HomeMy WebLinkAbout1992-004595 - convert to 4 season � , _ - _
\ � PERMIT
.
���I��' OF ORONO PERMIT TYPE:
� 1335 Brown Rd. South • P.O. Box 66 Permit Number: ��j'ty���i���
Crystal Bay, Minnesota 55323 Date Issued: i?����3f f'��'
(612) 473-7357
SITE ADDRESS:
:�'7'.�� �'H�A'1Afi�T Ra
C:�-f
F'. I . N. � i i-11:—�:_;—�:�—c�i 3��
DESCRIPTION:
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FEE SUMMARY:
VAL�IATI�=+t� �,�_,�t�ti
C,ctSe Fe� $1 t=1�;,C)i)
F'l�t� R�:vi�w �7i�.:�iy
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C.�.QNTRACTOR: ' — A��F=1 i c ar►t. — OWNER:
FtEA}V+��C G��Y i_�:��.���.���� DAV I D D�:1hl
f��;:�_�ts Ftif;E:��T HI�L'�� �p ��:�5 F'HEl�°��ANT ��
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APPLICANT/P�f�MITEE SIGNATURE ISSUED BY:SIGNATURE
,. � CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee• $ �`fi,..�'.-r > Date P.eceived: �,1��/�j�
Da�e P.pproved:
Entered By: � �'l;_,
PermitQ; ����<i `�
AI�L INFORMATION MDST B$ SIIBI�iIZ'�ED IIJ FIILL BEFORE PI,�N REVIEW WIZ�L BS STAR�ED
(See Check-cff List Enclosed)
------------------------------------ -.-----------------------------------------
THE APPLICANT IS: (circle cne) QWNER 'or CONT.�tACTOR
,
JOB SITE ADDRSSS: -�_� -�`=� ` t�s-�r��:�Hra� �:Lr�'��d�� ZIP: `�;�.>> ':�':'a 1
(work) `ti� � � � ��2-2-
.� ` . � _ .
N� oF owr��x: � ��►v �� � ;_� ���..; <�� � �� �' �� �
PHONE: (home) �� l' � �. -� �-
r� . �.` i:-- -.=� .�.
HAILING ADDRESS: -�'"1�`� \' t�1�.;�'r`-�,�1Q_3"j l�I'. CITY: C_���r�1 r� ZIP. .;t ,,; ...s .:, 1
CONTFL�CTOR: �� v'�;2`-C \ V2 E�tJ� c= PHONS: �1 �� - r.�� U�r
MAIZING ADDRBSS: 1 "�� `��� �vy^-r"`:�; l��l,l�`� ���� CITY: f�i��_�_� �'�r'.�r��'�:-�C. ZIP: :'a�'J ��`��
STATS I,ICENSE: � ' .-.� �- .
� �.�b`,��c-r'�3C:... 'i� � ��r�_ ' �ti t r��t��:
ARCHITECT/ENGINEER: PHONE:
MAIZING ADDR.$SS: CITY: ZIP:
N�ME: RBGISTRATION A
TYPE OF WORK: New Addition Accessory Structure Move
Demo Resnodel/Alteration )< Renovate Land Alteration
�_� :
PROPOSF.D WORR (describe in detail) : �J�J��'� ` ��i�G�,�l�.�� 1��:�`��1� ��i� `-� ���1��si�
,
���.ti:`i�-1 1 1�+�'��;rJ i 'J�f',''a t�-� ."�!w ����a„�..�vl='� !`3� �L�. 1Jt"v`.: �:����J QS Y'`i.�i t�i� �
� � • 7 �\T1�r>��
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u.� �Z`Ly Cr2,r�•.rJ� S�'ACF , . :)_: '_T_t.ic'��►�ZLI. �9�l.u�c. SILY L►C��-1 i 5 , Z'"v���, � rv t�_i i�N,Er--�
STORISS: � SQ. FEBT OF EACH FLOOR: (��'�2'�t - .� 1 v:.•
NO. F BSDROOMS: � GARAGS STAI.LS: ATT. ��'- DET.
EST TED CONSTRIICTION VAI�IIATION (eacluding la.nd) : $ ��,����-= �
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 accordance with the approved pian.
APPLICANT'S SIGNATDRE: "'�� 1`v�l � �� c�V�.i t c�� DA : � / 3 � �G Z
�"f� _ ' A ' .
�- /(-�// /L f' � 1 ��-L�.�'
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9
��zi Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Offices
�''3"�i.� `-;
a:��� 's, f .�
;� -� + � = On the North Shore of Lake Minnetonka
DATA PRI�7ACY 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
I.icense 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 inf ormation may become public.
5. You have certain rights under M.S. 13.04 to review priva��
data on yourself.
6. Your full name is required to process this application or
permit.
>.i �
�,) �� 1� ��`����.v`�� :'1 1f f-�,�,,; a��
First Middle Last
�._"( �`� �f 1--�k-.�r'`��j f�\�'� "+v ���r�� .)
Address
�_� ,�W-J ��.,� � �-~� r� � "j ;�_?-,�� �
City State Zip
C
'�•_l 'l E �`���.
Phone
I understand my rights as stated above.
L l, _`��,� ti �1 � � �`• � �JLJ � CS�} _
Signature
BUILDING&ZO:VING-473-7357 • AD'�tL�lISTRATION&FINANCE -473-7358 • PUBLIC WORKS -473-7359
ASSESSItiG
---- - - - � _
� `
, .
