HomeMy WebLinkAbout1994-006148 - deck . PERMIT �/
. CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 �������='���t-
Orono, Minnesota 55356-0815 Permit Number: t:��F;��;_;
(612) 473-7357 Datelssued: ���,f�y?! _��
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SITE ADDRESS:
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PLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE � ,
� CITY OF ORONO - BIIIZDING PERMIT APPLICATION
Total Fee• $ �C�•�� - Date Received: _��3i �i�
Date Approved:
Entered By:�/' � Permit�: (�J��
AT•T• INFORMATION MIIST BS SIIBMITT� IN FIILL BEFORE PLAN REVIEW WILL BB STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPI,ICANT IS: (circle one) OWNER or CONTRACTOR
�' ' _ � _- Y�('J �- ,C� ��`�- ZIP:
JOB SITE ADDRSSS: '
(work)
�
NAME OF OWNER: ;'��!'�� Y � � �` �` --- PHONE: (home)
� ,
MATLING ADDR.ESS: �C ��� '- %���� ` �l" CITY: C�/f� '',' ��� Z�P:
CONTRACTOR: �� >��v^�"`"'�:" , -y'-'' �' PHONE: �c��"� � �)
i�3AII�ING ADDRBSS: / �� ��C�,C� �,1.��-� /"'�'��- _ CITY:����! ��'j ZIP: �� ��_�' I
�<� {�
STATS LICENSE: � `� r J �--
�h�/ �. ��,�,. PHONE:
ARCHITECT/ENGINEER: ;; � -
MATI,ING ADDRSSS: CITY: ZIP:
NAME: RBGISTRI�TION �
TYPE OF WORR: New Addition Accessory Structure '�� Move
Demo .,� Remodel/Alteration Renovate Land Alteration
/' � �.� -. " ;,,� -r ;_. )
PROPOSED WORR (describe in detail) : /=��-�'`� `� - �
STORI$S: SQ. FE$T OF EACH FLOOR:
NO. OF B$DROOMS: GARAGE STALI,S: ATT. DET.
�. �
ESTIMATED CONSTRIICTSON VALIIATION (eacluding Iand) : $ � � ��L� �
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work wil7. 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 wiI 1 be in accordance with the approved plan.
�
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A.PPZICANT'S SIGNATQRE: �, __ DATE: � ` �
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CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 5a323•Municipal Offices
•
� _ � � 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:
l. The information you furnish wil.I 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 I.icense requires Councii. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 Lo review pri�a��
data on yourself.
6. Your full name is required to process this apt-licaticn or
permit.
���� � �^ -� � `�=�'`� �l -
First Middle Last
�.J�/ �/r/'�/ r • !i, �.` �/� �� ._
/ '
Address
�jl;� S� �j .J ;a ,� � l
!'
City State Zip
:/ �-�_ � ; l ,�
Phone
I understand� my rights as stated above.
�,.
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Si ture �
_____..--__-`
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSING
---- --- -- ti . � .
513.04 RIGHTS OF SIIB�7ECT5 OF DATA �
Subdivision L Type of da�e- The righ Se tion. viduals on whom the data is
stored or to be stored shall be as set forth in th�s • ���� An.individual esked to
gubd, Z, Information r�d
to be gzven in
� � 1 rivate or confidentisl data concernin a�BmWi�hin the collect g state gency,
supp y P v refuse or is legallY
purpose and intended use �f the req em�d (b) whether he ma„ from his
political subdivision, or statewide sys �C� any �oWn consequence arising
required to supply the requested date.; �d (d) the identity of
1 in or refusing to supply private or confidentiel date;
supp y g state or f ederal law to rec in est e at ve da a
other persons or entities authorized by
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 ma lace the notice re uired under this
s
ubdivision in the individual income tax or ro ert tax re und instructions instead o
on those orms. � --- - .
c� t� �� by ����, Upon request to a responsible
Subd. 3. A
thorit an individuel shall be informed Wh uti c h r vateeor aonfidential.e Upon his
e u y' u b l i c d a t a o n
individuals; and w he t her i t i s c l a s s i f i e d a s p �
e to him and, if he desires, shall
further request, an individue� �ts Without aiiy chargtored priva te o rviduel has been
individuels shall be shown the of that data• After an inti�
�e informed of the content and meaning the data need not be disclosed to
shown the priv�an��he�s�fte°�e�o8 i�sPuteor�action pu�uant to this section is
him for six m n request by
' 'n or additional data on the individue1 h� gte or public datarupoeated. The
, pendi g require the
responsible authority shall provide copies of the Pro�ible authority maY �in the
the individuel subject oft�e actuel�co ts of making, certifying, and comp 6
requesting person to pay -
copies. y ssible, with any request
The responsible authority shell comQly immediatel , if po uest,
ursuant to this subdivision, or within five days of the date of the req
made p S�dg� �d legal holidays, if immediate complisnce is not
excluding Saturdays, with the
ssible. If he cannot comply with the request withinNithintw ch tohcomply form t e
p° have an additional five daYs
individual, and maY �d le al holidays.
