HomeMy WebLinkAbout1994-006110 - deck/interior basement PERMIT
� CI�Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: �'�"��'`�"'`�'��'
Orono, Minnesota 55356-0815 �t"�,1 3"
(612) 473-7357 Date Issued: 4�c;:��;;f:._��
SITE ADDRESS:
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APPLICANT PEFiMITE SIGNATURE I D BY:SIGNATURE �jyc�i(.
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V �` CITY OF ORONO — BIIILDING PERI�LIT APPLICATION
Total Fee: $ �"'`,>.(�y � Date Received:
Date Approved:
Entered By: � ,�li
Permit�: �,�/c�
j.�T.T. INFORMATION MIIST BE SIIBMITT� IN FIILL BEFORE PLAN REVIEW WII.L B$ STARZ'ED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
' X�� L � (�,c:.� zzp: .��� �. �/.
JOB SITE ADDRBSS. '� �� V �"W=� t /
(work)
_ ,, 4 PH�NE: (home) `/ �� �'� :3 `/
N� OF OWNER: / G i / Lr i L�i<..,
I�AIZING ADDRESS: `Cj��� �� j-��Li J�,�' CITY: �` � L'��� ZIP: SJ���
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CONTRACTOR: I`�a�-��1 ���-[�i_ ��' PHON$: -t;� ,_ �'�`� �,��
MATLING ADDRBSS: ZZ��' C.�-��7%��C�� ,�'.�,,''. .-�
� CITY: /`'ZE�cci✓:� ZIP: �r� �
STATS LICENSE: $ `� �����
ARCHITECT/ENGINEER: PHONE:
MATLING ADDRSSS: CITYs ZIP:
NAME: R.SGISTRATION �
�YPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration_� Renovate Land Alteration
; � ..�
PROPOSED WORR (describe in detail) : )�>D �x z� �2,C.� �Li�' r�=�; l���;���-�-
, -�" -� -
%��'���,�T" c_�� 7- r'1�;�ti�L• ..�,r�/ �Ni'��c}P. ����' i J!�-C:�. �-�rJ�Si`f �J��4-�Ls � ,�:
, _ �
� , . �--� L�r��wC�, C',?�;,c . tcn�('`
,� ir�'t C � ��7",� - �uS��Z,v, � �
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF BEDROOMS: GARI�GE STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �� �j��:�f.�
r 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
.rdinances and codes of the City and with the State Building Code; that I
�nderstand 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.
�� '7 .,
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APPLICANT'S SIGNATURE: �C� �'"L - DATE: � / S �
.
�
CITY of ORONO
Post Office Box 66•Crystai Bay,Minnesota 55323•Municipal Offices
�
� - � � On the North Shore of Lake Minnetonka
DATA PRIVACY AD�7ISORY
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 wiZl 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
federaZ agencies to the extent necessary to process the permit or
license.
4. If your requested permit or 3.icense 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 name is required to process this apglicatian or
permit.
. . ,
r ,
� ��-L'��`�j ��f<�f k�:'< < < ��L iG c i,�v
First Middle Last
, ,
-��� �, r �;� �� �... �����j
Address
/ j �J� `/
,���c (f��t,ir��,_�,�
i+;�.;
City State Zip
�`,/j�?' ✓S :I 1
Phone
I understand my rights as stated above.
� , � > �_\
��� /` <�-.
Signature
BUILDING&ZOIYING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBL[C WORKS-473-7359
ASSESSING -
�.04 RIGflTS OF SIIBJECTS OF DATA � � �
Subdivision L Type cf date- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
- - to be gi�en in�iv��• An.individual asked to
gubd, Z. Information required
� ' supply private or confidentiel data concernina amwi�in the collecting stat agency,
purpose and intended use of the requested
olitical subdivision, or statewide system; (b) whether he ma� refuse or is legally
p the requested date; (c) any known consequence arising from his
required to supply
supplying or refusing to supply private or confidentiel data; and (d) the identity o
other persons or entities authorized by state or federal law to receive the data. This.
1 when an individual is asked to supply investigative date,
requirement shall not app Y to a law enforcement officer.
pursuant to section 13.62, subdivision 5,
The commissioner of revenue m8 oleTt tgX re�und u�structio uinste8dh�s
subdivision in the individual income tax �r r
on those orms. . - --- - - .
Subd. 3.
Access to data bp individual- UPon request to a responsible
authority, an individusl sha]1 be informed whether h=�ateeor confidential.e Upon his
individuels; and whether it is classified as public, p u�lic data on
further request, an individuel who is the subject of S� to himrlande if he desires, shall
individuels shell be shown the date withou�fan�y ��8. �ter an individual 1�as been
�e i n formed of the content and meaning t h e data need not be �isclosed te
shown the private data end informe d o f i t s m e a n i n S� ursuant to this section is
him for six months thereafter unless e dispute or aetion p
� ending or additional data on the individ�h h�gte�or p blie datarupon8request by
' p requfre the
responsible authority shall provide coples The responsible authority may
the individuel subject of the data• certif n and compiling the
requesting person to pay the actual costs of making, Yl 6�
copies. lmmediately, if pessible, with any request
The responsible authority shall comply '
made pursuant to this subdivision, or wit olida e dif Simmediategt ompliance eis not
excluding Saturdays, Sundays and legel h Y5�
P
ossible. If he cannot comply with the request withi withintw ch tohcomPlY w�h the
individual, and maY ha�e ar► additional �ive ys
request, exeluding Saturdays, Sur►daYS and legal holidays.
