HomeMy WebLinkAbout1993-005644 - add walls in admin CITY OF ORONO PERMIT PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 815
Permit Number: ;1 1 L L-)I N
Orono, Minnesota 55356-0815 otF-5 6 4 4
(612) 473-7357 Date Issued:
SITE ADDRESS:
ALL' U F '.)Y `'-C)
JR
p
DESCRIPTION:
N ri D t1i
Z
81ji I�ji 1-113 i yr-:e i N,-,.T-AL)D/REMCH-DEL
. _1 "FUT 1 CINAl
8L4 itij -riq W� L. C T
TV il C i-irflkhll
i j vi unwiyu
f L VfW:LI- L J, I IL-I-
j. i�4 ii:�Hrv)A H
'11J.1 VVVv- yr
V.L UL-17 L,.0
J.7 I�A 1 fl."'I A AA
.".PVA V V VVv
A.11 -:�T
'Lit _ry io
V.L bi-i
1'CPCT[,T -TUAMW
INCL-L-11 I-iiIHITP, i VLI
VVI INVL I v L.,•V 0
REMARKS:
�"FPAF,,ATF PERMIT REi"XJTL,-,:,i.) Frr-,1-jM :- -TELEr:TRIC.AL
r- -D !- -'-
FEE SUMMARY:
V T
iR S.e Of
Plan Rc,v i-nw C,E:1
'_�Ut,,charge ----------
TcAal Fee
CONTRACTOR: - OWNER:
L C:I K CADNOT i-I-
j ORONO 1`0 #'278
4
j; BAW 0'9 A r Af-I
LC CRYSTAL
DELANO MN 5 53 2 Lij A
-7
j LPVEII
T, '-M -T' N VE M11 I
11-1- • W,f f.-F,, F rl LJ
j CC 5 F;
T C T P Q f_7 -f- f--,i-I 1 1,1:-114-1.-:' T
'D . -,1`1-_ jI Nil TR ONI A t�CE-- fv,!I TH A! I -T T J-1
p % -_- — : -
e IT 7
q 3 IL N: I%j T
T t\' T I F T' -JF,- I T N (:Cd'-) 'R-0
Ll
. . . . . .. R IEN
L
kPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ 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) OWNER or CONTRACTOR
JOB SITE ADDRESS: ZIP:
(work)
NAME OF OWNER: /i l�t^�yl r•, �: ��.��. t ` %,' + > r° =,`� /L- 'PHONE: (home)
MAILING ADDRESS: - `,:� �� /CTYt ZIP:
f �-
CONTRACTOR: ;� . �' ° N� � PHONE:,
.w,
MAILING ADDRESS: 3 L3 M C'� ;,'. CITY: ZIP:
STATE LICENSE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION r
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration__ Renovate Land Alteration
PROPOSED WORK (describe in detail) : ip f7L, ✓rpt i i k� i ��,' i C'' Ii%"�i
/A'/ r'A
STORIES: SQ. FEET OF EACH FLOOR:
:40. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $
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
;rdinances and codes of the City andwith the State Building Code; that I
;nderstand this is not a permit and work is not to start without a permit; and
=hat the work will be in accordance with the approved plan.
'iPPLICANT'S SIGNATURE: / DATE: i
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 6 kS oc o C 57 tlK Bev OPID:
DESCRIPTION OF WORK: zew u 0EZ rgFFrGe SyhC-&
-------------------------
ZONING REVIEW BY: /U (V,� DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED: is, 11 3
-----------------------f ----------- -------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ti/ 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 CHECK LIST Zoning District:
1
Fire Depar ment: Post Office: SchobDistrict:
Lot Area: Width: Depth:
Survey Sub, it ed: Yes No DaJh
rvey:
Proposed Setbacks :
Front (La e) : Ri :
Rear l (Stre t) : Le
Adjacent St 'uctures : Wetland :
Building Height: Def . Hgt. Pea 3 Hgt.