request, excluding Saturdays, SundaYS g lete. An individuel may
Subd. 4. Procedtiu'e when data is not accurate or comP �mself. To
contest the accuracy or completeness of public or private data concerning
in writing the responsible authority
exercise this right, an individuel shall notify �ible authocity shall within 30
describing the nature of the disagreement. The respo lete and attempt to
days either: (a) eorrect the data found to be inaccurate or incomPeci ients named by
notify past recipients of inacethetendiv duel phat he beI e esdthe data t 8 b eement is
the individus13 or (b) notify
Data in dispute shall be disclosed only if the in d ivi du s l's s t a t e m e n t o f d i s g t'
• include d wi t h t he d i s c l o s e d d a t e• � ap p e a l e d p u i's u a nt to the
' The determination of the responsible authority mo contested cases•
provisions of the administrative procedure act relating
• � • CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAI,: �(��� L Y��C �1�L _PID:
DESCRIPTION OF WORR: J C�l�
-----�----------------------------------
Z ONING REVIEW BY: � L. �,_ � � ���---_ DATE APPROVED: [�-���7 Y
BIIILDING REVIEW BY:��✓ ,i , . �::-- . DATE APPROVED: C-�" 3-��
-------------------------
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: t ""� f � � �
Fire Department: � Post Offi,�e� i Sch�al District:
_ -- � r---
Lot Area: �/ �-� �Width: �� � �� ��h�--
Survey Submitted: Yes 1� No Date of Survey:
C�r� (=r �1�:�
Proposed Setbacks: ,
Front (Lake) : � �'`` Right Side: � l �
�
Rear ( Street) : 7�� + Lef t Side: �y
Adjacent Structures: �%7�-���--=� Wetland: �'� �/�'
Buil.ding Height: Def . Hgt. ���" ��'`� Peak Hgt.
i .
Avg. Setback: f`' �� Lot Coverage: G� <<- ��
Existing Proposed
Hardcover: 0-75 ' �
�
75-250 ' ;
-� D (L
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approva�e��xT_
Grading: Staff Approval. �D�te: By: ' Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File• # Reso�ution # ' Resolution Date:
REMARRS (in house) : .
BIIILDING RE'VIEW CHECR LIST
�C- y� � �� j CONSTRIICTION TYPE: _`�I1-U - ,
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X
2nd Floor X -
Garage X �
x =
TOTAL
Esti.mated Construction Value: $ _�S�`J b�
Inspections Rem�;red: Work Requiring Separate Permits:
Site Plumbing Grading/Fil�ing
�'Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa]:J: Board (Masonry) Lawn Irrigation
�Fina� (Mf g.) Other
Other Wel� (State Permit)
Electrical. (State Permit)
-----------------------------------
REMARRS (IN HOIISE) :
--------------------------------------
12.EVIEW BY OTHF�RS: DATE:
Access: Existing New
By:
Access Approval: Date ___________________
----------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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_=���5 �– �X �; �� �,,, �-.,,
STA1 RS ��� � �
-�-- ., „ �:�����
- 8 MA�. RlSER 9 MfN. TREAD
6'-�" MIN. HEADROOM
�i,o �`�M AT LEAST ON€ Hl�fvDRA1L REQUIRED
�'`'^h` �,s,� ����' �, �-�p��l�,��i GU�f�C3t�il O�E"d SIDES
i �
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SPECIAL NOTE ""'
�„
SEE A�i'TACI6ED S�IEET'
� FOR
��r��'1,4(C.�
a CODE RE�G?UIfiEI'�E�ITS
� ���� �
� D TE TIME
CITY OF ORONO CALLED IN � �
INSPECTION N TICE SCHEDULED �' �� �
PERMIT NO. � � COMPLETED
ADDRESS '
OWNER �e� CONTR. �
TELEPHONE NO. '���`�I 3�
a DE TION ��i�L�
�
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETlTURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d WORKSATISFACTORY:PROCEED G PROJECTCOMPLETE
W
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN 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.473-7357
OwnerlContr to o site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED
PERMIT NO. COMPLETED
ADDRESS������.►r7�C� ��
OWNER T�r� CONTR.
TELEPHONE NO. •
� DESCRIPTION �� CJYC�—
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 W BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINAL� 14 SEWER HOOK-UP 06 PROGRESS
� O-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
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
D COMMENTS:
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d�M1IORK SATISFACTORY:PROCEED JECT COMPLETE
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� � ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. Ci PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �-� CITATION ISSUED
❑ INSPECTION REQU�RED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCont or on site:
Inspector
White Copy/lnspector's File Canary CopylSite Notice
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