HomeMy WebLinkAbout1994-005919 - deck/porch/shed �
PERMIT �-
CITY OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway • P.O. Box 815 hi�•_��.C..�r`!�•v��
Orono, Minnesota 55356-0815 Permit Number: . ._ _ .
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Date Issued: �
(612) 473-7357 i t;.:','f .:i.'�:�;;
SITE ADDRESS:
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APPLICANT/PERM�TEE SIGNATURE ISSUED BY SIGNATURE. �_,
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $������ �U Date Received:
Date Approved:
Entered By: �L-fj,•
Permit�: `)�//%
AT•7• INFORM�TION MIIST B$ SIIBMITTSD IN FIILL BEFORE PI,AN REVIEW WILL B$ STARTED
(See Check-aff List Enclosed)
--------------------------------------------------------------------------------
2'HE A.PPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: �� 3� YUo`�u` � �,� �r� ZIP:� '� ,� ���
(work) ��•1 G�r_. t'�; �;�
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NAME OF OWNER:��� ��Vr+ �� � ' PHONE: (home)„��,� �f�C�E'`;
MAILING ADDRESS: 2 i ,�- , + CITY: �`�� )�t.�!""►(,� ZIP: S�`�f .� �:� �/
CONTRACTOR: �! / ? �` � ; •� , - PHONS: �� � °fy 7 ;
s�-•d i
CITY: :�' � i : ,: r�ZIP: ., . ,
MAILING ADDRESS: �,�� � �; i , ; � � �.:��� �
STATS LICENSE: �
ARCHITECT/ENGIN�: PHONE: � %= .
:�SAII,ING ADDRBSS: ���! 1 � ," '1 CITY: . ZIP:
N�: RBGISTRATION � ;
TYPE OF WORK: New Addition_� Accessory Strncture Move
Demo Remodel/Alteration Renovate Land Alteration
i � a.< �
PROPOSF.D WORK (describe in detail) :� V`� _ � ` ��
i r�;,
�N ` •ti � 4.l 1 r
STORIES: SQ. FEBT OF EACH FLOOR: ��� ��
NO. OF BEDROOMS: GARAGE STAI.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ �( ` . "
I hereby appl.y 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 worJc wiI 1 be in accordance with the approved plan.
V
APtZ,ICANT'S SIGNATURE: � ' -l'�-� \ DATE: "_ � � r
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� �� �Ar'� CITY of ORONO
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� _ � � On the North Shore of Lake Minnetonka
DATA PRNACY 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:
1. 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 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 pub3ic.
5. You have certain rights under M.S. 13.04 �o review pri�at�
data on yourself.
6. Your full name is required to process this apFlication or
permit.
�� � _ , �
(�� ���;� t- �i�I� �_ <, ,'� t � �� � _
First Middle Last
� ��i 1 �� � , ,�� � � � -� _
Address
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, )�) - ) l� (��� � ��� �� d� � � � ��� � � _� 5� S
City ^� State Zip
���� ? -�� �'
Phone
I understand ,my�'�ts as stated above.
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Sig ature
BUILDING&ZON[NG-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBL[C WORKS-473-7359
ASSESSING
_ � .
�.p,� RIGHTS OF SOB.TECTS OF DATA � -
gubc�ivision L Z�pe of data- The rights of individuels on whom the data is
stored or to be stored shell be as set forth in this section.
Subd. 2. Informaticn requi�d to be given individuel. An.individuel asked to
• himse2f shal]. be informed of: �a) the
� ' supply private or confidentiel data concerning state a en
purpose and intended use cf the requested data within the coIleT� or is egauY
political subdivision, or statewide system; (b) whether he ma, from his
1 the requested dats; (�) 8�Y �O� consequence arising
required to supp y rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply p y�8te or federal law to rice�Veth g�ve data,
other perscns or entities authorized by
requirement shall not apply when an in tlo 8�W en orcementuofflcer.
pursua�t to section 13.82, subdivision 5,
The commissioner of revenue ma le�� t� Te°�a��uctio insteadh�s
subdivision in the individual income tax or r�
on those orms. . - � --- � � - .
U n request to a responsible
Subd. 3. � Acce,� to data bp individuel. P�
authority, an individusl shall. be informed�he��ec hp VBteeorueonfidential-e IIP°n �
individusls; and whether it is classified p � ublic data on �
further request, en individuel who is the subject of e to himriantd,e if he �res, shall
individuels shall be shown the data witho o��t at d�a s. After an indiviclual hes been
�e informed of the content and meaning � �� need not be disclosed to
shown tr►e Private data a�d informed of its ute�Be�Uon pursuant to this section is
him for six months thereafter unless a d�sP �
� ending or additional data on the individuel h�8 eeor P blic datarupon8request bY
t responsible authority shall provide cepies of t P �ible authoritq may require the
the individual subjeet of the data• The respe �rt��g� �d comp�ing the
requesting person to pay the actual costs of makirig,
copies. �' ssible, with anY request
The responsibls authority she]1 comply immediately, Po uest,
made pursuant to this subdivision, or within five days of the date of the req
g�ndays and legal holidays, if immediate compliance is not
excluding Saturdays, With the request within that time, he shall so inf'o� the
possible. If he cannot comply Wi�n W��h to comply �
individual, and may have an a d d i tio n a l f i v e da y s
request, exeluding Saturdays, SundaYS and Iegel holidays•
chae when data �s not accurate or complete. � ��mS�. To
. Subd. 4. P� rivate data eoncerning
contest the accuracy or completeness�of public or p ��e authority
exercise this right, an individuel sha]l notify in ��e author�tY shall within 30
describing the nat�e of the disagreemenL Z'1�e resP°
days either. (a) eorreet the data found to be inae��gei°�u�g reec pients namedt by
notify past recipients of inaccurate or incomple .
