HomeMy WebLinkAbout1993-005037 - shed � PEI�MIT -
, CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: ��'���;�}����'
Orono, Minneso ta 5 5 3 5 6-0 8 1 5 Date Issued:
(612) 473-7357 `-}�'���:f!-�:_'
SITE ADDRESS:
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REMARKS:
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A , LICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE��t.,�',�L.�
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� CITY OF ORONO - BUILDING PERMIT APPI,ICATION
, Date Received:
Total. Fee: $
Date Approved:
Entered By: �
Permit u: -_t� ; �
ALI, INFORMATION MIIST BB SIIBMITTSD IN FIILL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed?
THE A.PPLICANT IS: (circle one) CONTRACTOR •
JOB SITE ADDRRSS: �5 7�"C /��, .�ftc+r� �,*�i �� � ZIP: ��j-�L ��
(work)
NAML OF OWNER: -� ��n� PHONE: (home) �7/-�/�-�
� �_ ��� /� c �CITY: /�-'�ct�>� C( ZIP: S����
Z�SAILING ADDRESS: �i�� i[,-. �� � -' �
CONTRACTOR: �— PHONS:
I�iAII.ING ADDRESS: �— CITY: ZIP:
STATS LIC�NSE: � �''—
ARCHITECT/ENGINEER: �� PHONE:
MAIZII�TG ADDR.$SS: �' CITY: ZIP:
�I�MEs --- RBGISTRATION u
TYPE OF WORR: New Addition Accessory Structure (/ Move
Demo Remodel/Alteration Renovate Land Alteration
� tI. �
PROPOSED WORR (describe in detail) : c' � �' � S � � /II �
STORIBS: SQ. FE$T OF EACH FLOOR:
NO_ OF BBDROOMS: GARAGB STALLS: ATT. DET.
- n�.
ESTIMATED CONSTRIICTION VALIIATION (eacluding 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
snderstand this is not a permit and work is not to start without a permit; and
that the work will be in accordance with the approv pl . �
APPLICANT'S SIGNATDRE: / �-�.� DATE: �`- �` /��_
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` � � ��j{�� CITY of ORO�TO
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1s'��";_� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
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i - ,� ``�` On th.e 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:
l. The information you furnish wil.l. 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 IocaZ , 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 priva�e
data on yourself.
6. Yc�ur full name is required to process this applicatian or
permit.
e �,�_ -E i' o�
First Middle Last
3%.�� /�� c ��or �1�.—� c- -'2
Address
� -_ � �
City State Zip
�l�7�- �r�`,�
Phone
I understand my rights as stated bove.
�- i-
ignature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
.�� _...._..._.._...�---�--�-- ----- -- �
513.04 RIGS15 OF SIIB.TECTS OF DATA � �
Subdivision 1. Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
- to be given indivi��el- An.individual esked to
Subd. 2. Informaticn required
� ' supply private or confidentiel data concernina �mWi�n the collect g stat agency,
purpose and intended use of the requested v refuse or is legally
political subdivision, or statewide system; (b) whether he ma,
required to supply the requested date; (c) any known consequence arising from his
rivate or confidentiel date; end (d) the identity of
supplying or refusing to supply p
other persons or entities authorized by state or federal law to rece�veste at ve da a
requirement shall not apply when an individuel is asked to supply 6
pursuant to section 13.82, subdivision 5, to e law enforcement officer.
The commissioner of revenue n►g plert t8x re�und instructi ns�nsteadhos
subdivision in the individual income tax �r r
on those orms. . - _ --- - -
3 A�� t� �� bp ��yg�. Upon request to e responsible �
Subd. .
