HomeMy WebLinkAbout1993-005059 - finish basement PEI�MIT j
CITI� OF ORONO PERMIT TYPE: ✓
2750 Kelley Parkway • P.O. Box 815 E��1 I LL}I Ni�
Orono, Minnesota 55356-0815 PermitNumber: �;t��ta�,�
(612) 473-7357 Date Issued: k��!�,��'�:�;
SITE ADDRESS: .
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: — �F=��t �.��,;s�. —
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PPLICANT/PE ITEE SIGNATURE ISSUED BY:SIGNATURE
, < CITY OF ORONO — BUIZDING PERMIT APPLICATION
Total Fee: $ /';�.�-(,- ->' Date Received: � �
Date Approved:
Entered By: � ;� ��,�
" Permit�: _:�� : � ,;
AI�L INFORMATION MIIST BE SIIBMITTED IN FUI�L BEFORE PLAN REVIEW WII�L B$ STARTF,D
(See Check-off List Enclosed)
------------------------------- =-�-----------------------------------------
THE A.PPLICANT IS: (circle one) �WNER �r CONTRACTOR
JOB SITE ADDRSSS: �']Z�, /��VV`i� i-cw�- � . ZIP: �S'3� (�
(work) 3 3�; -�� �cru
N� OF OWNER: C��"1 C, � , �t A-���c�✓ PH�NE: (home} y"1� -�(3r 1
MAILING ADDRESS: �'7Z� Ai�N1� ��w•�•.- i�;J � CITY: �,�i 1,:,:1t`-z ZIP: SS '»L:
CONTRACTOR: L�A� C, �, . ��/V��,ti� PHONS: ",7 6 c/�j�I
MAII,ING ADDRESS: i �Z c, /'lj�ti;�•� �-r.,r ,,,,. �,J . CITY: ��-^^� l�..�� ZIP; j�'�.Zj'�
STATS LICENSE: �
ARCHITECT/ENGINEER: PHONE:
MAII,ING ADDRSSS: CITY: ZIP:
N�: RSGISTRATION �
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : T��^�5�^ u+ � �J���-�^^��"' `r�-✓ ��J``� �����^--
�^( `r{�� tl ( Vc...�.. In�—�� Y ,c_
STORIES: � SQ. FEBT OF EACH FLOOR: � I c-z a __
NO. OF B�DROOMS: GARAG$ ST1�I.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �U���: ���
I hereby apply for a building permit and I acknvwledge 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 acc rdance wi,th the approved plan.
� . �
APPLIC.ANT'S SIGNATURE: DATE:� : �/ 3
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C ITY of ORONO
Post O�ce Box 66•Crystal Bay,Minneaota 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 like to inform you that your request for a permit or
Zicense 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 wi3.1 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 license requires Counci3. 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. Yaur full name is required to process this ap�lication or
permit.
t Q� 1 � 1��� i�'��,�✓
First Middle Last
��(,��. �...,,,�,� (�L1�.
Address
� ti��.
City State Zip
C��zl ���- �� � �
Phone
I understand my rights as stated above.
,
Signa ur �
BUILDING&ZOIYING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
� .
i
�.04 RIGHTS OF SIIBJECTS OF DATA �
Subdivision L Tppe of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
- to be given in�vi�usl- An.individual asked to
Subd. 2. Information required
� � supply private or confidentiel data concernina BmWi�in the collecting state agency,
purpose and intended use of the requested
political subdivision, or statewide system;
(b) whether he may refuse or is legally
required to supply the requested dat8; (c) any kncH►n conseqAune�nc(a,s�henident ty of
supplying or refusing to supply private or confidential date;
other persons or entities authorized by statu��e�kedlto s pplyein est gat ve da a
requirement shall not apply when an individ
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma olert taX re°und instructions insteadhos
subdivision in the individual income tax •r r
on those orms. . � --- - - �
Subd. 3.
Access to c�.ta bY i��n�• IIPon request to a responsible '
authority, an individuel shall be informed whether h=�ateeor confidentisl•e UPon his
individusls; and whether it is classified es public, p ublic data on
further request, an individuel who is the subject of Se to himrlande if he desires, shall
individuels shall be shown the data witho of�hat da a. After an individual has been
�e informed of the content and meaning t� �ta need not be �isclosed to
shown the private date and informed of its u���action pursuant to this section is
him for six months thereafter unless a d�SP
� � pending or additional data on the individuh h� ate�or public datarupon request by
responsible aathority shall provide copies cf P o�ible authority may require the
the individual subject of the data• The r�P certif n and compiling the
requesting person to pay the actual costs of making, Yi 6�
copies. immediately, 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, Sur►dsYs and legal holidays,
possible. If he cannot comply with the request within thet time, he shall so inform the
hsve en additional five daYs within which to comply with the
individuel, and mgY �d le al holideys.
request, excluding Saturdays, Sunda3'S g
. Subd. 4. Proced�ae when ��o ublic o�r private dat�a lconcerning himse�. To
contest the accuracy or completeness P the respcnsible authority
exercise this right, an in�i�dual s� notify in ���e authority shall within 30
describing the nature of the disagreemenL The respo
days either. (a) correct the data found.tcom lete dataeincludin6 pee�Pie�ts namedt by
notify past recigients of inaecurate or m P
the individuel; or (b) notify the individual lnd�'v dualb s statementof disagreement is
Data in dispute shall be disclosed only if
• included with the disclosed daLa. � 8ppe�ed purs�t to the
' The determination of the responsible authority mp contested cases.
provisions of the administrative procedure act relating .