the individuel; or (b) notify the indi�+idual that he believes the data to �em nt is
Data in dispute shall be disclosed only if the individuel's statement of disag'j'
• included with the disclosed data. ealed pursuant to the �
" The determination of the resgonsible authority to conte.pst d cases.
provisions of the administrative procedure act relating
-; �` CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDR$SS OR LEGAL: ''I3� 6'����� 5�1� ��� PID: �
D$SCRIPTION OF WORR: Y��-<<- f�N � 3 S''-'`�So� �J 2C (-1
-------------------- -
---------------------- � 5
ZONING REVIEW BY: DATE APPROVED: L Y �/
BIIILDING REVIEW BY: ��: — DATE APPROVED: Z -�`� � �
---------------------- ------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes ci 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: G
— -------
Fire Department: I� �_ os Office: School. District:
Lot Area: �( )5!> � Width: ��� ' + __ Depth:
Survey Submitted: Yes�_ No Date of Survey: I - FS ��g� -
Proposed Setbacks: � � �
Front (Lake) • ( °l2 +' Right Side: � 28'
Rear (street) : Af (A-
Left Side: W t �� �'
Adjacent Structures: (����� Wetland: pU��-
Building Height: Def . Hgt. (� •IL _ Peak Hgt.
Avg. Setback: �•i2 P�2- -� •'�• �- Lot Coverage: ���
Existing Proposed
Hardcover: 0-75 '
75-250 ' 1 S� '� l g d `�
250-500 '
500-1000 '
Hardcover Variance Required: Yes No oC Date of Council Approval:
Grading: Staff Approvall�ate: fBy:� �uncil. Approval Date:
;
� �
Septic: Staff Approval. I��te: � I BY=..;_ ,'
Zoning File:# � `�tesol.�tion #: ' Resolution Date:
� �
REMARRS (in house) : 1 �
V � �
�
� �
BIIILDING REVIE�1 CHECK LIST '� �-
�----� •
IIgC: � '3 CONSTRIICTION TYPE: �_ �
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor X -
Garag� �,i F z s(�__ x y N. z 9 = r�,33�s z y
�c� 3r� x e�_o� = Z�s�k-a
TOTAL
00
F3stimated Construction Va].ue: $ (,� �l�o
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Fil�ing
_�C Footing Mechanical Fire
�Framing Septic Water Connection
a Insu�ation Fireplace Sewer Connection
�WaI.Z Board (Masonry) Lawn Irrigation
D� Final (Mfg.) Other
Other Wel� (State Permit)
DCElectrical (State Permit)
----------------------------------------------
R�ARR$ (IN HOIISB) :
-------------------------------------------------
REVIEW BY OTHF�2S: DATE:
Access: Existing New
Access Approval: Date BY=
----------------------------------------------
gEMARRS (TO BE NOTED ON PERMIT) :
DATE / TIME
CITY OF ORONO CALLED IN ��'�—7 �
INSPECTION NOTICE SCHEDULED � �l✓3 a
PERMIT NO. � �� � COMPLETED �`��'^ � % ��+
ADDRESS �-g �% '�-'�- ��'t'
OWNER �e�-C� CONTR. /�i.9oSGc�u.GL�e-�/
TELEPHONE NO. �� � ~`�'"'x�
� DESCRIPTION
�
� 1 FOOTI G� 11 MECHANICAL RI 16 WELL TEST PUMP
Q NG 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 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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W� ,�'�NORKSATISFACTORY:PROCEED " PROJECTCOMPLETE
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W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. I; PHOTO TAKEN
INSPECTOR WILL RETURN
:-;STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract' s' � _
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN .�/���9'f
INSPECTION NOTICE SCHEDULED .���5/�9� --8�'- -�r�3d
PERMIT NO. ��/9 COMPLETED -2�-� �'"�S
ADDRESS '� `�// '
OWN ER CONTR.
TELEPHONE NO. �`7 "�! ' .3�Z��
� DESCRIPTION �,���'��_�.L�'i
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FFiAA 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
03 INSULATIO 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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p ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIOR!REQUIRED.CALL�NGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract on s e:
inspectoc
White Copp/lnspector's Flle Canary CopylSite Notice
ATE TIME
CITY OF ORONO CALLED IN -3��'�g�
INSPECTION NOTICE SCHEDULED ��'Z-!�S� �D.' s o
PERMIT NO. , J �/�c _ COMPLETED
ADDRESS .3 `� ���� • � ,�
OWNER � CONTR. ���C��✓
,
TELEPHONE NO. �7�" 3-�� �
� DESCRIPTION ���.�
�/� 11 MECHANICAL RI 16 WELL TEST PUMP
Q� 02 FRAMIN �" 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 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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� ❑ CORRECT WORK&PROCEED L ISSUE CERTIFICATE OF OCCUPANCY
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❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTl1NSAFECONDITiONWITHIN HOURS. r- pHOTOTAKEN
INSPECTOR WILL RETURN
�. CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-73�J7
OwnerlCont�a t o ite: _
Inspector. ��
White Copyllnspector's File Canary CopylSite Notice
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