HomeMy WebLinkAbout1995-007526 - interior remodel � PERMIT
�ITY OF ORONO PERMIT TYPE: - - -
2750 Kelley Parkway- P.O. Box 66 -.��_�_:,�_���r �-_
Crystal Bay, Minnesota 55323
Permit Number: �:;;i,�.-:�,��;:����
(612)473-7357 Date Issued:
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: ` �� '- - � - � OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE '
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Total Fee: S '���.�'�i DateReceived:�/- �j-�,S
DateApproved:
Entered By: ,('�, Permit7: �'��,.Z �-
CITY OF ORONO - BU�DPIG PERI�IIT APPLIC�TION
AI.L�F'OR1ti1ATION litiST BE SLBl�1ITTED L�t FULL BEFORE PL�`T REVIEW WILL
BE ST:�RT'ED
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THE :�PPLIC.-��iT IS: (circle one) O�V�1ER OR�CONTRACTOR�'
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JOB SITE �DDRESS: � " -`: � �� �� � -
NAiti1E OF Oti�NER: -,uf��� ��' �l,��''��`�'<i,.•� 1���=� PHON"E: (home)�J� ' �c�-'
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vI�INGADDRESS: ��f� � Z� PC -CITY: Z�:
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CONTRACTOR. -�= 1'.�`,l � tr' 1'?1�%`, Ci"a;�,��4k`�r"6lPHONE: �,j�f, / �
T' �IpBILE PHO�IE/PAGER:�
v1AILINGADDRESS.z k-; � �, � ��,� �s, CITY• , t 4 ��— ZIP: z,_.�.
•�,�1'�.-� � Y- � ��r�,
ST�TE LICENSE: # ��� �' _
�RC�II'I'ECT/ENGliYEER: PHO��tE:
l�1AILI�IG�DDRESS: CITY: Z�:
���,�: REGIS'I'RATI0�1 �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �_ I.and Alt�rarion
PROPOSED WORK(describe indetail): �r��� `/f��'�0�+����'� �� ��`�-�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: G�RAGE ST�LLS: ATT. DET.
EST�1�"I'ED CONSTRUCTION V�I.L'ATION(eYcluding land): S �,� S U CJ • �"�
I hereby apply for a building permit and I acknowledQe that the inforriation 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 plan.
' SIG�v���: �/"; -/ /'s. ,���'�'��iT DA�: �/�"�% /t��
:�rrLICANT S
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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`'�,� , , ��.' - '� ��' Crysial Bay,�linnesota�53Z�OObb
�9kESH�4�
DAT� PRIVACI' ADVISORY
In accordance «�irh �i.S. 13.0�> Subd. ?. "Ri�hts of subjects or daca", �ve would like to
inform you that your request ror a p�:mit or license irom the Cicy of O:ono or any of its
depanments may require ��ou �o :�s�sn cercain pri��a�e or conridential intormaLion.
You are notiiied that:
1. The info�-rnacion ��ou �srnish will be used to determine ��our qualification for the
permit or license reauested.
?. You may refuse to supply data, but refusal may require that the City der.y the
pernit or 'icense.
3. The information may be snared with other local, state or federal aQencies to tr:�
extent nece55ary to o.o::ess «�� PerM�t or licer.se.
4. If ��our :equested �e:mit or license requires Council action to approve. sorrie
inrormacion may becom� DUDIIC.
� You have ce-:ain ri��ts under ��1.S. 13.04 (see fo!Io�j�inR p3Q�) to review private
data on �ourseLf.
6. Your iull name is :equired to process this applicacion or permit-
PL�asE P�rr
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I understand my riahts as srated above.
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Sianacure
v TELEPHO?V�-�373-1357• FAX-�373-0510
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�.� �Gg� �g gQg�7ECTS OF DATA
Subdivision L T�ipe of ��- The rights of i�ndividusls on whom the data is
stored or to be stored shall be ss set forth in this sect An.individual asked to
Subd. 2. Information required
to be given in�ividuaL
� 1 rivate or confidentiel data concerning �TnWithin the collecting state agency,
supp y P
purpose and intended use of the req em'd �b�whether he may refuse or is legallY
political subdivision, or statewide sys }�own consequence arising from his
required to supply the requested dat8; tc) �y
su 1 in or refusing to supply private or confi federal law to re�e1ae he data.1tThis.
PP Y g state or
other persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an indt�vla�w en orcementuofflcer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lace the notice re uired under this
s
ubdivision in the individuel income tax or ro ert tax re und instructions instead o
on those orms. � - --- - .
