HomeMy WebLinkAbout1995-007431 - deck � �— �
' PERMIT
( CITY OF ORONO
.
2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: _ i �:;��1�
Crystal Bay, Minnesota 55323 Permit Number: :;;�::;��:Y;;
(612)473-7357 Date Issued: -
SITE ADDRESS:
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CONTRACTOR: OWNER: — ������? �c���;t. —
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A P ICANT/PE MITEE SIGNATURE ISSUED BY:SIGNATURE ,
; • - CITY OF ORONO - BIIII.DING PERMIT APPLICATION
• �� - �%`'"� Date Received: � /,,�S�i��J
Total Fee: $ 1 / —��! "
�
Date Approved: � ' ' �' �
�,
,
Entered By:�' ��� _ j,�` �� .'
;/
Permit�: "� "'
ALI� INFORMATION MIIST B$ SDBMITTBD IN FULI� BEFOR.E PLAN REVIEW WII.L B$ STARTED
(See Check-aff List Enclosed)
-----------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRRSS: ��� � � �/,r� �- /'�✓ ZIP: S��j�G/ �
(work)
N�ML OF OWNIIt: �a,,�,�y /"t ��?"�"��S t'"ci c•��f PHONE: (home) y 7�77,�1
MATI,ING ADDR.ESS: �`�C�� �~�/�� C- �✓ CITY:�.Z/4+,.�Zc�-t-�1 ZIP:S ') 3�f �
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CONTRACTOR: (i��/v� � � PHONS:
?�iAILING ADDRRSS: S � �N� � CITY: ZIP:
.—�
STATE ZICENSE: �
ARCHITECT�ENGINE�t: �'� /,�1 � _ PHONE:
:SAILING ADDRBSS: CITY: ZIP:
�,r��g: RBGISTRATION u�
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : �C� f�- ,� ���� '7��t r�-��n�'�f'�n- �� -
--�<;:� ►- S c; r'� ��. ��c:�- �t,1 - 1 .�N X 3� .
STORI$S: SQ. FEBT OF EACH FI�OOR:
�70. �F BgDROOMS: G�GE STALLS: ATT. DET.
- ��% �
�STIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ � � �"" � ��
= hereby apply for a building permit and I acknowledge that the information
;bove is complete and accurate; that the work will be in conformance with the
crdinances 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
=hat the work will be in accordance with the approved plan. - �
ry y
A.PPLICANT'S SIGNATORE: � DATE: ����/ �
: � . ,
"�� C� �'SY.:k:�
�� a ����°,����� CITY of ORONO
t��
��zx ; �t���.:
Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
•
� - e � 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 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 �o review pri�a�e
data on yourself.
6. Your full namP is required to process this appl.icatian or
permit.
—�.�„M-�s -� rc�,�� /v �,�TfC�51"l�.tc�-f-
First Middle Last
3`1�� t_�i�, � �v
Address
i.,�t/ ,,✓uA7��� ,/� � .�S ��/
Cit � State Zip
Y
y7� - 7 � f�l
Phone
I understand my rights as stated above.
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Sign ure
BUILDING&ZOMNG—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
.. r i
513.04 RIGSTS OF SIIB.TEC'I5 OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be ss set forth in this section.
gubd, 2, Information required
to be given in���' An.individual asked to
- � su ply private or confidentiel data concernin a BmWit�h�in the collect g state agencY�
P
purpose and intended use of the req em;d �b� Whether he ma� refuse or is legally
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 persons or entities authorized by state or federsl law to receive the data. This.
when an individual is esked to supply investigative data,
requirement shall not apply to a law enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lart tgx re°und �nstructi nsuinsteadh�s
subdivision in the individuel income tax or r• e
on those orms. . --- - - .
Subd. 3.
Access to data by in�vidusl• Upon request to e responsible
authority, an individu8l shall be informed�whe blic, pr vateeor confidential.e UPon his
individuels; and whether it is classified p ublic data on
turther request, an individuel who is the subject of se t�e�mri�v�aae if he desires, shell
individuels shall be shown the data witho of�hat da a• After an individual has been
�e informed of the content snd meaning the data need not be c�isclosed Lo
shown the private dats and informed of its ute orgaction pursuant to this section is
him for six months thereafter unless a disP
� ending or additional data on the individusl has been �blic dataruponarequest by
' P require the
responsible authority shall provide copies The resrorisibler authority may
the individuel subject oftrie actual costs of making, certifying, and compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comply '
made pursuant to this subdivision, or with�dB e �if Simmediate8 compliance eisu not
excluding Saturdays, SundaYs and legal YS�
ossible. If he cannot comply with the request within that time, he shall so in�orth the
P have an additionel five daYs v+►ithin which to comply
individual, and maY 5��� �d legel holideys•
request, excluding Saturdays,
Subd. 4. Proced�a'e when data is not accarate or complete. An individuel maY
himself. To
contest the accuracy or co�p�et�eenl s�Pnb�y lnrl�i�the�respenslble aut�o�i30
exercise this right� an ln
describing the nature of the dfsa��e�d to be inaccurpa e ori n omplet and at empt to
days either: (a) correct the data
notify past recipients of inaceurate or incomp�t he belie esdthe datalto be correct
the individuel3 or (b) notify the in�vidual
Data in dispute sha]1 be disclosed only if the individual's statement of disagreement is
• included with the disclosed data• ealed ursuant to the
' The determination of the responsible authority may be 8PP p
provisions of the administrative procedure act relating to contested cases.
i
' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
.
' � FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2`�GS� �y�'� ���. PID:
DESCRIPTION OF WORR: � -,��
-------------------j� --��-----------------
------------��--5--------------
ZONING REVIEW BY: Cf� LQ DATE APPROVED: �U - �1
BIIILDING REVIEW BY: dc�o�� DATE APPROVED: IC� -�4 'r1`>
---------------------- -
FEES TO BE CHARGED: ` Misc. Fees Calculated By:
PERMIT Yes ✓� No
PLAN REVIEW Yes �' No 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 Department• Pos Off ' c : chool. District:
�
Lot Area: Widt • e
Survey Submitted: Yes eL. No Date of Survey: o� '�=«� � '1e'`�0
Proposed Setbacks:
Front (I�ic�) : �I��-�" Right Side: ��c� ` *
Rear (St-��et) : ,5 Z � Left Side: N �r/�
Adjacent Structures: �2� t Wetland: N�/fi
Building Hei t: Def . Hgt. Pea Hgt.
Avg. Setback Lot Cover ge
Existing Propose
Hardcover: 0 75 '
75- 50 '
250- 00 '
500-1000 '
Hardcover Var' ance Req ired: Yes No Date of Coun il Approval:
Grading: Staf Approval ate: Council A proval. Date:
Septic: Staff Approval Da e: BY=
Zoning File: # R lut on # : Resolution Date:
�2RMARK$ (in house) : _
BIIILDING REVIEW CHECR LIST _--_ _
�
IIBC: f2-3 CONSTRIICTION TYPE: �W
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Fl.00r x =
Garage X -
(J.e.caG �2 x :�b = y 3 Z X 8.cx� = 3,�+� _
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Pl.umbing Grading/Fil.�ing
�Footing Mechanical. Fire
,�Framing Septic Water Connection
Insu�ation Fireplace Sewer Connection
Wal.l. Board (Masonry) Lawn Irrigation
o�Final (Mfg.) Other
Other Wel 1 (State Permit)
Electrical (State Permit)
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Ru�tARR$ (IN HOQSE) :
--------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approva�: Date BY=
--------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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':� APPRO'��_u AS SL�BMITTED
�APPROVED WITH CORRECflONv �S NOT�p
NOT APPROVED -- CO�RECT & RF��BMIT
�►�ese comatents are tor your �ntormatfon AI! work ehaii fe b�y,s
tp1; cornpliance witr at! app�ica�Ea tx::'dl+� •9 zotih� adle� .�
'"+�«�a�ts inauc�n: ;tems not spectfically n�ted �n tF,k �:��,-:<�
�icF3� ;�Hi� A�. � , � 4dt: a�� :1� � ��r, .
D TE TIME �
CITY OF ORONO CALLED IN ���s�
INSPECTION NOTICE, SCHEDULED �
PERMIT NO. �7 '�.3 � COMPLETED h
ADDRESS s '���n P �a��
OWNER %IJ�������/_-l": CONTR.��� �
TELEPHONE NO. �7�� �7��
� DESCRIPTION ��� �
� Ot FOOTiN 11 MECHANICAL RI 18 IXCAW�RADINCi/FIWNO
y 02 FRAMINO 13 MECHANICAL FlNAL 19 UI�SHOREIWETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FlREPLACE 34 TREE AEMOVAL
Z p4 WqLL Bp. 12 WATER HOOK-UP 17 SITE INSPECTION
ti� p5 FlNAL 14 SEWER HOOK-UO 06 PRO(iRESS
v 07 DEMQ—SfTE 27 SEP11C NWM. 21 COMPWNT
W 07 DEMO—FlNAL 15 SEPTIC INSTALL 22 FpLLpW.Up
= 09 PLUMBINf3 RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
v 10 PLt1MBIN0 FlNAL 36 FOUNDATION REMOVAL
Z OWNER/CONiRACTOR TO MEET YOU: YES_NO
y COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑CORRECT WORK d PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTEO.CALI INSPECTOR ❑CITAT�ON ISSUED
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra n s�e,
Inspector: t• �
Whib CopyAnspeetor's Flk Canary CopplSite Nolfc�
DATE, TIME
CITY OF ORONO CALLED IN -��-ZB ��k
INSPECTION NOTIC scHEou�E� 51��� �<> !C� �� .3�
PERMIT N0. �� COMPLETED �_ �
ADDRESS .' �� , t� � � "'
OWNER ���� CONTR. e r�-��
TELEPHONE NO. �f7/ ' .��C� / c L .S�7 -(':�'�`��� r'-��.�.,
,�—
� DESCRIPTION �� ��!
� 01 FOOTINO 11 MECHANICALRI 18IXCAV/GRADINO/FIWNO
Q 02 FRAMINCi'; 13 MECHANICAL FINAL 19 LAI�SHOREJWETLANDS
h� .—
� 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SfTE INSPECTION
Q
Z ps�►�q� 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBINCi RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINCi FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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Wd ORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CAL�FOR REINSPECTION TEMPOAARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CAL�INSPECTOR ��CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
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