Avg. Setback: Lot Cover4ge :
Existing ; Propose
Hardcove : 0-75 '
75-250 '
50-500 '
5 0-1000 '
Hardcove Variance Required: Yes No Date of Council Ap4oval :
Grading: taff Approval Da e: B Council Approval Date :
Septic: S aff Approval Date: By:
Zoning Fiie: # R�' solution #: Resolution Date:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC: i_. I CONSTRUCTION TYPE: N �c-
Sq Footage $ Per Sq Ftg
Basement x -
1st Floor x -
2nd Floor x -
Garage x -
x -
TOTAL
Estimated Construction Value: $ 3, Zom
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical Fire
XFraming Septic Water Connection
Insulation Fireplace Sewer Connection
_Wall Board (Masonry) Lawn Irrigation
'Final (Mfg.) Other
Other Well (State Permit)
Electrical (State Permit)
--------------------------------------------------------------------------
R—ARKS (IN HOUSE) :
--------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval : Date By:
------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
- OOn 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.
First Middle Last
i
Address
? C
City State Zip
Phone
I understand my rights as stated above.
SignafurE'
V
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7 35 9
ASSESSING
93.04 BIGHTS OF SUBJF-CTS OF DATA
Subdivision L Type of data- The rights f individuals on whom the data is
stored or to be stored shall be as set forth in this section. asked to
to be giv individual. An.individual
Subd. 2. information required hi self shall be informed of: (a) the
supply private or confidential data concerning state a ency,
purpose and intended use of the requested data within the collecting g
orpose subdivision, or statewide system; (b) whether he may refuse in from his
p own consequence arising
required to supply the requested data; (c) nfi and (d) the identity of
supplying or refusing to supply private or confid�:ntiel data;
other persons or entities authorized by state or f deralle w to receive the data. This
1 when an individual yS�asked to supply in
data,
requirement shall not appy to a law enforcement officer.
pursuaTit to section 13.82, subdivision 5, 1
The commissioner of revenue Ina lent tax re°teatructionsiluired uinsteader d om
subdivision in the 7`11indiii`vidual income tax �r r•
on those I orms. - -- - -- -
Subd. 3. - Access to data by
���. Upon request to a responsibled data on
authority, an individual shall be informed whether hp=s tee subject idential.store 'Upon his
individuals; and whether it is classified asp ' public data on
further request, an individual who is the subject of chargeany red to himriande if he desires, shall
individuals shall be shown the data without
hatte. After an in
has been
Se informed of the content and meaning the data 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
or additional data on the individual has been collected or created. The
pending n request by
responsible authority shall provide copies of the private or public data upon Tequire the
the individual subject of the data. The responsible authority and may
the
requesting Person to pay the actual costs of m�diig, certifying,
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 cif-immediate compliance is not
excluding Saturdays, Sundays and legal holida�y,
e If he cannot comply with the request w�lthin that time, he shall so inform the
he
possible. within which to comply
individual, and may have an additional five days
request, excluding Saturdays, Sundays and legal holidays•
gubd 4• procedure when data is not accimte or complete. An individual To
private data concerning himself•
contest the accuracy or completeness of public or P the responsible authority
exercise this right, an individual shall notify !in wrt ngauthority shall within 30
describing the nature of the disagreement. The! responsible to
days either. (a) correct the data found to be inaccurate��u�ngQeecipie�.nts namedtby
notify past recipients of inaccurate or income '
the individual; or (b) notify the individual that he believes the data to be correct.
is
Data in dispute shall be disclosed only if the in 'vidual s statement of disagr
eement• included with the disclosed data. be appealed pursuant to the
The determination of the responsible au ority tccontested cases.
provisions of the administrative procedure act r latingo
I
. a
�1
i
1 - Q
r - - x
a a �I
CL
' ��,r � Lt ..L � - �•til �
r�1
{� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTE SCHEDULED
PERMIT NO. Iq COMPLETEDp / 2Z�i �r 0-
ADDRESSL .c,, /a'
OWNER �/l r'7�1 dC� .i CONTR. /
TELEPHONE NO.
DESCRIPTION
LAj 01 FOOTING 11 MECHANICALRI 16 WELL TEST PUMP
02 FRA ING� 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
03 SULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O ALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SET(TURN ON 17 SITE INSPECTION
h 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
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
COMMENTS:
W � , 4— Ito
a
cc
0
cc
0
W
cc
Q
Z
W
W
d
LAJ bRK SATISFACTORY:PROCEED PROJECT COMPLETE
f C7 CORRECT WORK&PROCEED ❑
W ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contracto
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice