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1995-006954 - remodel
PERMIT CITY OF ORONO � . PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 _ _ - Crystal Bay, Minnesota 55323 Permit Number: (612)473-7357 Date Issued: - SITE ADDRESS: _ _ _'� :y,-;_.;;.� ;;..:,. ._ .:, ;s � _ ., _ -., : . _ ' � �'.% _ ' ' ' ... �, :: . DESCRIPTION: ._:!?�. '-_..._;-���� .=��,:-,;F;:,"�.. ._.: ....y. � -.-r+:::s�i'="`"_:•'•._`�=��:-:.... ,_�ia i_ E ,---. . - A:``_�':%'. � ;%'; �. . .�'.�',�i}t'�%'';':'--:t�l`�'.-.','�_,!t"`'?".:.. _=d. _ � _ ... _. ...'._k;-=:'•l' t''_- .., _. ..�_i.''i�a� _� . .. . , . _ �,�fw _.____.. . .. .. . �L .. ,i,. . ..�-. ...'.. . . .- . . . � k "'"''1".. . . .. :Jt.i l_' - _ __'_' iF? ^f �:M. . . . _. .. . REMARKS: ._ _ - - - _ .,_ , . . - - � . , _ �_ ;. .� ; __ �. ... .:_: _s: . . _:_�. . _:;_,,� _ ��.��, ;_. _._ �.: _; ; _. ;_ �. .; , � ,_.. � . . . . . . .� . ._ . � :-�.. _ :_ . , . ;: ._ . _ ._. : �.� .:. E .' ..._�.. . ... .. .. � . . ._ ...'..�._ FEE SUMMARY: `,��t°:`_t _ i�l:�: �= i_;�_:.;�: i=�_._ _ . __._ $•���:a . . _ }'� f.�f= . .... .'�.F.`�'. ' _ . . �"..�i~ _. ._.. , .- _.._.«..�..«..�.�.�._�:�.:_�. .... . _ _ .... . .._.... . __i ! . j'�-! CONTRACTOR: OWNER: — ", _ _ _._...-_ - - - :: ..<..__.,`�a ... ... _. _. =:i;Y_ii-i 3 . . :�!'"'tY:t,';-. __ . .,�_.,_::.i�� ;j --t4—::a� T��� =.�i���.��==s�.���i�.[:t �_:#�-����i� ���.��.��...€:„< �'�:i�`°���°w;�>��� ;£= t.�-,��:� i�i� �.�::��i�. Is���='r����'����:;�l�'`�: �-��_� ��'�- �i..�y �:�.��� �`�c�����': �'�i' ��::� f L�, ��_��;�;: �i� ���'F'���' �;�..���`�..�Al���E ��Tl� �L� t' F . t� i�� ;� �t = `� �_,i=:�� �C.��� °�?t-��'� S'_'�= �T�ti,�����»=#:.t��'� ��i i T t_�'f I#'��� �":���+�. �:�{:;�.'I��'���'#���"�_ . . , . _ _.. � L �7 � ��Lc.� APPLICANTPERMIT SIGNATURE ISSUED BY:SIGNATURE ~ CITY OF ORONO - BIIILDING PERMIT APPLICATION ,� 7, �J �' � Date Received: �'a�a- q� lotal Fee: $ �� Date Approved: yntered By: � ��� �,y,�-y Permit�: ALI, INFORMATION MIIST BE SIIBMITTSD IN FIILI. BEFORE PLAN REVIEF7 WII,L BB STAR�.ED (See Check-off List Enclosed) ---------------------------------�--------------- � APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDR$SS: �v� /V� J�lor� Uh (�{'Q Rv . /�'�/V� ZIP: ,5�� -1 � (work) NAML OF OWNER• �Qv� C. . lJ �� N PHONE: (home) �/�/ I�'' �zzxc �DxEss: „36 b.i AJd �S�r�r..e or cz�: � /�o�l� /Z'IitJ zzp: s.�.�y/ CONTRACTOR: ,�� �a✓I `tJ ri<�e� (,t)it'`i �S�L�istR.r�� n241 t�0�i fiv.+ PHONE: N�ILING ADDRBSS: CITY: ZIP: STATS LICENSE: � ARCHITECT/ENGINEER: PHONE: MAILING ADDRBSS: CITY: ZIP: ZJ�: R$GISTRATION A mYPE OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration� Renovate Land Alteration pZOPJSED WORR (describe i.n detail) : .TnS�a�j"�QQ�e.�S ,C3�v�u�.S' t,cJdi..��S w�nOa�,f tAr�c� / /n j7 ��� pl� S�j't/i�LJ�^�2 . ,,[H57at,�� �/I•/n S�l1C�fhOC� GtNG► /�n.r��T���7�7 I.� /'�YtJ G�fX�. STORSSS: I a SQ. FEST OF EACH FLOOR: qb a �!3��I NO. OF B$DROOMS:�_ GARAGE STAI.LS: � ATT.�_ DET. ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ �(>d�3. d � 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 tnat the work wiI 1 be in accordance with the approved plan. • APPLICANT'S SIGNATIIRE: i����"''�'i'L �• � DATE: h, � ,o�� ���� . . � . , � CITY of OR4NU 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 like 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: l. The inf ormation you f urnish wi 11 be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusa]. 