Subd. 4. Proced�e when data is not accurate or complete. An individ�a� Tnay
himself. To
contest the accuracy or completeness�of public or private � the�res orisible authority
exercise this right, an individuel sheu notTh ����e 8uthorty shall within 30
describing the nature of the disagreement.
days either. (a) correct the data found to be inae aetaeincludingreec pients namedtby
notify past recipients of inaecurate or incemP
the individuel; or (b) notify the individuel that he believes the data to �ement is
Date in dispute sh a l l b e d i s��a d c n 1 Y i f t h e individual's statement of disagr
• included with the �isclosed ealed pursuar►t to the
' The determinetion of the responsible authority may be aPP
provisions ef the administrative procedure act relating to contested cases.
, , CHECK OFF LIST FOR ISSDANCE OF PERMITS
v FOR OFFICE USE ONLY
ADDRSSS OR LEGAL: S�d NO 14��"'� Q/Q pID'
DESCRIPTION OF WORR: �C-'GC� fi ZNTt,�10�. ��N151-� !�'v �ASQ��
------------------- ------------------------------
ZONING REVIEW BY: DATS APPROV�: S- Z�'S `I
BIIII,DING RSVIBW BY: DATS APPROVSD: S LS'�`'j �(
-------------------- --
FEBS TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes f No
PLAN REVIEW Yes �"' No SEWER CONNECTION
STATE SURCHARGE Yes v No WATER CONNECTION
INVESTIGATION FEE Yes No � PARR FEE
SAC Yes No �� SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------------------------
ZONING CHEGR LIST Zoning District:
\
Fire Department: Post Office: Schoo]. District:
� Lot Area: Width: Depth:
� rvey Submitted: Yes �C No Date of Survey:
'�Ar�► r=i��
Proposed Setbacks: �/�
�t (Lake) : /� Right Side:
�. (Street) : Lef t Side: 1(�c��
Adjacent Structures: �-7'T'�G��� Wetland: �'�
Bui�ding Height: Def. Hgt. ,��� Peak Hgt.
Avg. Setback: � •�C Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250'
�c �_
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approva�:
Grading: Staff Approval D te: By: C uncil Approval Date:
Septic: Staff Approval Da e: By:
Zoning File:# R olution esol.ution Date:
REIKARRS (in house) :
BQILDING REVIEW CHECR LIST . .
y'
DBC: 2'� CONSTRIICTION TYPE: � �
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x = '
x = •
TOTAL
o�
Estimated Construction Value: $ ���
Inspections Required: Work Requirinq Separate Permits:
Site ' Plumbing Grading/Fil]�ing
Footing Mechanical Fire
Framing Septic �Water Connection
Insulation Fireplace Sewer Connection
Wal7. Board (Masonry) Lawn Irrigation
Fina 1 (Mf g.) Other
Other WeII (State Permit)
�Electrical (State Permit)
------------------------------------------------------------------------------�
REMARRS (IN HOIISB) :
------------------------------------------------------------------------------�
RLrVIL�I BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------�
RE!lARRS (TO BE NOTSD ON PffitMIT) :
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8" MAX. RISER 9" MIN. TREAD DATE S"�L S-�,.`�,T,,,,,,_„ pgF�t�lPT WO, „�.._ ' �rl L�•���� ��t r� \`�:;� � �
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APrRO�I�D AS St1Rh4ITTED I � . �
AT LEAST ONE HANDRAtL REQUIRED �' �PPRO��E� U,iiTH �C��f7E'�TiUN� RS NOT£n �
Gt1ARDRQ{L �PEN SiDES ` C, ,�� rl r�o�r F���r,t?YE� — CORr�,E:�i' & RESUBMII' j I
� �-- � 1"hese comments arc for your irzf�rr;�ticn. 1�11 wor�C shall be dota� ; - ---" ------ j
tu11 compllarca �vtth ari a�plicubte t���kilr+�g & �oising rAG�-si1� , r
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► � APPROVED (
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� _ _ _ _ 1 hereby certify that thts plen. survey or report was �Qg� ^
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE � SCHEDULED
PERMIT NO. � �� COMPLETED �� �
/ ��! '
ADDRESS Jr(�D N� fN� ��_
OWNER CONTR.
TELEPHONE NO.
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� OOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Q 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q 05 FINAL 13 METER SET/TURN 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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❑STOP ORDER POSTED.CALL INSPECTOR �-' CITATION ISSUEO
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlCont o s e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
CLAT TIME
CITY OF ORONO CAL�ED IN '" � � �� �
INSPECTION NOTIC SCHEDULED ����' � � ' � �
PERMIT NO. �=� 1 co LETED ' ' :j:�.:oa
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lu 01 F ING 11 MECHANICAL RI 16 WELLTEST PUMP
y02�MIS_%�^� 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
3�NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL D. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q 5 FINAL C�� 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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0 BEFORECOVERING PERMANENT
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INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR '�' CITATION ISSUEO
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract o si :
Inspector.
White opy/inspector's File Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN J� �`�
INSPECTION NOTICE //6 SCHEDULED '7 •a�- -�r S�
PERMIT NO. �` ` COMPLETED �
ADDRESS � / . �
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� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
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y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENUETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTHACTOR TO MEEi YOU:_YES_NO
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Call fw the next inspection 24 hours in advance.473-7357
Owner/Cont ite:
Inspector. � '
YVhite Copyllnspector's ile Canary Copy/SIM Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED r-
PERMIT NO. y �' c PLET
ADDRESS 4 j1 ,��_ C�I G- .
OWNER �� vL_- CONTR.
TELEPHONE NO.
� DESCRIPTION �21 d �- Q'S�''�
� 01 FOOTING 11 MEC ANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
O 04 LL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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0 FINAL% 14 SEWER HOOK-UP 06 PROGRESS
-�--Q7"6M0-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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL iNSPECTOR '=7 CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7557
Owner/Contr cto o sit -
Inspector - -
White Copyllnspector's File Canary Copy/Site Notice