HomeMy WebLinkAbout1991-003817 - deck w/screens PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS: _RTH_
T IB
DESCRIPTION:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee : $ �� C� Date Received :
Date Approved:
Entered By:
Permit#:
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed )
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one ) 1OWNER or CONTRACTOR
JOB SITE ADDRESS: V � C-0 /lbR) jI�1 e m) /-iy ZIP: �5
(work)
NAME OF OWNER:- r>h r1 R 1,Q r(\ PHONE: (home) r-)
MAILING ADDRESS: '3.1bC) Alt)P,4 IAF J2AI AVF CITY: (L)nY7_)9 • rn ZIP: 55,391
CONTRACTOR: Tomah PHONE: 4_21 _211 (m
MAILING ADDRESS : E3`16 MD/2+l+EV_Aj #gVECITY: W19YZIq�f} ZIP: 15!53
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : AM Porgy C.\ 0l,l
ttoP-A , S i DE �-)OuSC
STORIES:-�- SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : roc
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
Drdinances and codes of the City and with the State Building Code; that I
inderstand this is not a permit and work is not to start without a permit; and
7-hat the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: J44 DATE: ') 1
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: PID:
DESCRIPTION OF WORK:
---------------------p-- ------------------------------
- -- - ---------------
ZONING REVIEW BY: paAM DATE APPROVED:
9 t
BUILDING REVIEW BY: b. DATE APPROVED: Q
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes3 No SEWER CONNECTION
STATE SURCHARGE Yeses_ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Width: I Depth:
Survey Submitted: Yes- No Date of Survey:
Proposed Setbacks : AI
Front (Lake) : /V Right Side: N '
Rear (Street) : Left Side:
Adjacent Structures : Wetland:
Building Height: Def. Hgt. Peak Hgt.
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:
Septic: Staff Approval Date: By:
Zoning File: # Resolution #: Resolution Date:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC: R- D CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x
2nd Floor x -
Garage x =
x =
TOTAL
Estimated Construction Value: $ �.J
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�( Footing Mechanical Fire
_Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
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REMARKS (IN HOUSE) :
-----------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT) :
CITY of ORONO
Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
•
- 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
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:
1. The information you furnish will be used to determine your
qualification for the permit or license 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 local , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Council 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. Your full name is required to process this application or
permit.
C)
First Middle Last
-�1�Q(--)
Address
WAYCA� (,} )VLA) �� 1
City �} State Zip
C/ /f —ZS �I�rJ
Phone
I understand my rights as stated above.
11i6i >1 A 1ti
Signa ure
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
513.t� RIGHTS OF SU&TEM OF DATA
Subdivision L 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 individual An.individual asked to
Subd. 2. Information required be informed of: (a) the
supply private or confidential data .concerning himself shall the collecting state agency,
purpose and intended use of the req adt whether he may re °r is from his
political subdivision, or statewide system;. known consequence arising
required to supply the requested data, (c) any
supplying or refusing to supply private or confidential data; and (d) the identity of
other arsons or entities authorized by state or federal law to receive the data. This
p 1 when an individual is asked to supply investigative data,
requirement shall not appy ent officer.
pursuant to section 13.82, subdivision 5, to a law enforcem
The commissioner of revenue ma lace the notice re uirRo under this
subdivision m the individual income tax or pro
pert tax re and instructions instead o
on those orms. -—
Subd. 3.
Access �� by �� �. Upon request to a responsible
authority, an individual shall be ed data on
informed whether h r atis eeor cbonfidentiaL Upon his
individuals; and whether it is classified asp , p public data on
further request, an individual who is the subject of stored mriavna��he desires, shall
individuals shall be shown the data without of any
data. After an individual has been
Se informed of the content and meaning the �� need not be disclosed to
shown the private data and informed of its meaning, pursuant to this section is
him for six months thereafter unless a dispute or action p
endin or additional data on the individual h or public data en collected rupon request by
rThe
esponsible authority shall provide copies of the private nsible authority may require the
the individual subject of the data. The res
po and compiling the
requesting person to pay the actual costs of making, certifying,
copies. immediately, if possible, with any request
The responsible authority shall comply i of the date of the request,
made pursuant to this subdivision, or within five days f the a compliance is not
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot comply with the request within that time, he shall so inform the
and an have an additional five days within which to comply
individual, y Sundays and legal holidays.
