HomeMy WebLinkAbout1995-006874 - window fireplace instal 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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CONTRACTOR: -- �':;::,::;; �_ ; ::<.::=,. - OWNER:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE -C'�.
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ / �'� ' "�� Date Received:�����r'�i
Date Approved:
y: . ��1
Entered B Pe�i��: /� �� CJ
<O 1
AT.T. INFORMATION MIIST B$ SIIBMITTED IN FIILL BEFORE PI.AN RE�7IEi�7 WILL BB STARTED
(See Check-off List Enclosed)
---------------------------------------�-------------------------------------
THE APPLICANT IS: (circle one) OWNER or �Cor�TRACTOR
Jos sz� x�nx$ss: �.��.� �_��w��,-�;�1_) zzP: SS3.3 /
(work)
NAME OF OWNER: �j��,�, Cf c--s i� h.; PHONE: (home) `�"I I - 1 k9�
MAIZ,ING ADDRESS: �S�'� L`1�)i r'r+�«� CITY: �-x t��--5� '=�•�-- ZIP: 5� 3� 1
-�—
CON2�2ACTOR: �. rJ . �i5`Yi�c i1 � �` `v PHON$: �)�� � �'.�7 1.
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MASLING ADDRESS: � �S'��I S�� �Z�,2 C; K���� CITY: l��'-1 Z �{-uv�- ZIP: S� _�l�
STATE LICENSE: � � �lv �
ARCHITECT/ENGINffi�: PHONE:
MAIZING ADDRSSS: CITY: ZIP:
N�,a� RBGISTRATIOA �u
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORK (describe in detail) : �tv S�i,� j�i"Z�-rAi; t-ti rzE-P c h�� � 1 rv S�ft��_
W�����t����
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: G�G$ STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Ia.nd) : $ �� S f_•C:��, "f
' hereby appl.y 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
�.:nderstand this is not a permit and work is not to start without a permit; and
�nat the work wiI 1 be in accordance with the approved plan. .
) /� ,--
APPLICANT'S SIGNATDRE: ����-- (� _ .,,'/-�--� DATE: -'a I,2-1 l�f �
► , CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z S�S Ly���, PID'
DESCRIPTION OF WORR: (,�l,•.r✓Jo�1 � Pa-�=l'� r(���"� G��
------------------------- ------------------------
ZONING REVIEW BY•� DATE APPRO�TED: 3 �7^ `7�
BIIILDING REVIEW BY: DATE APPROVED: 3 � Z? �5
--------------------
FEES TO BE CHARGF,D: Misc. Fees Ca�culated By:
PERMIT Yes �No
PLAN REVIEW Yes � N�2- 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)
-------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Depar ment: Post Office: School District:
Lot Area: Width: Depth:
Survey Submitt . Yes No Date of Survey:
Proposed Setbacks
Front (Lake) : Right Side:
Rear (Street) : Left Side:
Adjacent Structures Wet nd:
Building Height: Def. Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Vari nce Required: Yes No Dat of Council Approva�:
Grading: S ff Approval Date: By: Co cil Approval Date:
Septic: taff Approval Date: By:
Zoning FiJ.e: # Resolution #: Resolutio Date:
REMARRS (in house) : ,
\
BIIII,DING REVIEW CHECR LIST , .. f
IIgC: �L - 3 CONSTRIICTION TYPE: �I N
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Fl.00r X -
Garage X -
x =
TOTAL
00
Esti_mated Construction Va3�ue: $ -7 S��
Inspections Rern,;red: Work Reqniring Separate Permits:
Site Pl�umbing Grading/Fil].ing
Footing Mechanical Fire
ZFraming Septic Water Connection
-�Insulation Fireplace Sewer Connection
�Wa�l. Board (Masonry) Lawn Irrigation
_�Fina 1 (Mf g.) Other
Other Well. (State Permit)
Electrical (State Permit)
--------------------------------------------------
REMARKS (IN HOIISE) :
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REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
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REMARRS (TO BE NOTED ON PERMIT) :��,/���-�: r►�z--t� �-��^``r 2�`-�'`'�'
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"" �� ��� �` CITY of OROl�TO
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� `��� �' �''� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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s _ v � 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
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 license.
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 3icense requires CounciZ action
to approve, some infarmation may become public.