' C3EC� OFF LIST FOR ISSIIANCE OF P�MITS
� FOR OF�'IC�: L'SE ONLY
ADDRESS OR LEGdL: I?� NO �A2N1 PID:
DESCRIPTION OF WORR: F�N►5�-! �1'�SEYv��."►`+T"
------------------------------------------------------------ ---
ZONING REVIEW BY: N�� DATE APPROVED:
BIIII.DING R�?VIEW BY: CP�✓10 �Lv�►.--- DATE APPROVED- �-1'�!-!3
----------------------- -------------------------- -
FEES TO BE CHARG�D: Misc. rees Ca.Iculated Bv:
PERMIT Yes ✓� No
PLAN REVIEW Yes f No S�.WER 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 Distr;ct:
Fire De�artment: Pos` Ofr"ice: Sc�oo1 Dist;ict:
Lot Area: Width: Depth:
Survey Submitted: Y s No Date or Sur e�T:
Proposed Setbacks :
� Front (Lake } ignt Sid
Rear ( St�ee ) Ler"t Si �
Adjacent S ructure / Wet?a
Building Heig . Def. gt. P� k Hgt.
Avg. Setback Lot Cov rage:
EX S�� 5 P?'OD S eQ
Hardcover: 0-75 ` �
� 75-250 ' /�
250-500 ' %
i
500-1000 '
Har cover Variance qnired: Yes No Date of Cou ciI Approval:
Gr ding: Staff Appr val Date By: Counci Approval. Date:
Septic: Staff Approval Date: BY=
Zoning File:tt Resolution n: Resolution Date:_
F�RMARK$ (in house) :
.. _ _ �--- _ ____._ , -� -,
BIIII.DING RL�TIEfd C�CK I.IST ' ,
IIgC: $,� R �3 CONSTRIICTION TYPE: ���
Sq Footage $ Per Sq Ftg
9ase�e^.t X
lst Floor X
2nd Floor X
Garage X _
x
TOTAL
Bstimated Canstrnction Value: $ ( 0 �dd��
Inspections Required: Work Reqniring Separate Permitss
Site d� Plumbing Grading/Filling
Footin �C Mechanical Fire
g Water Connection
�Framing Seatic
Insulation Fireplace Sewer Connection
�Wa11 Board (Masonry) Other
(Mfg. ) Well State Permit
�Final �Electrical (State Permit)
---Other-----------------------------------------------------------------------
RBMARRS (IN HOUSE) :
--------------------------------------
gEVIEW BY OTHERS: DATE:
Access : Exis�ing New_
-----Access_Approval---Date------------------By--------------------------------
R$MARRS (TO BB NOT'� ON PERMIT) :
�.
-- '� DAT TIME
CITY OF ORONO CALIED IN J� '���-3 ��-�
INSPECTIAN NOTICE ��j SCHEDULED ���-.i- 3 / I 34
PERMIT NO. U �U � ( COMPLETED �
ADDRESS 17v�U �.��� �h.vK
OWNER C� �c-�-r,--_ CONTR.
TELEPHONE NO. ���0 " `� 3 ��
� DESCRIPTION � ��'�'"��
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVICzRADINGIFILLING
3 INSULATIO 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN QN 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PIUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REIN&PECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �- pHOTOTAKEN
INSPECTOR WILL RETURN
�–' CITATION ISSUED
❑STOP ORDER POSTED.CALI INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnedContr site:
inspector. 6
White Copyllnspector' File Canary CopylSite Notice
y DATE TIME
CITY OF ORONO �� CALLED IN V �.�.5 ��
INSPECTION NOTICE �� SCHEDULED " Z�= /D� �'z
PERMIT NO. � COMPLETED : O '
ADDRESS j��� � � ����n ���-
OWNER�� � CONTR.
TELEPHONE NO. `��� `f3��
� DESCRIPTION _ �rde������,��
� 01 FOOTWG 11 MECHANIC._ ALRI C- � � 16WE�LTESTPUMP
Q 02 FRAMING � t ME HC ANICAL FI 'J l �-� 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
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-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMP�AINT
= 09 PLUM_@J[��RI � 15 SEPTIC INSTALL. 22 FOLLOW-UP
�10 PLUMBING FINA���7-Z 23 SEPTIC FINAL
J -�__ .
WNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED �:; ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. —, pHOTOTAKEN
INSPECTOR WILL RETURN
" CITATION ISSUED
�STOP ORDER POSTED.CALL INSPECTOR
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContrac e:
Inspector. �
White Copyllnspector's Fil Canary CopylSite Notice
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