authority, an individuel shall be informed whether h��gteeor confidential.e Upon his
individuaLs, and whether it is elessified as public, p ublic data on
further request, an individuel who is the subject of e to himrland, if he desires, shall
individuels shall be shown the data withou�f an���ta. Af ter an individual hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private data end informed of its meaning� u�uant to this section is
him for six months thereafter unless e dispute or action p
� � pending or additional data on the individuh h�8te or public datarupon request by
responsible authority shall provide copies of P require the
the individuel subject of the data. The responsibl cert f �nity and compiling the
requesting person to pay the actual costs of making, 3'i g�
copies. lmmediately, if possible, with any request
The responsible authority shall comply � of the date, of the request,
made pursuant to this subdivisi�d le Wltholidays,�f�immediate compliance is not �
excluding Saturdays, Sundays �
possible. If he cannot comply with the request within that time, he shall so inform the
individual, and maY hs�e er► 8dditional five daYs within which to comply with the
request, excluding Saturdays, Sundays and Iegal holidays•
Subd. 4. Proced�'e �►hen data is not accurate or eomPlete. An ind�msd�• To
contest the accuracy or completeness�of public or private � the�responsible authority�
exercise this right. an individusl shall notify in writing
describing the nature of the disagreem�o b�ac��e orencotmplete and att mpt to
days either: (a) correct the data found
notify past recipients of inaccurate or ���p�t he believesdtr►e rdatalto be correcty
the individuel; or (b) notify the in&vi
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the disclosed data. ealed pursua�t to the
' The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases.
, , � . CHECK OFF LIST FOR ISSIIANCE OF PERMITS
, FOR OFFICE USE ONLY
AD�RESS OR LEGAL: �'ID=
DESCRIPTION OF WORR:
-------------------- ------------------------------------/-��-----------------
ZONING REVIEW BY: • DATE APPROVED: �-"� "`1 �
BIIILDING REVIEW BY: DATS APPROVED: 4�7-�Q�
�EES TO BE CHARGED: 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: School. District:
Lot Area: Width: Depth:
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake) : Right Side:
r � ►
Rear ( �rAPt ) ; �v Left Side: �
Adjacent Structures: Wetl.and:
� Peak H t.
Building Height: Def. Hgt. �� g
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approval.:
Grading: Staff Approval. Date: By: Council Approval. Date:
Septi c: Staf f Approval. Date: BY=
Zoning File: # Resol.ution # : Reso]�ution Date:
REMARRS (in house) :
BUILDING REVIEW CHECR LIST - • • �
IIBC: �'I I"1 f/(/ CONSTRIICTION TYPE: V"/V •
Sq Footage $ Per Sq Ftg
Basement x =
lst Fl.00r X =
2nd Floor X =
Garage X =
X =
TOTAL
$sti_mated Construction Value: $ �d�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/FilJ�ing
Footing Mechanical Fire
Framing Septic Water Connection
Insu�ation Fireplace Sewer Connection
Wa�l Board (Masonry) Lawn Irrigation
�Fina 1 (Mf g.) Other
Other Wel 1 (State Permit)
. E�ectrical (State Permit)
-------------------------------------------------------------------------------
REMARRS (IN HOIISE) :
-------------------------------------------------------------------------------
.
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval.: Date By=
------------------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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DATE TIME
CITY OF ORONO CALIED IN Q��!�/9�
INSPECTION NOTIC SCHEDULED �B/� �/ � 0 a
PERMIT NO. ��� � COMPLETED H N
ADDRESS _ ��'J'�D � .��� lQit �
OWNER ���i/�-e�-� CONTR.
TELEPHONE NO. '��/ ' ���`�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWEfLANDS
Z 04 L BD. 12 WATER HOOK•UP 34 TREE REMOVAL
05 FINAL 13 METER SETITURN 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
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERlCONTRACTOR TO MEET YOU:_YES_NO
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� �ORKSATISFACTORY:PROCEED �'PROJECTCOMPLETE
W ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCon r site:
Inspector.
White Copyllnspect 's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN y-�-�z
INSPECTION NOTICE �� r SCHEDULED `1- 4° / ; 3 �'
PERMIT NO. � COMPLETED � h
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ADDRESS 3��� � �/�
OWNER � 1G�2�G� CONTR. �,Q �v�--�v
TELEPHONE NO. '� � �- yl� ��
� DESCRIPTION a'�'�'����'"''l`�
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILI.ING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
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Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 5 FI AL 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
? 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �,' PHOTOTAKEN
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnedContr o n site:
Inspector.
White Copyllnspe tor's File Canary CopylSite Notice