HomeMy WebLinkAbout1991-003785 - change windows —
PERMIT
���'��' O� ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 ��t��������G
Permit Number: `•�;?��f�=�'�
Crystal Bay, Minnesota 55323 Date Issued: ��'=���=�_�����
(612) 473-7357
SITE ADDRESS:
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FEE SUMMARY: �� �L,�j ,,�,�,j
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CONTRACTOR: py�(NER• -- ►�F�F�lica�-�t. --
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
f � _
CHECR OFF LIST FOR ISSIIANCE OF PgRMITS
FOR OFFICE USE ONLY
ADDRBSS OR I.EGAL: �3�� �Ci�SI�L l��l �Q �� PID:� �—I� 7 � a1 � ��T (���-1
y� � r.
DESCRIPTION OF WORR. ' � Q � �`'' "..'`�.`" - ��'= '^!
C, L� ;i�y' .+nS� t v`- < ` �+.-�., o�
��—����—��---��—��������� �—�—����—�����—���������—��—�--��—����������������—
ZONING REVIEW BY: C, / �/ � DATE APPROVED:
BOILDING REVIEW BY: DATE APPROVED: ( "'2b� �L'(
FEES 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 N
o v SITE INSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECR LIST Zoning District:
��'7 �
Fire Department: Post Office ,,l�Z„���. School District: ��-
Lot Area: Width: Depth:
Survey Submitted: es No Date f Survey:
Proposed Setbacks _
Front (Lake) Right Side:
Rear ( Stree ) : Left Side:
Adjacent St uctur s : W land:
Building Height Def. gt. Peak Hgt.
Avg. Setback: Lot C verage:
Exis ing Pr posed
Hardcover: 0-7 ' �
75-2 0 '
250-5 0 '
500-1 00 '
Hardcover Variance Required: Yes No Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File:# Resolutio #: Resolution Date:
RBMARRS (in house) :
_ ._ � 1. . _ '
BIIILDING REVIEW CHECR LIST
IIBC: 1�� Q-�� CONSTRIICTION TYPE: �N�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor X =
2nd Floor x =
Garage X =
x =
TOTAL
�/r� c�
Bstimated Construction Value: $ /; t�0�
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
inal (Mfg. ) Well State Permit
ther Electrical (State Permit)
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REMARKS (IN HODSE) :
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Rh'�7IEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
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RRMARRS (TO B$ NOTSD ON PERMZT) :
T :��,�e�,�'�r 7
� .� CITY OF ORONO - BUILDING PERMIT APPLICATION`� �
� Date Received: � -��- ��
Total Fee : $ �� C (��
Date Approved:
Entered By: /`-�r ti'� 2
Permit#: ,�a '�S
AT•T• INFORMATION MUST BE SIIBMITTED IN FIILL BEFORE PLAN REVIgW WILI, BE STARTED
(See Check-off List Enclosed )
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THE APPLIGANT IS: (circle one ) OWNER or CONTRACTOR
JOB SITE ADDRESS: •lj 3 �� �Q.�S�da L �f�l IC�#✓_ Z IP: .5 5����1 �
(work)
C� / ` f � ) ' �
NAME OF OWNER- J��- S�v�e �t � � (� � V l � � ���n•���� PHONE: (home ) �)�'- ��7�
MAILING ADDRESS: C�1- t,��---cz _ CITY: W Z-�t�►�+- ZIP: S�S.3 f�
�
CONTRACTOR: �Q � �� �� ���< <�' " s PHONE: �f 7 / '� ��7�
MAILING ADDRESS:��S ���"�S�'3���`y� /�'+' CITY: /'�,'��yz`' 7`'°` ZIP: .S=�3 j /
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
PROPOSED WORR (describe in detail) : �: �� ; � ��"�
_ G O
�'C.��,r/
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
/ �G `�r
ESTIMATED CONSTRIICTION VALIIATION (egcluding 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
understand this is not a permit and work is not to start without a permit; and
that the work will be in accord nce with the approve plan.
___
' � !�p o�:S'
APPLICANT'S SIGNATQRE: DATE:
i �
l- '
�� xYr i�-,+�M �
,� O� F H..
�n `� ��'��' o� (�R�N�
�:�..� �.��.�a�
n�'� ���"�`'�F�v::
a� 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 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:
1. The information you furnish wi3.1 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 license.
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 Council. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 �o review priva�e
data on yourself.
6. Your full name is required to process this application or
permit.
.
S'-��� C� �� �� S�( :.� �.. ��
First Middle� Last .
3� f� � �5�.�-� ��� �
Address
�j.J �.� 2 �a- T� �vV� � r ��J t1� _
Cit� State Zip
T �( — 7�7�
Phone
I understand my rights as stated above.
