HomeMy WebLinkAbout1995-007257 - deck _ PERMIT
�CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �
Crystal Bay, Minnesota 55323 � - � -_�
(612)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS: - � � -
FEE SUMMARY:
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CONTRACTOR: OWNER: -- -, = :. _ . _.
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APPLICANT/PERMITEE SIGN RE ISSUED BY:SIGNATURE
� . , . CITY OF ORONO - BIIIZDING PERMIT APPZICATION
Tota.I Fee- %�' :_ �j Date Received: � �� ���� 'f_�` �
. $ r,.�
Date Approved:
Entered By: � �/,_�
Permit� ";•',��a'7
�T,T• INFORMATION MIIST B$ SIIBMITTSD IN FDLL BEFORE PL�N REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
� APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRRSS: �> ��J /� �� C�L ZIP:
(work)
.
�3� OF OWNER: �� ��;i2i� 1�� C�1� 1'���= PHONE: (home)� I"�� ���
MAILING ADDR.ESS: lC�`Y � � �(rC! �ti• CITY: '� �� ZIP:
�_ �, G�7�r�/D,
CONTRACTOR: �C:� /'u- �C�2��� PHONS: ���� '� �Q �_�
MATLING ADDRBSS: I � L G'i ��� � �� � � CITY:���('/L���l'�� � c�
Z �� zzP: �� ' /
STATS I,ICENSE: �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRBSS: CITY: ZIP:
N�ME: R.BGI STRATION �
TYPE OF WORR: New � Addition Accessory Struczure Move
Demo Remodel/Alteration Renovate Land Alteration
�
PROPOSED WORK (describe in detail) : ���1✓FrU� � 1����� ����-
��)C /� _` �� �C ��-
STORIES: SQ. FEBT OF EACH FI,OOR:
NO. OF B$DROOMS: GARAGS STALLS: ATT. DET.
- � r��� �� �
ESTIMATED CONSTRIICTION VALIIATION (eaclnding Iand) : $
I hereby apply for a buiZding permit and I acknowledge that the informativn
3bove is complete and accurate; that the work will be in conformance with the
�rdinances 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 accordance with the approved plan.
�----,
APPLICANT'S SIGNATDRE: /�`' .n� `������'C _ ' DATE: � ~ ! � � / `J
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�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323�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
license from the City of Orono or any of its departments may require
you to furnish certain private or confidentia]. 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 iocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or 3icense requires Council action
to approve, some information may become pub3ic.
5. You have certain rights under M.S. 13.04 to review privat�
data on yourself.
6. Your full nam� is required to process this application or
permit.
� � �
/ l�s a s��n
First Middle Last
12 Z Za s� �r� C',�e rv
Address ,
������ l � m� ss 3� �
City State Zip
�� � - � �- � �
Phone
I understand my right as stated above.
�
Si ture
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
I
. � - �
�.0.4 RIGH15 OF SIIBJECTS OF DATA �
Subdivision L Type cf date- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section. •vidual asked to
g�d. Z, Information required
to be given individuel. An.indi
� � su 1 rivate or confidentiel data concerning BmWi�in th� collect g state agency,
PP Y P
purpose and intended use of the req tem;d � whether he may refuse or is legally
political subdivision, or statewide sys �oWn consequence arising from his
required to supply the requested date; (�) �Y
1 in or refusing to supply private or confideae��w to receive he data.1tThis.
supp y g state or fe investi ative date,
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.
'ssioner of revenue ma lace the notice re uired under this
The commi
subdivision in the individuel income tax or ro ert tax re und u�structions instea o
on those orms. • --- - .
Subd. 3.
Access to data bp in�vidual- Upon request to a responsible
authority, an individuel shall be informed whe b c h r vateeor confident al•e UPon his
individuels, and whether it is classified as p � P ublic data on
further request, an individual who is the subject of e t��mrl�ae if he desires, shall
individuels shau be shown the data witho of�hat da a. After an not��5��ea Lo
�e informed of the content and meaning the data need
shown the private data er►d informed of its meening+ u�uant to this section is
him for six months thereafter unless a disPute or action p .
rivate or publie date upon request by
e
ending or additional data on Lhe indi O duh has been collected or create ' the
� p rovide eo ies P uire
responsible authority shall p P
the individual subjeet of the ��'�os h of making,l cert nngy�d c mpiling the
requesting person to pay the act _
copies. ssible, with any request
The responsible authority shall comply immediately, if po
made ursuant to this subdivision, or within five days of the date of the request,
p g�days and legal holidays, if immediate compliance is not
excluding Saturdays, 1 With the request within that time, he shall so inf�orth the
possible. If he cannot comP Y within which to cemply
individual, and may have �Sunde 1O end legal�holidaYS.
request, exeluding Saturdays, Y5
diae when data is not sccurate or complete. An individuel may
Subd. 4. p� ublic or private data concerning himself. To
contest the accuracy or comQleteness�ef P � �i� the respensible authority
exercise this right, ar► individusl shall notify
describing the nature of the disagreement. The resPonsible authority shall within 30
da either: (a) correct the data found to be inae a�8ei°�u�ngpeec pients namedt by
Y5
notify past reeipients of inaceurate or incomp �
the individuel+ or (b) notify the inc3ividual that he believes the data to b eement is
Data in dispute shall be disclesed only if the individual's statement of disagr
• included with the disclosed data• � 8ppealed pursuant to the
' The determination of the responsible euthority may
provisions of the administrative procedure act relating to contested cases.
