HomeMy WebLinkAbout1993-005138 - deck platform PEI�MIT �-
CITY .OF ORONO PERMIT TYPE: �-
2�50 Keliey Parkway • P.O. Box 815 �"- `��-`'}��'�`'
Orono, Minnesota 55356-0815 Permit Number: t�4�5�.;;;�;
(612) 473-7357 Date Issued: t_i�..'t�.i�i:=;
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: — t�F���� ��=�f��� —
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
• � � � ' CITY OF ORONO - BIIILDING PER�iZT A.PPLICATION
Tota�l Fee: $��.�s Date Received:
Date Approved•
Entered By:�'/►� permit�: .�/� �
r'�I, INFORMATION MIIST B$ SIIBMITT� IN FIIIaL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
-----------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER r CONTRACTOR
JOB SITE ADDRBSS: ��cJ�� �-�rlC� �-tl:� ZIP: �� � / 1
(work) ���A`'�-3
(� /� �7 /- `7 'P��
N� OF OWNER� �Gc-1'l-�� t�. I�C�S� PHONE: (home) �-7/' �!D�5
�[ATI,ING ADDRESS: d�j�c:� �� f.�-�YlG �(.' CITY: ��, �'� ZIP: ����,�✓
r
CONTRACTOR: PHONE:
tiiAILING ADDRESS: CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGINffi�: PHONE:
MAILING ADDR.$SS: CITY: ZIP:
N��: RSGISTRATION n
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
. J/ ,
PROPoSED WORR (describe in detail) : , -'
�.� , -
�
, ,
�) C'�eC�..��C:-C1�j..
STORIES: SQ. FE$T OF EACH FI,OOR:
NO. OF BEDROOMS: GARAG$ ST�LLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eaclnding land) : $ � � � ` �'
I hereby apply 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
understand this is not a permit and work is not to start without a permit; and
that the work wil 1 be in accordance with the approved plan. .
APPI�ICANT'S SIGNATUftB` DATE: � / � ��
�
.� .
«�e�
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Y a , °
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� GITY of OI���TO
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� �,._x �,� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
� �;�
� � i'~,� �'' 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 3ike 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 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 Iicense requires Councii action
to approve, some information may become publ.ic.
5. You have certain rights under M.S. 13.04 to review priva��
data on yourself.
6. Yaur full name is required to process this application or
permit.
� C <_
C� �3�LI ��L l.�k�.h
First Middle Last
��G � 1���c. i�l�� -
Address
r� no ' �� �
City S ate Zip
�CP�� ) '�7/- G0�5
Phone
I understand my rights as stated above.
. �
gnature
BUILDING&ZONING—473-7357 • ADMIN[STRATIOti&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSING
----------- � � ��
r
�.p,� RIGHTS OF SIIBJE�TS OF DATA � .
Subdivision L Type of data- The rights �ti n viduels on whom the data is
stored or to be stored shall be as set forth in th�.s se
gubd, 2, Information required
to be given indi��� An.individual asked to
� � su 1 rivate or confidentiel data concerning himself shall be informes at a8ency,
pP y P v refuse or is legally
purpose ar�d intended use of the rs9 tem;d (b) whether he mgllecting om his
political subdivision, or statewide ys �own consequence ar�.sing fr
required to supply the requested date; (a) �Y
su 1 in or refusing to supply private or confidential date; and (d) the identity of
PP Y g state or federal law to receive the data. This.
other persons or entities authorized by 1 investigative date,
requirement shall not apply when an indt�via lg en orcementuofflcer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lBCt tgX re°una�nstructio uinsteadhos
subdivision in the individual income tax or r• er
on those orms. . - - -- - - .
Subd. 3.
Aecess to �ata by inffivic�l• npon request to a responsible
authority, an individual shall be informed wh ub�C �r vateeor confidential.e Upon his
individuels; an d w he t h e r i t i s c l a s s i f i e d a s p � P u b l i c d a t a o n
e to him and, if he desires, shall
turther request, an individusl who is the subject of stored priva te o r�du� � been
individuels shall be sh°wn the data witho of�hat da a• After an ind�
�e informed of the content and meaning the dats need not be �sclosed to
shown the private date and informed of its meanin8, ursuant to this section is
him for six months thereafter unless a disPute or action p
� ending or additional data on the individuel h� 8teeor Public datarupon request by
� p require the
responsible authority shall provide eepies o t e P o�ible authority maY �in the
the individuel subject of the data. The r�P certif n and comp g
erson to the actual costs of making, Yi 6�
requesting p PaY -
copies. ssible with any request
The responsible authority shelt comQly immediatelY, it po �
made pursuant to this subdivision, or within_a8 e �ysimmediateatcompliance eisu not
excluding Saturdays, SundaYS and legal hol� ys,
ossible. If he cannot comply with the request within that time, he shall sp in�orth the
P have an additional five daYs Within which to com ly
individuel, and m S t���� S��� �d legal holidays•
request, excluding
Subd. 4. Proced�e when data is not accurate or complete. An indi�id� Tngy
contest the accuracy or completeness�of public or private data concerning
himself. To
in writing the respcnsible authority
exercise this right, an individuel sha11 notify �ible authority shall within 30
describing the nat�re of the disagreement. The respe
days either: (a) correct the data found to be inae a Lae including pee�iPi��namedt by
notify past recipients of inaccurate or incompl �
the individuel; or (b) notify the individual that he believes the data to �ement is
Data in dispute s h a l l b e d i s c l o s e d o n l y i f t h e individual's statement of disagr
• included with the disclosed data• ealed pursuant to the
' The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases.
