k
W
�
Q
�
Z
W
�
W
�
j
d C WORK SATISFACTORY:PROCEED
� �PROJECT COMPLETE
W C CORRECT WORK&PROCEED �- ISSUE CERTIFICATE OF OCCUPANCY
O CI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑ CORRECTUNSAFECONDITION WITHIN HOURS. r- 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.473-73�J7
OwnerlContractor ite
Inspector.
White Copyllnspector's File Canary CopylSite Notice