i
i
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
' ' • FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _���� '�� ���- v;�`�,l_{�., l,C.�r,�, _�� PID: �
D�SGRIPTION OF WORK:
-------------------- --- ----------------
ZONING REVIEW BY: �L►��,1 DATE APPROVF�D: � -/ 7-y 5`
BIIII.DING REVIEW BY: ��� DATS APPROVED: g •l 7 -`� 5
---------------
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: L12�I �-
Fire Department: �n/�uv,.�✓, Post Office: �A��4���rv� School District: c�,�s-�t�nrk�
Lot Area:��� Width: � Depth:
Survey Submitted: Yes +c No Date of Survey: o� ���
Proposed Setbacks:
Front (�e) : ���' Right Side: �S `
Rear (Str�et) • ���` �' Left Side: fS � �
Adjacent Structures : ,4l`7�4-�lXz��� Wetland: /v��-
Building Height: Def . Hgt.� Peak gt.
Avg. Setback: L�t Cover ge:
�
Exi t ng �;' Propos
Hardcover: 0-75 ' /
75-250 '
250-500 '
500-1000 ' �
Hardcover Varia ce Requ red: Yes N ate of Council Approval:
/ �
Grading: Staf Approval. Dat : By: � Council Ap roval Date:
Septic: Staf , Approval Da e: By:
Zoning Fil :# Resolution $ : Resoluti n Date:
i
REMARRS ( n house) : '
BIIILDING REVIEW CHECR LIST ,
UBC: /Z-3 CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement x =
lst Fl.00r � X -
2nd Floor x -
Garage X -
x =
TOTAL
Estimated Construction Value: $ Z,Ooo�
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/FilJ�ing
_�Footing Mechanical Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
WaI.Z Board (Masonry) Lawn Irrigation
o<Final (Mfg.) Other
Other Wel]. (State Permit)
Electrical (State Permit)
--------------------------------------------------------
REMARKS (IN HOIISE) :
----------------------------------------------------------
REVIEW BY OTffi2S: DATE:
Access: Existing New
Access Approval. : Date BY=
-----------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
I
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' vireR►ents Inc4udin ttems not
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- DATE TIME
CITY OF ORONO cn��Eo iN �' ' � -�� �_�'��`'=' ��»'�
INSPECTION NOTICE scHE�u�Eo � '.� �=�% � `� �j
PERMIT NO. ' -' / c�oMPLETED �`�
, ` � � �
ADDRESS �� '�G� C�-� ' � ` ,��'�' � � � _ �' ` -
OWNER % � � -���<<� .:�: t - � CONTR.
TELEPHONE N0. �� �� "� ��- � �
� DESCRIPTION ����� �
ti� 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 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q=Q 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
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: /�' ��, _ C� � ,R : -��,��,� .i,� _,_ . ;; �_�
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W� I�WORKSATISFACTORY:PROCEED �OJECTCOMPLETE
.
W C CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,-, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR �' CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContra o n si e.
inspector.
White Copyllnspector's File Canary CopylSite Notice
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ANULAflUU[VGLOI'�dfl�ll CUfJSUITAN�(S �/�.���
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13621 VINEWOOD LANE DAY7�ON, MN 55327
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SURV�Y FOR: Shermer. Constr�iction Co. , [nc.
DGSCI�}�'�'1„QN•.,J,�,>�,� �i�ci g�•B�] Ic 3, NAVARftO, City of Orono, flec�nepin County, Minnesota
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o De[lotes Iron Mo�turnetit � R'�za.�� A1•o°f _ 43.2") R, ,,,o.04
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Beiich Mark: ,}��..
'I'op of {lydrant - — _--- - _ � ._ _ _-
15 StIOW[i I �--
Elevation 948.51 I ��,�a, o p�`�°' I
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xxx:x benotes �xisting Grounci q4 •4 1, q41•1 � I
Elevations . I �,����� `� ,.Z°\\ 9�4851 , 9So��
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[xx.x] Denotes Proposed I�inal "� ' m� ra °' I
Grade rlevations. I �a�''` �a � 'i41�t
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SCALE: �.��=30� ' x SITE PLAN GR6, iP�G P�sa��1
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� -a. r : I , � � A Pf�OVE� .
� �� " �, ' `�,� � ;� � � ' % € � A PR04'��ITH I�Elfl�i ��
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I hereby certify tliat Ll�is survey was ��,G I
E�repared by me or under my direct � '}� �� �� q48•5 � � % '
supervision and that I am a duly lie�;istered �, '��J ��
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l,and Surveyor under the la�as of. the State oE �' o�,�` / �
Plinnesota. � . � (�
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Dated this ?.7th clay oE April, ].989. '� `�� ���r,� �'
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��%'���".?� ,�C_..f _�p `
M'�-t nesota License No. 122G7� ';/ ,
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