HomeMy WebLinkAbout1995-007415 - storage/closet addition - 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:
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DESCRIPTION:
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CONTRACTOR: OWNER: - :--. �_: : : =� -:' �
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APPLICANTiPERMI E SIGNATURE ISSUED BY:SIGNATURE .�/�i,
. • CITY OF ORONO - BIIIZDING PERMIT APPZICATION
�� Date Received:
Total Fee: S ��� L' � -
Date P.nproved:
�
�ntered By: � Per:nit�: '���J
AI,.L INFORMATION MIIST B$ SDBMITTE:D IN �I' B�FORE PI�N �I� �� BS STAR�'�D
(See Check-oif List Enclosed)
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� AppLI�T Ig: (circl.e cne) E. or CONTRACmOR
� ZIP:
JOB SITE ADDRBSS: � � ��-�- }-���
(work) 7c. " 34-3 "
PH�NE: (home) `�'��-�
x� oF owrr�z: �/�T�L-�>N �`'�,U.�?�"`� —
�iA1I,ING ADDRESS: � �J�] �
t21.L �2 cz�: (�2eJ 1'�'v zzP:
� PHON$:
CONTRACTOR: �' r
CITY: ZSP:
MATI,ING ADDRESS:
STAT$ LIC.LNSE: n
,r PHONE: -.
ARCHITECT/ENGINL�R: �
CIZ'Y: ZIP z
MATZING ADDRSSS:
RBGISTRATION A
�7AME:
Accesso Structure Move
Z*ypg pg y,7pgK: New Addition � � Land Alteration _
Demo Remodel/Alteration Renovate
- � CL.��i r�.C�l
PROPoSF.D WORK (describe in detail) : �'-SG�n��� .
STORSES:�_ s4• FEST OF EACH �LOOR: �C� � � • l
NO. QF BEDROOMS= G��� STAI.I�S: ATT. DET.
ESTIMATED CONSTRIICTION VALUATION (eacluding Iand3 : $ ' �
_' hereby apply for a building permit and I acknvwledge that the informatio=
above is complete and accurate; that the work wil.l be in conformance w�thath`.
ordinances and codes of the City and with the State Building Co e��it; anc
understand this is not a permit and work is not to start without a p
that the wor3c will be in accordance with the approved plan. .
�r �
DATE s �Z�s� �
APPI�ICAr7T'S SIGNATQRE:
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;"�^�� Post Office Box 66•Crystal Bay.Minnesota 55323•Municipal Offices
" S�.n``a.
4�f ..
r � _ � � 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 wou3d Iike to inform you that your request for a permit or
license f rom 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 Iocal ► �it or
federal agencies to the extent necessary to process the p
license.
4. If your reque f�atlon may become public res Councii action
to approve, some i
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6, Yaur ful.I name is required to process this aot,licatiaa o�
permit.
First Middle Last
,��7� 1�;� �� llr2
Address
1� 1.5 t�� �� ti� � -
City State Z1p
��2- �- � � �'�
Phone
I understand my rights as stated above.
Si natu
BUILDING&ZONING—473-7357
• ,�.D!�tINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-73
ASSESSING
513.04 RIGHTS OF SIIBJECTS �F 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 5ection. An.individual asked to
to be given indivi�ual.
Subd. 2. Information r�d himself shall be informed of: (a) the
" supply private or confidential data concerning
uested data within the collecting state agenc ,
(b) whether he may refuse or is legally
purpose and intended use of the re4 tem; uence arising from his
political subdivision, or statewide sys � any �own conseq
required to suoply the requested dat8; ( ) �d (d) the identity of
1 in or refusing to supply private or confidential dats;
supp y g 'ties authorized by state or federal law to ricenvest gat ve da a
other persons or enti
requirement shall not apply whenlo?n tola law en orcementu°f cer.
pursusnt to section 13.82, subdivis �
'oner of revenue ma lace the notice re uired under this
The commissi ropert tax re und instructions instead o
subdivision in the individuel income tax or —
on those orms. ' onsible �
to �ata bY indi��' Upon request to a resp
Subd. 3. A�� Upon his
' dividual shall be informed whether h��ateeor coenfident al.�d gta on
authority, � in ified as publ�c, p uau� data on
individuels� a�d whether it is cless if he desires, shall
further request, an individuel who is the subJecc�ge to himrl�de or au� � been
individuals shall be shown the data withou�fanh t �tg. �ter an i��� �Sclosed to
�e informed v te���a 1-nformed ofgts meaning� the data need not be
shown the pr ute or action pu��t to this secticn is
him for six months thereafter �� a �P or ublic data upon request by
e
or additional data on the individual hes at�Qn p llected or create ' the
t pending rovide ccpies of the g require
responsible authority shall p The responsible authority maY �in the
the individual subject of the data• certifying, and comp g
requesting pe�on to pay the actual costs of making,
y ii ssible, with any request
copies. immediatel , P°
The responsible authority shsll comply ' li�Ce y� not
suant to this subdivi,sion, or within five �ySimmediate8t�mp the requ he
made p� Sundays and legel holideys,
excluding Saturdays, 1 With the request within that time, he shall siinf�th �he
possible. If he cannet comP Y within which to comp y
individuel, and may have sn additio�d le aldho days.
request, excluding
Saturdsys, Sun�Ys g
te or complete. An indi�du� To
Subd. 4. Proced�e �►hen data is not a��ivate data concerning himseLf.
