HomeMy WebLinkAbout1992-004639 - kitchen remodel ; PERMIT
* CITY OF ORONO PERMIT TYPE: �;t��Lplt�G.
1335 Brown Rd. South • P.O. Box 66 Permit Number: t}f i�'=�:�'�
Crystal Bay, Minnesota 55323 Date Issued: ��'��Lii/'��
(612) 473-7357
SITE ADDRESS:
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF ORONO - BUILDING PERMIT APPLICATION
' .,<'/�-� <«'
Total Fee: $- �''�-��-�- Date Received: �-!� � j �-
Date Approved:
Entered By: �" ��
Permit#: �� - � i
AT.T• INFORMATION MIIST BE SDBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
----------------------------------------- -_---- ---------------------------
THE APPLICANT IS: (circle one) OWNER or C NO TRACTOR
�---
JOB SITE ADDRESS: �� , ZIP:
(work)
NAI� OF OWNER: � -� � , PHONE: (home) `� ``. ` - —
MAILING ADDRESS: �- CITY: ZIP:
CONTRACTOR: ' , l ( ,.� PHONE: " - � -
MAILING ADDRESS: -_ ; CITY.�:_ � ,. ! � ZIP- r �V �
;�_.�
- �
STATE LICENSE: #
ARCHITECT/ENGINEER: PH��=
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION i�
TYPE OF WORR: New Addition Accessory Structure biove
Demo Remodel/Alteration x' Renovate Land Alteration
PROPOSED WORR (describe in detail) : " , - N r"•; !J'� � _ '
� � � � � �� F�,!�� �'L f i�� �
STORIES: SQ. FEST OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (ezcluding Iand) : $ ; � W:>..� . _
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 will be in accordance with the approved plan. •
C.t_-
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APPLICANT'S SIGNATORE: , DATE: g 7 ��_
, , •
.
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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 confidential information.
You are notified that:
1. The information you furnish wil.l be used to determine your
qua].ification 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, s�ate or
federal agencies to the extent necessary to process the permit or
I.icense.
4. If your requested permit or license requires Council act�on
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to process this appZication or
permit.
!�L-��S� �, G�c��}i S v �
First Midd3.e Last
1 �0 �� v � �/C2 �,2i�lC
Address
C ���N�-1-�tsS � r_) ►M � S53I �
City State Zip
33� - �I�c�� ��`�-a`��o
Phone
I understand my rights as stated above.
��c (� -
Signature
BUILDING&ZONING—473-7357 • ADMIIVISTRATION Fc FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING •
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513.04 RIGSTS OF SIIB.TECTS OF DATA �
Subdivision L Type cf dsta- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section.
. Subd.
2. Information required to be given in�viduel. e nformeduof:�(a)t he
� ' supply private or confidentiel data concerning himse�f Shall State a ency,
purpose and intended use of the Te9 tem;d (b) whether he ma�eref e °r � eg�y
po li tic a l s u b d i v i s i o n, o r s t a t e w i d e s y s �o"yn co n s e q u e n c e a r i s i n g f r o m his
required to supply the requested date; (a) �Y . �d (d) the identity of
supplying or refusing to supply private or confidentiel data,
other penons or entities authorized by state or federal law to receive the data. This_
1 when an individual is esked to supply investigative data,
requirement shall not app y
pursuant to section 13.B2, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lert t� re°und lnstructio uinsteadh�s
subdivision in the individuel income tax or r�
on those orms. . - � --- -- - � .
A�� to �� � ����, Upon request to e responsible
Subd. 3.
suthority, an individuel shall be informed wh ublic pr'vateeor eonfiden ial.e IIPen his
individuals, ar►d Whether it is classified es p � ublic data on
further request, an individuel who is t1�e subjecc of � to himrlande if he desires, shaIl
individuels shall be shawn the data v�rithou�t an�y t�� �ter an individuel hes been
6e informed of the content end meaning t� �� need not be disclosed to
shown the private data and informed of its u��T�Bction pursuant to this section is
him for six months thereafter unless e d�SP
� ending or additionel data on the individuel h�a eeor public datarupon8request by
� P
responsible aut hori ty s h a ll p r o v i d e c o p i e s o f t e P o�ible authority ma y r e q u i r e t h e
the individual subject of the data. The resp ��rtif n and compiling the
requesting pers�n to pay the actusl costs of makinB, Yi g'
copies. ' lmmediately, if possible, with any request
The responsible authority shall comply ' of the date of the request,
made pursuant to this subdivision, or within five ��immediate compliance is not
excluding Saturdays, Sundays and legal holidays,
ossible. If he cannot comply with the request within that time, he shall P in�th the
p within which to com ly
individuel, and may have en additio� i���o days-
request, excluding Saturdays, SundaYs g
Subd. 4. Proced�ae when data is not accurate or complete. An individuel maY
himself. To
contest the accuracy or completeness�of public o inri�vna�t�thE°res�b1e authority
exercise this right, an individuel sha11 notify �ible auLhority shall within 30
describing the nature of the disagreement. The r� lete and attempt to
days either: (a) correct the data found to be inaccurate or incomQ .
notify past recipients of inaecurate or incomP�t��e esathe datalto be correct
the individuel; or (b) notify the individuel eement is
Data in dispute shall be disclosed only if the individual's statement of ��' the
• ineluded with the disclosed data• ealed ursuant to
' The determination of the responsible authority may be aPP p
provisions of the administrative procedure act relating to contested cases.
�
. • CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: (, (� I�'�,h f .- r.t��-� _-�L /f��_ PID: ���� _- �,�' - .2 � �3-j" �'�'�.�S_
DESGRI PTION OF WORR: �-��ic-z-� i�� 1�<<•r��-F��
-------------------------------------------------------------------------------
ZONING REVIEW BY: N�� DATE APPROVED:
BUILDING REVIEW BY: �i�,Qo �Q�vticv�--- DATE APPROVED: GJ ' �O 'Cl 2-
FE$S TO BE CHARGED: Misc. Fees Ca�culated 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 Dis rict:
Fire Department: Post Offi e: Scho 1. District:
Lot Area: Width: Depth:
Survey Submitted: Ye No Da e of S vey:
Proposed Setbacks:
Front (Lake : R' ght Si e:
Rear (Stree ) : ft Si e:
Adjacent S ructure : Wetlan :
Bui�ding Heigh : Def . gt. Pea Hgt.
Avg. Setback: ot Cover ge:
Exis ing Propose
Hardcover: 0- 5 '
75- 50 '
250- 00 '
500- 000 '
Hardcover V riance Requi ed: Yes No Date of Council Approva�:
Grading: S aff Approval a e: B : Council Ap roval. Date:
Septic: S ff Approval a By:
Zoning Fi e: # esol ion # : Resoluti Date:
REMARKS ( 'n house) :
�.
BUILDING REVIEW CHECR LIST • .
UBC: �K (Z-3 CONSTRDCTION TYPS: �
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage X =
x =
TOTAL
Sstimated Construction Value: $ i ��� o� ��
Inspections Required: Work Requiring Separate Permits:
Site �C Plumbing Grading/Fil�ing
Footing Mechanical Fire
�Framing Septic Water Connection
�Insulation Fireplace Sewer Connection
�Wa�l Board (Masonry) Lawn Irrigation
�C Fina 1 (Mf g.) Other
Other Wel]. (State Permit)
�Electrical (State Permit)
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REMARRS (IN HOQSE) :
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REVIEW BY OTHERS: DATS:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
i/
ATE TIME
CITY OF ORONO CALLED IN � %�
INSPECTION NOTICE SCHEDULED `' /`� 2" �' 3C�
PERMIT NO. '��=?'7 COMPLETED « U
ADDRESS f (? � � '�'� ' ' �✓ �
>� ��.�
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OWNER����� CONTR. ! �-•� � � l�
TELEPHONE NO. � ��� ' '`�.�U' 7 ---
� DESCRIPTION ,�7�,�ir�f'�-��
�
W 1 FOOTING?; 11 MECHANICAL RI 16 WELLTEST PUMP
� G 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
�
Q 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENT : �
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W WORKSATISFACTORY:PROCEED L' PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED L. ISSUE CERTIFICATE OF OCCUPANCY
W
O OG CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
C' CITATION ISSUED
C STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac n e: _
inspector.
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN /� '7�i2-
INSPECTION NO/T/IC?E SCHEDULED �Z �' J6
PERMIT NO. �Y�'>_J`I COMPLETED K � /
i�J
ADDRESS
OWNER CONTR..,,,�� ,�l�v
TELEPHONE NO. ��G.a '' �-�� 7
� DESCRIPTION„L��i���C-
lL 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
ti
031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 5 FIN � 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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d �NORKSATISFACTORY:PROCEED � PROJECTCOMPLETE
W
� �(=J CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL INSPECTOR '- CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContr tor,c�n site:
Inspector. U
White Copylinspector's File Canary CopylSite Notice