HomeMy WebLinkAbout1994-006099 - shed P�R.��VIIT �/
CITY OF ORONO PERMIT TYPE: _h,..
2750 Keliey Parkway • P.O. Box 815 ��'j���-w'���'��'
Orono, Minnesota 55356-0815 Permit Number: t ii j€�,i�,:�,� I
(612) 473-7357 Date Issued: �j�; r i;i �,,�; , I
--____.__
SITE ADDRESS:
DESCRI PTION: _ '--------.__-------------
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FEE SUMMARY:
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CONTRACTOR: OWNER: -- �.����:�i ;.����t. —
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APP I ANT/PE ITEE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF ORONO - BIIILDING PERMIT APPLICATION
/ ,� '/�:� .,-, //
Total r ee: $ "r �` Date Received: �.`� � ��, - � Y
Date Approved:
Entered By: �
� Permit�: %�.�c � � `!
AT•T• INFORMATION MIIST B$ SIIBMITTED IN FDLI� BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
---------------------------------- ----------------------------------------
THE APPLICANT IS: (circle one) WNER or CONTRACTOR
JOB SITE ADDRSSS:�����I�V`G II�� ZIP: J� ,�j -G /
(work)
NAME OF OWNER: /v I ('� G[ � PH�NE: (h ome) L�7�Q �f
MAZI,ING ADDRESS: ��� � L��/►� (_�� CITY:v"��Za"�� ZIP:S J���
CONTRACTOR: �r�/' (�1.��- PHONS:
HA2LING ADDRBSS: „ ,�,(� CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGIN�: PHONE:
MATyING ADDRBSS: CITY: ZIP:
N�ME: RBGISTRATION tt
TYPE OF WORR: New Addition Accessory Strncture Move
Demo Remodel/Alteration Renovate Land lteration
PROPOSED WORR (describe in detail) : � �e� ttf OC'' � p� „�.y� � Gt,"��"'6�G�.Ga _
�� �G.�i � �� Q�.l.�������QL�G� � l� �Q�r � / "/ � /1 el.t/ /�I/1C'�Cfit r
STORI$S: SQ. FE$T OF EACH FZOOR:
NO. OF BEDROOMS: GARAG$ STi�I.LS: ATT. DET.
" ��
ESTIIrSATED CONSTRIICTION VALIIATION (eacluding Ia.nd) : $ �����
I hereby apply for a bui�ding 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 th S ate Building Code; that I
understand this is not a permit and work is no t start without a permit; and
that the work wil.l be in acc dance wi th a pr ved lan. , .
APPI,ICANT'S SIGNA DATE:_���/ _
�
C ITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� - � � 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 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 license 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 iocaZ, state or
federal agencies to the extent necessary to process the permit or
Iicense. •
i
4. ��your requested permit or license requires Councii action
to, pprove, some information may become publ.ic.
---- 5. You have certain rights snder M.S. 13.04 to review priva�c
data on yourself.
6. Your full name is required to process this application or
permit.
�,�'S ��f'a,�, � � I f�(5?��� �
First Middle Last
� �/ � �� r ,`�. ,,� �
Ad�re 's
City State Zip
�7i-�'zal
Ph no e
I understa my right as a ove
—
Si e
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING ,
�.04 RIGHTS OF SIIB.TECTS OF DATA
gubdivision L Type of data- The rights e tion�viduels on whom the data is
stored or to be stored shall be as set f orth in thLs s
Subd. 2. Information required
to be given in���' An.individuel asked to
' su 1 rivate or confidentiel data concerning amWi�in the collecting state agency,
PP y p v ref use or is lega7ly
purpose and intended use of the req t med �t whether he ma„
political subdivision, or statewide sys �oWn consequence arising from his
required to supply the requested data; (�) �Y �d (d) the identity of
supplying or refusing to supply private or confidential data;
other ersons or entities authorized by state or federal law to receive the data. This.
p 1 when an individual is asked to supply investigative data,
requirement shall not app y to a law enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lBCt taX re°una�nstructio�n�teadh°5
subdivision in the individual income tax or r� er
on those orms. . --- " .
Subd. 3.