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 CounciZ action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 to review private data on yourself. 6. Yaur full name is required to process this application or permit. G�enh � �,a��2S �(�o�'"on First Middle Last 31� � S Na . s1'!vrQ ,�1'; Address �l�l�N� /�I N ��'3R'1 City State Zip �7� �O`S� Phone I understand my rights as stated above. e. � Signature BUILDING 8c ZONING—473-7357 • ADMINISTRATION Bc FINANCE—473-7358 • PUBLIC WORKS—473-7359 AS3ESSING ' .._.`� -- -�--�------._____ . . . , � $13.04 RIGS15 OF SIIB.TF•CTS OF DATA � 'vision L Type of da�- The rights of individuels on whom the data is Subdi stored or to be stored shall be as set forth in this section. An.individual asked to Subd. 2. Information r�d to be given in�ivi�ual. - • rivate or confidentiel data concerning �mWit�h�in the collect ng state agency, supply p uested data v refuse or is legally purpose and intended use of the re9 tem; (b) whether he ma„ political subdivision, or statewide sys � any �oWn consequence arising from his required to supply the requested date; ( ) �d (d) the identity of supplying or refusing to supply private or confidentiel data; rsons or entities authorized by state or federal law to rice�est gat ve da a other pe 1 when an individuel is esked to supp y requirement shall not app Y to a law enforcement officer. pursuant to section 13.82, subdivision 5, Th e commissioner of revenue me lace taX re°und instructionsu nsteadhos subdivision in the individual income tax or ro ert on those orms. • - �-- - t� �� by ����. Upon request to a responsible Subd. 3. Aecess rit an individusl shall be informed whet�c h r�ateeor confidential.e Upon his autho y, ified as pub � P ublic data on individuals; and v�►hether it is cless� ta without any charge to him and, if he desires, shall further request, an individuel �c is the subject of stored private or��u� � been individuels sha11 be sh°wn the of that data. After an uid� 6e informed of the content and meaning the dats need not be disclosed to shown the private data end informed of its u�e�BC�on pu�uant to this section is him for six months thereafter unless a �P n request by ' or additicnel data on the individuel h�8te or p blic dataruQoeated. The , pending rovide copies of the pri uire the responsible authority shall p �n the the individual subject of the �ta'cos h of m lcing,1��t fYing,�a�a �omp g requesting pe�on to pay the actuel _ copies. y if ssible, with any request The responsible authority shell comply immediatel , p� ursuant to this subdivision, or within five �ySimmediateatcompliance eis not made p S�de and legel hol�days, excluding Saturdays, �with the request within that time, he shall s linforth the possible. If he �ann°t �°mply within which to comp y individuel, and maY haVe a� additio� le al�ho�Y�� request, excluding Saturdays, Sun�Ys g dtiae when dats is not accurate or complete. An individusl may Subd. 4. P� ublic