5. You have certain rights under M.S. 13.04 to review privat�
data on yourself.
6. Your full name is required to process this applicatian or
permit.
�r�t��-1 L E F-�1 /� . ���c'C��
First Middle Last
� s�'�'y S�� /`� Z��2c— r�c:,.�-r�
Address
(,�..i��H Z.�+ �t--r-� �t.tv S� ���
City State Zip
`-I� �C,`��s' .�7 �
Phone
I understand my rights as stated above.
���..0 L_ ��; �f �- -
Signature
BUILDING&ZO[YING—473•7357 • ADMINISTRATION&F[NANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSING
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�.� �Gg� �g �IIg,Tp.CTS OF DATA
S
ubdivision L 4`ype of date- The rights of individuels on whom the data is
stored or to be stored sha11 be as set forth in this section:�. An.individuel asked to
gubd, Z, Information required
to be given indivi
� � rivate or confidentiel data concerning �mWi�t�hin the collecting state agencY,
supply p uested data v ref use or is lega]ly
purpose and intended use of the req tem; (b) whether he ma„ from his
political subdivision, or statewide sys �pwn consequence arising
the requested date; (�) gnY �d (d) the identity of
required to supply rivate or confidentiel data;
supplying or refusing to supply P State or federal law to receive the data. This.
other persons or entities authorized by 1 investigative date,
requirement shall not apply when an individual is asked to supp y
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
T
he commissioner of revenue me lace the notice re uired under this
subdivision in the individual income tax or ro ert tax re und instructions instea o
on those orms. � - �-- -
Subd. 3. Access
to �aLa bY in���' UPon request to a responsible
thorit an individual shall be informed wheublic h r vateeor confidentisl•e Upon his
8u y' ublic data on
individuals; and whether it is classified as p �
further request, an individual who is the subject of stored private if he desires, shall
e to him and,
individuels shall be shown the data witho of�hat da a• After an u���du� � been
�e informed of the content end meaning t� �ta need not be �isclosed to
shown the private data and informed of its m�e�BC�on pu�'s�t to this sectioT��
him for six months thereafter unless a �P n request by
� endin or additional data on the individual h�8teeor p blic datarupoe8ted.
� p g• rovide copies of the p require the
responsible authority shall p onsible authority may �ln the
the individuel subjeet oft�e actual�cos h of making, certifying� and comp g
requesting person to pay -
copies. y ssible, with any request
The responsibls authority shall comply immediatel , if po
e ursuant to this subdivision, or within five days of the date of the request,
mad p �d le al holidays, if immediate eompliance is not
excluding SBturdaYS+ Sundayswith thegequest within that time, he shall siin�orth Lhe
possible. If he cannot comply within which to comp y
individual, and may hsve �Sunde 1O e.cid legaldho days.
request, exeluding Saturdays, Y5
dure when data is not a�te or complete. An individuel m8Y
Subd. 4• p� rivate data concerning himself. To
contest the accuracy or completeness�of public or p the respensible authority
exercise this right, an individusl sha11 notify in writing
The respcnsible authority sha11 within 3 0
describing the nature of the disagreement. lete and attempt to
days either: (a) correct the data found to be inaccurate or incomp
notif ast recipients of inaceurate or incomplete de bel e esdthe datalto be correcL
y p or (b) notify the individuel that h eement is
the individuel, lf the individual's statement of disagr
Data in dispute shall be disclesed only ' �u�t to the
• included with the �isclosed data• ealed p
' The determ8d���trat ve procedure a t relating to contes ed cases•
provisions of the
�
D TE � �TIME
CITY OF ORONO CALLED IN � �`5 � ' b�
INSPECTION NOTICE '/ scHE�u�eo ' / ' '��
PERMIT NO. � g� `� OMPLEfED ' y _T
ADDRESS � `
OWNER CONTR. �
TELEPHONE NO. 7� ��a��'
� DESCRIPTION
� 01 FO 11 MECHANICAL I 18 EXCAV/GRADING/FILL�NG
Q FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RET RN
❑STOP ORDER POSTED. L iNSPECTOR ❑CITATION ISSUED
❑ INSPECTIONREQUIRED. ALLT ARRANGEACCESS.
Call for th t in ion 24 hours in advance.473-7357
OwnerlContract sit : �
Inspector. � �
White Copylinspector's File Canary Copy/Site Notice