- or completeness�of public or P the respensible authority
contest the accuracy in writing within 3 0
exercise this right� � ln���� eemenL tThe respensible authority shall
describing the nature of the disagr lete and attempt to
lete data, including recipients named by
days either. (a) correct the data found to be inaccurate er incomP ta to be correct.
notify p8st recipients of inaccurate or incomp eement is
the individual� or (b) notify the individuel that he believes the da
ute shall be disclosed only if the individual's statement of disagr
Data in disP Q�ied pcu'su�t to the
• included with the �isclosed data• � 8pp
' The determination of the responsible authority to contested cases•
provisions of the administ�'ative proced�u'e act relating .
. �
HARDCOVER CALCULATION WORKSHEET �
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 25-500' S00-1000'
EXISTING AARDCOVER IN Z0��1E 2� _ �Q�
A. House x S.F.
�Yidth •
un�n r z � _ � 2��
. �s r g s.F.
z �. q r� _ ?10 Z_ S.F.
� z — S.F.
B. Gazage 77 R �� _ �_ S.F.
�.
�� ` (o�� � Z = ��� S.F.
C. Driveway R _
1 � x 1 — — ?7 Q_S.F.
x �I�, = C S.F.
D. Sidewalk o �� _ p S.F.
x —
x '� = I �b S.F.
E. Patio/Deck ��_ _ � 2 S.F.
� � x —S.P �—
z (..P = �Q s.F.
F. Landscape _�t^1 _ S.F.
Underlain x
= S.F.
By Plastic x
= S.F.
G. Other x � /
TOTAL HARDCOVER IN ZONE - `�_] S.F. A
TOTAL PROPERTY AREA IN ZONE - O S.F. B
A �7 �/+�— — g ►C� 7 CO x 100 = %
PROPOSED HARDCOVER IN ZONE � Gj(p, S.F.
A. House f Z� x
I.ength Width
= S.F.
z = S.F.
R
= S.F.
R
S.F.
B. Garage X
S.F.
C. Driveway R
= S.F.
R
� S.F.
D. Sidewalk X S.F.
z —
S.F.
E. Patio/Deck x S.F.
z —
S.F.
F. Landscape . z S.F.
Underlain x S.F.
By Plastic z
S.F.
G. Other R �
9(p S.F. A
TOTAL HARDCOVER IN ZONE - Q S.F. B
TOTAL PROPERTY AREA IN ZONE - --1�`— �
A �_ — B 2,�'� x 100 =
1'�
�
� O�
O O
�T�;��., �ITY o� URONO
� �';���, � rt��oe�
� 1 �=�..
^:� � {., �oes�s��
`�� �3� ,��%:,1� ti, c��say,;���ss3Z3-oo�
�r���t!J���,.�0
�sk s��o�
i1Ei.it1�CO�R O��T��TCE- In�197�, the Orono City Council adopted an ordinance limitinQ
the percentaQe of lot area that can be covered with impervious surface ("hardcover") such as
roofs, driveways, sidewalks, etc. on properties located within 1,000 feet of a lake. Studies have
shown that sediments, oils, and debris carried into the lake from hiQhly urbanized areas have
a detrimental impact on the qualiry of water in the lak�et�o ah Qras edOor�veQetaoted yard areas
ensure that rainfall run-off will be cleansed by filterui, ., �
before entering the lake.
Hardcover Zones - Allowed Pe O�ntages:
0-7�
75-?50' 25 0
250-�00' 30`70
500-1000' 35 0
Hardcover includes:
- Roofs
- Sidewalks
- Paved or �ravel drive«rays
- Patios & dzcks (includes slatted decks) ,.
- Tops of retainin� walls & rock walls
- Decorative landscape areas underlain by plastic sheeting or fabric
- Any ocher surface that does not allow direct absorption of rainfall into
the �round
L�STRUCTIONS FOR CO�TPLETLtiG HARDCO��ER C:�I.CULaTIO'�T `VORKSHEET
1, Circle �vhich setback zone (0-7�', 7�-250', e«•) the calculation is for.
2. For each item of hardcover within that zone, encer the lenath and width, and multiply to
Qet square footaae (s.f.).
3, Add up all the square foota�es to �et total square foocage of hardcover.
4. Divide by the total area of property within the zone and multiply by 100 to �et
percenta?e of hardcover ui the zone.