�,pq RIGHTS OF S'QB�TS �F DATA �
gubdivision 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 r�d
to be given individuel. An.individuel esked to
� ',supply private or confidentiel data coneernin�8m i��e collecting stat age�,
purpose and intended use cf the requested
olitical subdivision, or stetewide system; (b) whether he ma� refuse or is legally
p the requested date; (�) g�Y �O� consequence arising from his
required to supply to supp p p
su plying or refusing 1 rivate or confidentiel data; and (d) the identity o
P state or federal law to receive the data. This,
other persons or entities authorized by p �vesti ative data,
requirement shall not apply when an individual is asked to su ply ' g
pursuant to section 13.62, subdivision 5, to e law enforcement officer.
The commissioner of revenue ma rolert taX re°und�nstTuctio�nstead o5
subdivision in the individual ineome tax �r
on those orms. . - --- - � _
Subd. 3.
Access to �ata bY i����' UP°n request to a responsible
authority, an individusl shall be informed whether h��teeor confidentisl.e �Pon �
individuels, an d w he t her i t i s c l a s s i f i e d 8s public, p u b l i c d a t a o n
further request, an individuel whe is the subjecc�ge to himrlande if he desires, shall
individuels shall be shown the date withou�t an�y t �t� �ter an individusl has been
�e informed of the content end meaning t� �� need not be �iselosed to
shown the private date and informed oi its U��action pursuar►t to this section is
him for six months thereafter unless e �SP �
� � pending or additionel data on the individuh h�g e or public dataruponarequest by
responsible authority shall provide copies The res onsible authority may require the
the individual subject of the data. p certif n and comp�ing the
requesting person to pay the aetual costs of making, Yi g'
copies. ' lmmediately, if pessible, with any request
The responsible authority shall comply ' of the date of the request,
made pursuant to this subdivision, or within five �YSlmmediate compliance is not
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot comply with the request within that time, he shall so in�h the
individual, and may have an additionel five deys within which to comply
request, exeluding Saturdays, SundaYs and legal holidays.
Subd. 4. Procediae when data is net accurate or complete. An in��� mgY
himself. To
contest the accuracy or completeness�of public or private � the�nresponsible authority
exercise this rigl'►t• an inditnduel she� notify � ��e Buthority shall within 30
describing the nature of the disagreemenL The respo lete and attempt to
days either. (a) correct the data found to be inaecurate or incomp
notify past recipients of inaceurate or incomp�t��e esdthe datalto be correct
the individusl; or (b) notify the individual eement is
Data in dispute sha]1 be disclosed only if the individual's statement of disagr
• included with the disclosed data. ealed pursuant to the �
' The determination of the responsible euthoritq to contested cases.
provisiorLs of the administrative procedure act relating
a su � v � Y
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_�=�� � � SURVEY�RS �,�.Q�a��� � __- �_
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ZBZS HARRtET AVE. E F MINNEAP6LI5� MINNESOTA
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CERTI�ICATE OF SUi�1/EY
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Descripfiio�: That part of Lo,t 10, lying Northerly of a_-lfine drawn at righ_t
angles to the Westerly 1 ine of said Lot 10 from a poin't` the�-�in distant • •�
' 192.3� feet Sautherly (measured elong said westerly. tineffrom the
lVorthwesfi corner' fhereof . , " Phaasar�t lawn ..", except fhat part thereof
lyf.ng Nor.therlX of a ,t 1ne parai lef wi th and ,32 fee# Southerty� Cmeasurec! -
at right angtesl from fihe Northeriy line of ssid Lot 10,
We hereby certify thal this is a true and correct representation of a survey of
: the boundarfes of the (and above described and of the location of alFbuilding�
� if any, thereon, and all visible encroachments, if any, from or on said land.
• Stakedbuilding this �4th day of June, 1973.
Dated �his 23r� day af M�Y , 1972 . EGAN, FIELO b NOWAK
� ' R v t sed �h i s 20th da of June 1972. rveyo � ,��� " }
� �� } ��� � �'�,�.����-.-'
r ' tr_ �_►�� <A� 0....L �1.. 'I A�r._l d bY t ♦c,tr5v1 �
DATE TIME
CI fY OF ORONO CALLED IN Iv��/��YZ_T_
INSPECTION NOTICE SCHEDULED �� - /� ��' ' -3a
PERMIT NO. 4� 9� COMPLETED ►� �(
ADDRESS � 7 �-� /`���Z-0 PZ�.� �l.�
OWNER�-.C��.f-t�r,�-�.� CONTR. � � r �
TELEPHONE NO. /�`� � �� `��
� DESCRIPTION
W 1 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
h
Q 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
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 O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
Q
= 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� WORKSATISFACTORY:PROCEED � PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED ,-! ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r- pHOTOTAKEN
INSPECTOR WIIL RETURN
C STOP ORDER POSTED.CALL INSPECTOR �-' CITATION ISSUED
❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr o��ite: _
Inspector v
White Copyllnspector' File Canary CopylSite Notice
� D�ATE � % TIME
CITY OF ORONO CALLED IN �� .�4 /� / � l"' G �° �
INSPECTION NOTICE SCHEDULED J�` 3� -9� •' d a'�
PERMIT NO. �S g� COMPLETED j� �� ' � '� � ' ?�
ADDRESS � 7�� ,���--�A�-����
OWNER �C(� CONTR. �L �
TELEPHONE NO. � �� ` ��D�9
� DESCRIPTION
� 01 F 11 MECHANICALRI 16WELLTESTPUMP
Q 2 F AMI � 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
� INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z . 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
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WORK SATISFACTORY:PROCEED i7 PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C: ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �_ PHOTOTAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractocAn s,i�ez
inspector. �;`' ���'Fti . _
,��.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �"a�"G3
INSPECTION NOTICE SCHEDULED 3— �—q� /�s�
PERMIT NO. y 5�9� COMPLETED �_ �L�
ADDRESS�'7.? � �►1 P Q Saw � d'�cx
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION ��°I.IM 0 d �P l
llr 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
�
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 INAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 7 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
� 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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