HomeMy WebLinkAbout1994-006233 - garage foundation ,� PERMIT
� C`�TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 }�t��►_�J 1�4 i7
Orono. Minnesota 55356-0815 Permit Number: �y{��.�;,:;
(612) 473-7357 Date Issued: +: ����,��
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SITE ADDRESS:
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APPLICANT/P EE SIGNATURE ISSUED BY:SIGNATURE �
, ..► -, CITY OF ORONO - BOII,DING PERMIT APPLICATION '
t Date Received:
Total Fee: $
Date Approved:
Entered By: '
Permit�:
ALI� INFORMATION MIIST B$ SIIBMITTED IN FULL BEFORE PI,AN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
Tf� APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRSSS: �a(��O/��� ��''� /.�/'�v e ZIP:
(work) �S3 l3d�
NA1�II: OF OWNE,R: ��-cT��"� G-��C �'1 PHONE: (home) �j�vs��`1��
MATLING ADDRESS: 7/�� ��"f��vlyJ CITY: �YGl�Q ZIP:
CON2�ZACTOR: s���lis9v� ,��v/��S' ���. PHOIJS: S�`� �� >�
MAII.ING ADDRBSS:�� � ,� / �5�`{'.�a,CIZ7: �.�� .� ZIP: �� d
STATS LICENSE: �
ARCHITECT/ENGINEER: PHONE:
MATLING ADDR.BSS: CITY: ZIP:
pp�,'r: R.$GISTRATION ,�
TYPE OF WORR: New Addition Accessory �tructure Move
Demo Remodel/Alteration Renovate�� Land Alteration
PROPOSED WORR (describe in detail) : � G(J �G"`-�'�', v� (ir�C� _
. �
�X� �e�, .�
STORI$S:_� SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: GARAGS STALLS: ATT. DET.
ESTIIriATED CONSTRIICTION VALUATION (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 will be in accordance with the approved plan. •
.
APPLICANT'S SIGNATQRE: DA�: � / .
. �
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�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� - � � 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:
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 public.
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Y�ur ful.l name is required to process this applicatian or
permit.
First Middle Last
Address
City State Zip
Phone
I understand my rights as stated above.
Si na ure
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
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!
S13.0.4 RIGH'I5 OF SIIB.TECTS OF DATA �
Subdivision L Tppe of da�- The rights of individuals on whom the data is
stored or to be stored shall be ss set forth in this section. An.individuel asked to
gubd, Z. Information r�d
to be given indiv�duel.
� � su 1 rivate or confidentisl data concernina BmWi�in the collecting state agency,
QP y P v refuse or is legally
purpose and intended use of the requeste �b� whether he ma„
political subdivision, or statewide system;
the requested date; ��) 8nY ��Wn consequence arising from his
required to suQply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply P state or federal law to receive the data. This.
other persons or entities authorized by 1 investigative data,
requirement shall not apply when an indtola law en orcementuofficer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma la�t taX re°una instructionsu nsteadho5
subdivision in the individual income tax or r• er
on those orms. � - --- " .
Subd. 3.
Access te data bY ����' UP°n request to a responsible
authorit , an individusl shall be informed whe blic h r vateeor eonfident al.e Upon his
y ublic dsta on
individuels, and whether it is classified as p � P
further request, an individual who is the subject of se t�e�mri�ae if he desires, shall
individuels shall be shown the data witho of�hat da a. After an individual hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its meanin�� u�uant to this section is
him for six months thereafter unless a dispute or action P ta u n request by
endin or additional data on Lhe individuel h�BteQor p blie da �r �eated. The
• P g. require the
responsible authority shall provide copies of the p �in the
the individual subject of the data•
The responsible��=�f°nity�a comp g
requesting person to pay the actual costs of making, Yi g'
copies. 1 immediately, if possible, with eny request
The responsible authority shall comp y S of the date of the request,
made pursuant to this subdivisi�nd le al tholidays,�f immediate compliance is not
excluding Saturdays, SunaaYswith thegequest within that time, he shall s linforth the
possible. If he cannot comply within which to comp y
individuel, and may heve �Sundays and legalahol�days.