5. If chan;es in hardcover are proposed, you�shouldthan those allowedr ontact City staff
worksheet. If either results in percenta�es �.reater
before proceeding with your project planninQ! �
. TEI,EYFIONE-4'�T35'1•FAX-4T3-051�
� . r CHEC� OFF LIST FOR ISSUA,�CE OF PERVIITS
FOR OFFICE USE ONLY
:�DDRESS OR LEG:�L: l375 ��►c p/Z.�v� PID�
DESCRIPTIO\ OF «'ORI�: fl0/J rnvN - ���c �-O� ���''—
ZO\Zti G REV�jV BY: DATE APPROVED: I� -2 -95
- -�� , �_. DATE APPROVED: t,c� - Z-45
BUII,DL1 G RE�ZEtiV BY.
-------------------------- '
FEES TO BE CH_�,RGED: �Iisc. Fees Calculated By:
PER�IIT YzS � �o
�,ra SEtiVER CONti"ECTION
PL�N RE`ZE�V Yes �/� �ATER COiWECTION
STATE StiRCH�RGE Z'zS �-�0 pp,� FEE
I�i VESTIG:�TIO�i FEE Yes �o
SaC Yes No SITE INSPECTION
�iumber of S�C linics _ OTHER (specify) _� _�
---------------
--------------
ZON�G CHECK LIST Zoning District: (�!L-I� Shoreland District : �.p5
Fire Departmen[:
ry���.,� Posc Office: vvte.rr�c� School Discrict: ,�.�es�rr�svteA
De [h
Loc Area: Sq.it. Yz�`�� Acres •S$� Width P
Survev Suomicted: Yes �C
�,ro Da[e of Survey: 8-r� -�
Proposed Secbac�cs: � ('�
Ftorre (Lai:ej: l55 � Right Side: ?� '
R,ea� (Street): N ��4 Left Side: N�W ��
Adjaeeac Scructures: AT%�'-w�� Wecland: �✓�A
Buildiu� Heighc: Dei. Hgt• d •t� Peak H;t. O .l�
Avg. Secbacfc:
c� .K Bluff Setback: N�� Lac Coverage: �j•��.._�—
Exiscing Proposed
H:�rdcover: 0-75' z�•�y
75-250' Z`�
250-�00'
�00-1000'
Hardcover Variance Required: Yes No X Date oT Council Approval:
Gradin�: Staif �oproval Dace: By: Council :�pproval Date:
Se�tic: Starf .�pproval Da[e: By: -
ZaninQ Fiie: �
Re lucion: # esoiution Date:
RE�tii.-�R�iS (in house):
26
.
BL�..DL\G RE�`IE��' CHEC�i LIST
t,�sc• 2- 3 covsrxuc�ov �rnE: u'�
Sq Footase 5 Per Sq Ftg
Basement �
lst Floor �
Znd Floor C
Garage c
x -
TOT:�L
Estimated Construciion Value: � S ���
Inspections Required: �Vork Requiring Separate Permits:
Site Plumoin; Fire
�Iechanical �Vacer Connection
Hardcover Removai Sewer Connection
_� Foocin� Sepcic
�( Framing Fireplace Lawn Irrigation
/� Insulacion (Masonry) Other
-� Wall Board (Mfg.) Weil (Sta[e Permi�)
.�- Final Grading/Filling D� Eleccrical (State Permit)
Other
REi�1ARKS (L1i HOLSE):
-------------------------
REVIEW BY OTHERS: DATE:
Access: Existing �e"�
Access Approval: Date BY� r�
------------------
REl�1ARKS (TO BE NOTED ON PER1ti�IT�:
27
�
DA E TIME
CITY OF ORONO CALLED IN d �r S
INSPECTION NOTICE SCHEDULED ���1�i/�J '-s��
PERMIT NO. °7'��J COMPLETED ��, �
ADDRESS �3�5 .re�.�� L� .
OWNER r-�- CONTR. ��.✓
T� �
TELEPHONE NO. �'�-Z ' �/��
� DESCRIPTION �1 � ,��;�-�
�
� 1 FOOTING 11 ECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTtON
Z
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
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J
O
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W
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W� WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W ❑CORRECT V��ORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. - pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspect n 24 hours in advance.473-7357
OwnerlContracto.o
inspector.
White Copyllnspector's File Canary Copy/Site Notice
�
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED !f-Zo-g� t 6: 3�
PERMIT NO. `����f COMPLETED -� '�-1�
ADDRESS 13'?S 1?A2ic l�2�v�
�
OWNER CONTR.
TELEPHONE NO.
�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q �l FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEP'fIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
v�, COMMENTS:
�
W
a
�
O
�
�
O
�
W
�
Q
�
2
W
�
W
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�
� f�CNORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8.PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor 'te•
Inspector.
White Copyllospector's File Canary CopylSite Notice
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