Aecess te data by individuaL UP°n request to a responsible
authority, an individuel shall be informed whether h=�gteeor confidentiaLe UPon his
individusls, and whether it is clessified as public, p ublic data on
e to him end, if he desires, shall
further request, an individusl who is the subject of stored private or�du� � been
individuels shall be shown the data witho o f an�y ��tg. Af ter an indi
6e informed of the content and meaning the data need not be disclosed to
shown the private date and informed of its u���8ction pursuant to this section is
him for six months thereafter unless a �P n request by
� endin or additionel data on the individusl h�8t�or p blic dataruQoeated. The
� P g• rovide copies of the p require the
responsible authority shall p nsible authority may �in the
the individual subject oft�e actual�co ts o fmalang� certifying, and comp g
requesting person to pay -
copies. y if ssible, with any req u e s t
The responsible authority she]1 comQly immediatel , po
ursuant to this subdivision, or within five days of the date of the request,
made p S�da� �d legal holideys, if immediate compliance is not
excluding Saturdays, with the request within that time, he shall so in�orth thQ
possible. If he cannot comply within which to comply
individuel, and may hsve ai► additio� i���ol�days.
request, excluding SaturdaYs, Sundeys g
Subd. 4. Procefiae when data is not ace�8te or complete. An in�m��. To
contest the accuracy or completeness�of public or private data concerning
exereise this right, an individuel sha11 notify
in writing the respcnsible authority
describing the nature of the disagreemenL Tnacc�e orencomQleL and att pt to
days either: (s) correct the data found to be i
notify past recipients of inaceurate or incomp�t rie t�e esdthe datalto be correct
the individusl; or {b} notify the ind►vidual t eement is
Data in dispute shall be disclosed only if the individusl's statement of disagr
• included with the �isclosed data• �ble authority may be apPealed pursuant to the
' The determination of the respo
provisions of the administrative procedure act relating to contested cases.
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
AI�DRSSS OR LEGAL: �`{6SS �YR�L /�-1!L PID:
D$SCRIPTION OF WORK: ARACnL �1-��'}I T]p�'�/
--------------------n--- -------------------------------�-�y-�---------------
ZONING REVIEW BY: �}" DATE APPROVSD: �
BIIILDING REVIEW BY: �Q.�v.u--- DATS APPROVED: 5 "�� � / �
FEBS TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes c� No WATER CONNECTION
INVESTIGATION FEE Yes No �� PARK FEE
SAC Yes No v'- SITE INSPECTION
Number of SAC Units OTHER (specify)
----------------------------------------------------------
ZONING CHECR LIST Zoning District: L 2, lC_
Fire Department: �C/ Pos�O��� � School District:
Lot Area: �.�.. c� 5 .5� �T' Width: /,�� Depth: f 3 Y•5
�
Survey Submitted: Yes x No Date of Survey: 7-�S'F�
� o^-' 1='(L-G
Proposed Setbacks : �� C
Front (�e-) : /V j� Right Side:�_�2
R e a r (S�tx-ee-t) : ( � � L e f t S i d e: �/S�� �.""�
Adjacent Structures : �/-�-'�79Gt�C� Wetland: /���
Bui J�ding Height: Def . Hgt. (�• ��- Peak Hgt. C�� ��
Avg. Setback: Lot Cover e
Existing Propose
Hardcover: 0-7 '
75-25 '
250-50 '
500-100 ' �
Hardcover Var'ance Requ' red: IYes No Date of Council Approval:
�
Grading: Staf Approval ate: y: Cou cil Approval Date:
Septic: Staff Approval. Da e: By:
Zoning File:# Re luti n #: Re olution Date:
REMARKS (in ouse) :
BQILDING REVIEW CHECR LIST - -
IIBC: � � I�'l-� CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x -
2nd Floor x =
Garage x -
x =
TOTAL
os
$stimated Construction Value: $ � �o
Inspections Required: Work Requiring Separate Permits:
Site P].umbing Grading/Filling
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall. Board (Masonry) Lawn Irrigation
p�-Fina 1. (Mf g.) Other
Other Wel� (State Permit)
E�ectrical (State Permit)
------------------------------------------------------------------
REMARRS (IN HOIISE) :
-------------------------------------------------------------------
REVIEW BY OTHEEtS: DATE:
Access : Existing New
Access Approval : Date BY�
--------------------------
------------------�----------------�-�------��"t_
REMARRS (TO BE NOTED ON PERMIT) : C.p22-2c�1- �S "� d"��� ^� �'
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ATE TIME
CITY OF ORONO ca,��E�iN �>����- t`�
INSPECTION NOTICE scHE�u�Eo �'��� /`�=� _�
PERMIT NO. O � ' COMPLETED �- �
ADDRESS �%� � ^ = C �� '
OWNEli�,�'..�,c7't,L�,��-� CONTR. .�x ��
TELEPHONE NO. ��� - � � ���
� DESCRIPTION ,���- -C
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 VYAL�D. 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL� 14 SEWER HOOK-UP 06 PROGRESS
�'�-B�-B£IC�O-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTA�L. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W _ WORK SATISFACTORY:PROCEED PROJECT COMPLETE
� CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,_ pHOTOTAKEN
INSPECTOR WILL RETURN
;- CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7357
OwnerlContract site.
Inspector. --
White Copyllnspector's File Canary CopylSite Notice