or private data concerning himself. To contest the accuracY cr completeness cf P in �i� the respcnsible authority exercise this right, an individual shall notify �ible authority shall within 30 describing the nature of,the disagreement. The respc lete and attempt to de,ys either: (a? correct the data found to be inaccurate or incflmPeci ients named by notify past recipients of inaccthet ndi�duel phat he belie esdthe data to be correct. the individusl; or (b) no y eement is Data in dispute shall be discicsed only if the individuel's statement of disagr • included with the disclosed data• � BQpealed pursuant to the ' The determination of the responsible authority may provisions of the administrative procedure act relating to contested cases• • CH�CR OFF LIST FOR ISSIIANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3� �S (V02�1� 5t�o� '�(Z PID: D$SCRIPTION OF WORR: 121-�-1'v�.o rJ�Z- ------------------------ --- ------------------------------------------------ ZONING REVIEW BY: �� � DATE APPROVED: ��� BIIILDING REVIEW BY: G DATE APPROVED: S '`� -�I S --------------------- ------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes_�' No PLAN REVIEW Yes r� 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 Offic : hool District: Lot Area: Width: D pt : i Survey Submitted: Yes No Dat of Survey� Propos�d Setbac s: ��, Front (Lak ) : ' Rig t Side: , Rear (Stre t) : Lef Side: Adjacent S ruc ures: Tj�retland: 6t � � Peak H t 1 Building Height: De . Hgt. i ' g i ' Avg. Setba�k: Lot` Coverage: y� xisti roposed � 4 Hardcover: 0-7 ' 75-2 0 ' �a , y 250-5 0 ' �a , 500-1000 ' ` Va iance Re ir d: Yes No Date of Counc,il ApprovaJ.: Hardcover q Grading: Sta f Approva D te: By: Council A roval Date: Septic: Staf Approval a e: BY= Zoning File:�# eso�ut' n # : Resolution Date: REMARRS (in house) : BIIILDING REVIEW CHECK LIST � DBC: �2' � CONSTRIICTION TYPE: f v N Sq Footage $ Per Sq Ftg Basement X - lst Floor X - 2nd Floor X - Garage X - x = TOTAL dn $stimated Construction Value: $ S ��o — Inspections Required: Work Requiring Separate Permi.ts: Site �Pl.umbing Grading/Fil.J�ing Footing Mechanical Fire �Framing Septic Water Connection �_Insulation Fireplace Sewer Connection �WaJ�I Board (Masonry) Lawn Irrigation Final (Mfg.) Other Other Wel 1 (State Permit) _�C E�.ectrical (State Permit) ------------------------------------------- REMARRS (IN HOIISE) : --------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date BY= ------------------------------------------ REMARKS (TO BE NOTED ON PERMIT) : i3ED� OM V1l11�1DOWS � �. � � _ . �,, . ,: :� ,. ; �� 4 ' r i_..� �J � c. � /y V'', a i ri m m V « �FIF�E L-�+i.l�" R#�,�.1UIF:�b � �r v� �-�. / f�1 p p � .0 'l� � � v" ,�'��. �,. : `L t=:-'���2 ti�1/i L�7H �' • .�`'.�' �.�� `'• o -e� (U� � C� �4„ M ►�J. CLl�::�� F-�I�l�1-IT .. � c �� _� a , ,,, ,,.,, ►�7 S � .. 1,. ,� � m r o c� �' � G?. �T�'r T. M{i'�1. C���1W I N G � 4�- _.,�; � � �� � i ���,; ��. � Q � _�'� " AX. S I �.5� �' � � , �� � ;z; c� C� � �i LL. I-�EIGHT � 2 l; � � �-, � v� � � �� �� � : �� ��b�,r� o � ` 1t1 �.. � ^ 1 1 •. ,.'I _ �, z � �. �� `t j �, � i �_...__- - r\ b U i �� " I i� t.) ,� . 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