request, excluding Saturdays,
to or complete. An individual may
Subd. 4. procedure when data is not accura himself. To
contest the accuracy or completeness-of public or private dathe ta con �nsg authority
an individual shall notify in writing
exercise this right,
describing the nature of the disagreement. The responsible authority shall within 30
days either: (a) correct the data found to be inaccurate for Inco g reec and anamedttempt
by
to
notify past recipients of inaccurate or incomplete , to be correct.
the individual; or (b) notify the individual that�dual's statement Of e believes the disagreem disagreement is
Data in dispute shall be disclosed only if the in
• included with the disclosed data. ealed pursuant to the
The determination of the responsible authority tc��tested cases.
provisions of the administrative procedure act relating
ORONOCOPY
Certificate of. Survey for
I John R. Quam
of Lot 3, Block 1 , SOUTHVIEW ESTATES
Hennepin County, Minnesota
i N 7.1.0 �
psi► Drcinagc Iaf�lifrl
eascrncnts '^
N
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I hereby certify that this is a true and correct
N ( representation of a survey of the boundaries of
I I Block 1 SOUTHVIEW ESTATES the location
Lot 3, ,
I
Ito' of all existing buildings, if any, thereon, and
the proposed location of a proposed building. it
does not purport to show any other improvements
or encroachments.
I8ecic w;j� sr-feev. f6ft.
I5 I �Rar
I _ COFFIN & GRONBERG, INC.
Iaz
house I Mark S. Gronberg MN. Lit'. No. 12755
Gordon R. Coffin MN. Lic. No. 6064
I rags zz I Engineers, Land Surveyors, Planners
•__► I 3 Long Lake, Minnesota
N N
N Scale: 1 inch = 40 feet
Date May 12, 1986
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RMtT PLANR1I
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APPROVED AS
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-SUBMIT
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A. {f�g � WTH.0TGDTIONS AS
NOTED
-NDT.APPRQY�t1,—�_..__._.
fir' +•=!•_.: ' These comments are for your info:•m3tion. AIf rmric�`hs�1�tie�
in turf Com :Once wan all a P�.iica+h noted in.this ratite
auirements including items-nab-sa�`L Y
LAN SET i3�ty SIl' +�T Ali Re'Si'_
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CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED &'a�i-C/oZ
PERMIT NO. Co PLETED
ADDRESS 37
OWNER QU.A,_h CONTR. Q
TELEPHONE NO. A4
DESCRIPTION
01 FOOTING 11 MECHANIOKLRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 16 EXCAWGRADINGIFILLING
H 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
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 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES NO
Z
c0„ COMMENTS:
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W ORKSATISFACTORY-PROCEED PROJECT COMPLETE
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QC CORRECT WORK PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
Owner/Contrao n si :
Inspector.
White CopyMspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �} COMPLET - ( 1 S
ADDRESS 3 X00 /��1er1
OWNER OtA AA CONTR.
TELEPHONE NO.
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 3 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ONE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 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
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTSCC 4:
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Cc m i Pte-
0
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WCC WORK SATISFACTORY:PROCEED ElPROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 17 PHOTO TAKEN
INSPECTOR WILL RETURN
C7 S P ORDER POSTED.CALL INSPECTOR CITATION ISSUED
INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr r site:
Inspector.
White Copyllnspe or's File Canary Copy/Site Notice
—A-119
TE C� TIME
CITY OF ORONO CALLED IN [ /
INSPECTION NOTICE ry17 SCHEDULED a191
PERMIT NO. 0 COMPLETED
ADDRESS ) Y
OWNER CONTR.
TELEPHONE NO. Z/
4;MING
ION
TING11 MECHANICAL RI 16WELLTESTPUMP
11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
Oy 03 INSULATION 24/25'WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
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 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS.
a
cc
0
2
W
cc
Q
W
W
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W WORK SATISFACTORY.PROCEED ❑PROJECTCOMPLETE
QC W
CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra o ite•
Inspector.
White CopyllnspecWs File Canary Copy/Site Notice