request, excluding Saturdays,
te or complete. An individual may
Subd. 4. Procedure �►hen data is not accura �mself. To
contest the accuracy or completeness of public or private data conce o�lble authority
exercise this right, an individual shall notify in writing the resp
The responsible authority shall within 30
describing the nature of the disagreement. leLe and ettempt to
days either: (a) correcof inaceurate ordincomplete datae including recipients named by
notify past recipients
the individuel3 or (b) notify the individual that he believes the data to beement is
Data in dispute shall be disclosed only if the indieidual s statement of �8� t to the
• included with the disclosed data. . � 8ppe�ed pursuan
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
CHECR OFF LIST FOR ISSUANCE OF PERMITS
� • - FOR OFFICE USE ONLY
� ` �
ADDRESS OR LEGAL: � �� �`s O+ � �1^� ,�" : PID:
DESCRIPTION OF WORR:
----------------------------------------------------
ZONING REVIEW BY: DATE APPROVED:
BIIILDING REVIEW BY: � -v' DATB APPROVED: � � `�"
-------------------------- --
FEES TO BE CHARGF.D: � 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:
Fire Department• Post Office: SchooJ� District:
Lot Area: Width: Depth:
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks :
Front (Lake) : Right Side:
Rear (Street) : Left Side:
Adjacent Structures : Wetland:
Buil.ding Height: Def . Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes�C� No Date of Council Approval : �
�a;,� q3
Grading: Staff Approval Date: By: Council. Approval Date: � '
Septi c: S taf f Approval. Date: BY=
Zoning File: # Resolution #: _`��3? Resolution Date:
REMARRS (in house) : .
BIIILDING REVIEW CHECK LIST .
r, �_`'_�_ _ .. .
IIgC:� - I �� CONSTRIICTION TYPE: �-- 1
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Fl.00r X -
Garage X -
x =
TOTAL
$stimated Construction Value: $ ��U v
Inspections Required: Work Requiring Separate Permits:
ite PJ.umbing Grading/Fi��ing
�ooting Mechanical Fire
�c ���. r�.-r� Septic Water Connection
Insulation Firep�ace Sewer Connection
Wall� Board (Masonry) Lawn Irrigation
�Final. (Mfg.) Other
Other Wel� (State Permit)
Electrical (State Permit)
--------------------------------------------------------
REMARICS (IN HOIISE) :
----------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
-------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
DATE� . TIME
CITY OF ORONO CALLED IN �� " �
INSPECTION NOTICE SCHEDULED 'r ' %� —�-�—%—�—"-"O--
PERMITNO. � � �� COMPLETED 7��� �� v�� '
ADDRESS ��G yi ��;'�� i'�%.� .
,.-
OWNER �� CONTR.��lII(.Lv�.-L ��e�y
-, .— J
TELEPHONE NO. �-� -5 S �6 � O
� DES TION
01 FOOTING ' 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICA�FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24I25 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Q
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W L7 CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerfContract o
Inspector.
White Copylinspector's File Canary CopylSite Notice
ATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 9 /l� �. 3D
PERMIT NO. ��o?� COMPLETE �1 2 i
ADDRESS �
.
OWNER CONTR.
TELEPHONE NO. �O�.3 -S�� �
� DESCRIPTION —
� 01 FOOTING �. 1 ECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLINCa
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 T
Q 05 FINAL 13 METER SETITURN ON 7 SITE INSPECTIO
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY
0 BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for U�e next i spection 24 hours in advance.473-7357
Owner/C ra on '
Inspector:
White CopyAinpecto�'s File Canary Copy/SiM Notkx
f�
D TE TIME
CITY OF ORONO CA�LED IN -.'... �
INSPECTION NOTICE SCHEDULED %5 � '-�1�
PERMIT NO. ���.-.:. �� cornP�ETEo �_ �_
ADDRESS � �. �.
OWNER �"� .�° �_�Lz % CONTR. �''� c � , �
TELEPHONE NO. _ `).�.5 -/l��7C�
� DESCRIPTION ��-,
ty� 01 FOOTING 1 MEC NICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 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-41P O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNEH/CONTHACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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t��r ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION � TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
Owner/CoMra n i e:
Inspector.
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White Copyllnspector's File • Canary CopylSite Notice