, � F
� �
---. � �-
. - Y._ __
Signa re —
BUILD[NG&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
� ��
�.� �Gg� pg �IIg1ECT5 OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
gubd, 2. Information required
to be given in�iv��' An.individuel asked to
' su ply private or confidentiel data concernina gmWi�n the collect g state gency,
P
purpose and intended use of the requested
olitical subdivision, or statewide system; (b) whether he may refuse or from his
p the requested date; (c) any kncwn consequence arising
required to supply rivate or confidential data; and (d) the identity of
supplying or refusing to supply p state or federal law to receive the data. This.
other persons or entities authorized by 1 �vestigative data,
requirement shall not apply when an individuel is asked to supp y
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lert t8X re°una�nstructions insteadhos
subdivision in the individual income tax or r•
on those orms. . --- - � .
� � �� � ����y Upon request to e responsible
Subd. 3• A��
authority, an fndividusl shall be informed whetbh�c Pr vate or eonfidential.e Upon his
individuels, and whether it is classified as p � ublic data on
further request, an individuel who is the subject of se to�mrl�ae if he desires, shell
individuels shall be shown the data witho of�hat da a• After an in���u� � been
�e informed of the content and meaning the data need not be disclosed to
shown the private data snd informed of its u���action pui'suant to this section is
him for six months thereafter unless a d�sp
� ending or additional data on the individuel h� ate or p blic dataruponarequest by
� P require the
responsible authority shall provide copiesThe responsible authority may
the individuel subjeet of the data. c�rtif n and compiling the
requesting person to pay the actual costs of makinB, Yi g'
copies. lmmediately, if possible, with any request
The responsible authority shall comQly � S of the date of the request,
made pursuant to this subdivision, or within five �y immediate complianae is not
excluding Saturdays, Sundays and legal holidays, _
ossible. If he cannot comply with the request within that time, he shall sp in�orth the
P heve an additionsl five daYS �^'ithin which to com ly
individuel, and m S turdays, Sundays and legal holidays-
request, excluding
te or complete. An indi�idusl m8Y
Subd. 4. Proced�a'e when dtta is not acc�a himseif. To
contest the accuracy or completeness of public o ln��i� the�responsibie authority
exercise this right, en indivi� s� notify �ible authority shall within 30
describing the nature of the disagreemenL The resP°
days either: (a) correct the data found te be inae��e��a°ng pec pients namedt by
notify past recipients of inaccurate or incompl
the individusl, or (b) notify the individuel that he believes the data to �ement is
Data in dispute sh a ll b e d i s c l o s e a o n 1 Y i f t h e i ndividual's statement of �8� to the
• included with the disclosed data• � 8ppe�led pursuant
' The determination of the responsible authority m o contested cases.
p r o v i s i o n s of the administrative procedure act relating
`D_ ATE _ TIME
CITY OF ORONO CALLED IN `�� y�
INSPECTION NOTICE SCHEDULED �- S � O
PERMIT NO. 3 ��� COMPLETED
ADDRESS 3
.
OWNER ' � ONTR.
TELEPHONE NO. '7 ��— ��7 �
� DESCRIPTION � � �
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 2 F 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
v3 03 INSULATION 24l25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE HEMOYAL
Q 05 FINAL 13 METER SEf/TURN 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
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W� WORK SATISFACTOFlIF PROCEED ❑PROJECT COMPLETE
w O CARRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT VYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
�STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REf]UIRED.CALL TO ARRAN(iE ACCESS.
CaN for the next inspection 24 hours in advance.473-7357
site:
Inspector:
Whits CapyA Flk Canary Cop�IlSib Notko�
�
ATE TIME
CITY OF ORONO CALLED IN // � ��
INSPECTION NOTICE � SCHEDULED G�� r
PERMIT N0. �� ��5 COMPLETED �t �_
ADDRESS
�
,
OWNER CONTR.� �
TELEPHONE NO. "�7�"' 7���
� DESCRIPTION �i����-�8��
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
02 FRAMING 11 MECHANICAL FINAL 18 EXCAVICaRADINGIFILLING
03 INSULATION 24J25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q �FINAL 13 METER SETITURN ON 17 SRE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL �FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEi YOU:�YES_NO
y COMMENTS:
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W WORKSATISFACTORIFPROCEED ❑PRWECTCOMPLETE
� O CORRECT 1f1�RK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
Q ❑CORREGT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hairs in advance.473-7357
OwnerlContractor
Inspector:
White CopyAMpector's Flk Canary Capy/Sib NotiW