HomeMy WebLinkAbout1999-011604 - deck replacement/siding PERMIT
� C�'TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number. � ` ' ��-' `"�'
Crystal Bay, Minnesota 55323 Date Issued: �"��' v'�""� ;
(612)473-7357 :�i r',��:�;� .::_:=_
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — ;�:��_.�_� ; ,�:�,,,t. —
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APPLICANTi ERMITEE SIGNATURE ISSUED BY:SIGNATURE '��
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� Total Fee: $ %C��::� � ��' � Date Received:
Entered By: �-�' Permit#: %%�C`�
CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
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JOB SITE ADDRESS: 1' C� N IP: ���� 7�
�7 a , �-7�a�
NAME OF OWNER: / U�' PHONE: (home) G7
, (work)
MAILING ADDRESS: ��'/ CITY: ZIP:� �c
CONTRACTOR: PHONE:
CONTACT PERSON: l�bC,��� � MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describ 'n detai�:
,
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
av
ESTIlVIATED CONSTRUCTION VALUATION (excluding 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 ermit and work is not to start without a
permit; and that the work will be i co e w' th approved plan.
.� �d �.�
APPLICANT'S SIGNAT � DATE:
NOTE! Parade of Homes events require separate p mit approval by Police Department and
City Council 60 days prior to the event. Non permi ed events will not be allowed.
5
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is sWred or to be sWred shall be as set forth in this section.
Subd.2. Informati�reqidred to be given lndividual. An individual asked ro supply privau or confidential dara concerning himself
shall be informed of: (a)the purpose and ince�use of the requested data within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or
refusing to supply privau or co�'ideadal daffi;and(d)the identity of other persons or entities authorized by slabe or federal law W receive the data.
This requirement shall not apply when an i�ividual u asked W supply investigative data,pursuan.t to section 13.82, subdivision 5,to a law
enforcement officer. �
The c�mm��sioner of revei►ue mav nlace the no6ce reauired nnder this subdivision in the individual income taz or orocertv tax refund
inst�uctions i�tead of on thos�forms.
Subd.3. Access to data by individual. Upon request to a nsponsible authoriry,an individual shall be informed whether he is the
subject of stored data on iadividuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who
is the subject of stored private or public data on indivLduals s1�all be shown the data widiout any charge to him and,if he desires,shall be informed
of the conunt and meaning of that data. After an irdividual has been shown the private data and informed of its meaaing,the daha need not be
disclosad ro him for six months thereafter unless a dispute or acdon pursuant co this secdon is pecding or additional daha on the individual has been
collected or creared. The responsble suthority shall provide copies of d�private or�blic data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person w pay the acwal costs of maldng,certifying,and compiling the copies.
The responsible audiority shall comply immediately,if possible,with airy request made pursuant to this subdivision,or within five days
of the date of the request,eacluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
t6e request within that time,he shall so iaform the individual,arui may have an additional five days within wluch to comply with the request,
excluding Saturdays,Sundays a�lega(holidays.
Subd.4. Procedure when data is not securate or complete. An individual may contest the accuracy or completeness of public or
private daC�co�eming himself. To exercise this right,an individual shall notify in writing the responsible authority descn'bing the nature of the
disagreemetrt. The responsible suthority shall within 30 days either: (a)correct the data faud ro be inaccuiaoe or incomplete and attempt L�nodfy
past recipients of inaccurate or i�omplete data,including recipients named by the individual;or(b)nodfy the individuai that he believes die data
w be conect. Data in dispute shall be disclosed only if the individnal's statement of disagreement is i�luded with the disclosed data.
The deurminadon of d�e responsble authoriry may be appealed pursuant w the provisions of the administrative procedure act relating
to contested cases.
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�ity 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 qualificarion 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 rigb.ts under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
Ci�y State Zip Phone
I understand my rights as stated above.
signature
6
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE U�SE ONLY
ADDRESS OR LEGAL: � 3`�� ���% ���: ��-t �',2 �k�.
PID:
DESCRIPTION OF WORK: ��-�c�= , --p��_,.,�.�'t ��;� -�,�.-� �.�,�a-c� -�-5�n;n�_�
------------------------------------- --------- - ----------------------------------------------------------v--�-
ZONING REVIEW BY: ��� DATE APPROVED: G 3 t
BUILDING REVIEW BY: ,!) `, ' DATE APPROVED:
FEES TO BE CI��iTED: Misc. Fees Calculated By:
PERMIT Yes <�' No
PLAN REVIEW Yes ri' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONII�IG CHECK LIST Zoning District: �z.v C_���
Fire Department: Post Of ce: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes o Date of Survey:
Proposed Setbacks:
Front (Lake): R ght Side:
Rear (Streetl� ft Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: Resolution Date:
Shoreland District:
Avg. Setback: Blu f Setback: Lot Coverage:
Ex' ting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
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BUILDING REVIEW CHECK LIST
UBC: f� � � � CONSTRUCTION TYPE: ���
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
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Estimated Construction Value: $ ��U v�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
J�Footing Septic Sewer Connection
aC Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
� Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
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REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT�:
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T TIME
CITY OF ORONO CALLED IN � �
INSPECTION NOTICE SCHEDULED S' /��- �v
PERMIT NO. /r/ �C�`� COMPLETED
ADDRESS��'SD ���.�• �o:�, ,
OWNER CONTR.
TELEPHON �NO. 'S1'.:Z— '�/�-�
� ION l�i.c'�/
01 F 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMIN 13 MECHANiCAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. � 21 COMPLAINT
� 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_N j
� COMMENTS: �
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W ❑WORKSATISFACTORY:PROCEED G PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. n pHOTO TAKEN
INSPECTOR WILL RETURN
�- CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR `
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. ���.--'L�,(�V�
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Call for the next in ction 24 hours in advan .
OwnerlContr r o sit
Inspector.
White Copyllnspector's File Canary CopylSite Notice