CHECX OFF LIST FOR ISSIIANCE OF PERMITS
" ` � � FOR OFFICE USE ONLY
; � - , ' ' �
r1DDRESS OR LEGAL: �`�� �%�. �, .c, � .-`�--� PID: ��; �� ���' �� �C ? �� <_-��%-�
,
�
, � � , �
DESCRIPTION OF WORK: ,{�k�c'� �.����t�-_"�� �'t-
---CaC�o— ------------f--------------- �Z- ---
ZONING REVIEW BY: � _ DATE APPROVED: �S ' �!3
BIIII�DING REVIEW BY: Q` DAT$ APPROVED: S^`�Z`5 3
---------------------- -------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes 1/ No SEWER CONNECTION
STATE SURCHARGE Yes t/ No_� P�KRFEENNECTION
INVESTIGATION FEE Yes No
SAC Yes No � SITE INSPECTION
Number of SAC Units OTHER (specify)
-------
------------------------------------------ •
ZONING CHECR LIST Zoning District C./L-IG� I
Fire Department: /Yw�...c9 Post Office:J►,{)�jZATJ4 School District: r...�.��,�
Lot Area: �1�. Width: /'��� Depth: /✓�G
Survey Submitted: Yes�No Date of Survey:
� On� F�LL'`
Proposed Setbacks:
Front (�lcQ-) : 3� � Right Side: � � 'f N
Rear ( "�� ' N�� Left Side: /✓/A
Adjacent Structures: A v'�IN Wetland: /✓l/�
Buil.ding Height: Def . Hgt. P ak gt.
Avg. Setback: Lot Co era
Existin Pro osed
Hardcover: 0-75 '
75-250 '
250-500 `
500-1000 ' -
Hardcover Variance equired: Yes No Da e of Council Ap roval:
Grading: Staff App oval Date: � B : Council Appro al Date:
Septic: Staff Ap ovaJ. Date: B �
Zoning File: # Reso ut on # : Resolution ate:
RF.MARRS (in ho se) :
BQILDING REVIEW CHECK LIST , .
=1- _,
i�gC: �' Q•3 CONSTRIICTION TYP$: � �
Sq Footage $ Per Sq Ftg
Basement X - .
lst Fl.00r �� • - x -
2nd FJ.00r x = '� ``, .
Garage � '- X -
7 r x .vo - .� .
�
TOTAL
OQ
8stimated Construction Value: $ 50t7 •�C�
Inspections Required: Work Requirinq Separate Permi.ts:
Site ' P].umbing Grading/Fil�ing
Footing Mechanical Fire
�Framing , . . Septic Water Connection
Insulation � Fireplace Sewer Connection
�,. Wal�.; $pard (Masonry) Lawn Irrigation
ot Fin�l . �'t�ifg.) Oth,�r•, _
Other Wel]. (State Permit)
- - Electrical �(State Permit)
----------------------------------------------------.--------------------------
RENl�RRS (IN HOIISE) :
-----------------------------------------------------
. . . � ` �
REVIEW BY OTHERS: . DATE: .
, �
Access: Existing New •
Access Approval: Date BY=
------------------------------------------------------
Rffi�lARRS (TO BB NOTSD ON PERMIT) :
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE ���$ SCHEDULED �-Z�o'�rS O�ti�
PERMIT NO. COMPLETED
ADDRESS___ 36�2 C..Y2�L
OWNER �� C'n�S� CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS L 14 SEWER HOOK-UP O6 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
� OWNER/CONTRACTOR TO MEET YOU:_YES�NO
��., COMMENTS: �eCC-V�
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� WORK SATISFACTORY:PROCEED ROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR
�CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContractor o ' e:
Inspector.
White Copy/lnspecior's File Canary CopylSite Notice