Subd. 3. A��
to data by in�vidu�L Upon request to a responsible
uthorit , an individuel sha]1 be informed whe blic h r vate or confidential.e Upon his
a y ublic data on
individuals; and whether it is classified as p � P
further request, an individusl who is the subject of se to�mrl���he �ires, shall
individuels sha11 be shown the dat8 v�►itho of�hat da a• After an individual has been
�e informed of the content and meaning the data need not be c�isclosed to
shown the grivate date and informed of its u���action pursuant to this section is
him for six months thereafter unless a �Q n request by
� din or additional data on the individual h�8te or public datarupoeated. The
, pen g require the
responsible authority sha11 provide copies of t e p �in the
The respcnsible authority may
the individual subject of the �ta• certif n and comp g
requesting person to paq the actual costs of making, Yi g'
copies. lmmediately, if possible, with any request
The responsible authority shall comply '
ade ursuant to this subdivision, or within.flg e �f Simmediateatcompliance eisu not
m P S�de and legal hol�d ys,
excluding Saturdays, �With the request within that time, he shall so inforth the
possible. If he cannot cornPlY within which to comply
individuel, and may have sn additio�d le al�hol�days.
request, excluding Saturdays, Sundeys g
te or complete. An individual maY
Subd. 4. Proced�e �►hen data is IIOt a�rivate data concerning himself. To
contest the accuracy or completeness of public or p the responsible authority
exercise this right, an individuel shall notify in writing
eemenL The resPonsible authority shall within 30
describing the nature of the disagr lete and attempt to
days either: (a) correct the data found to be lete data�includingrecipients named by
notify past recipients of inaccurate or incomp
the individual; or {b) notify the individue� tn�dual'slstatementof disagreement is
�f the i
Data in dispute shall be disclosed only �t to the
• included with the disclosed data• � appealed purs
' The determinatioa of the responsible authority may
provisions of the administrative procedure act relating t� contested cases.
�
• CHECK OFF LIST FOR ISSUAI�iCE OF PERII�T'S
FOR OFFIC�,USE ONLY
�1DDRESS OR LEGAI.: / 3�� I���,� ��K� �'���
PID:
DESCRIPTION OF WORK r ,r � � Z k ._�'�'�'�`�2 �`J"�
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------------- --------
ZOi�tING REVIEW BY: DATE APPROVID: �/ p
BUIIIDING REVIE`� BY: DATE APPROVED: � t i_i3-5s
- ---------------------
FEES TO BE CHARGED: 1�1isc. Fees Calculated By:
PERI�IIT Yes '� NO
PLAN REVIEW Yes �' No SEWER CONivECI'ION
STATE SURCHARGE Yes t/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTE INSPECTION
Number of SAC Units OTHER (specify) �Y N �
---------------------------
Z0��1G CHECK LIST Zoning District: _ Shor d District:>,.
Fire Department: _ Post Office: School ist ct:
Lot Area: Sq.ft. Acres idth Depth
Survey Submitt . Yes No Date of Survey.
Proposed Setbac :
Front ( e): Right Side:
Rear (S eet): Left ide:
Adjace Structures Wetl d:
Building Height Def. Hgt. Peak H°t•
Avg. Setback: Bluff Setba : Lot Coverage:
Existing Proposed
Hardcover: 0-75 -
75-250'
250-500'
500-1000'
Hardcover V ance Required: Yes � o D te of Council Approval:
Grading: St Approval Date: By: Council Approval Date:
Septic: Staff pproval Date: By
Zoning File: _—
Resolutio # Resolution Date:
g;���[�R��S (in house):
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.
BUII.DING REVIEW CFIECK LIST
UBC: �-3 CONSTRUCTION TYPE: `��
� Sq Footage S Per Sq Ftg
Basement x =
1 st Floor x =
2nd FIoor x =
Garage r =
R =
TOTAL
p6
Estimated Construction Value: $ �3� 5�� '—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_ /�( Footing Septic Sewer Connection
�o Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit) '
pL F�� Grading/Filling _S Electrical (State Permit)
� Other
REMARKS (IN HOUSE): -
--------------
REV�W BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY�
RENIARKS(TO BE NOTED ON PERil�1IT):
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED = �
PERMIT NO. �' COMPLETED 1- ' S b ►�='�
ADDRESS <S �- �
OWNER CONTR.
TELEPHONE NO.
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� DESCRIPTION
�� FOOTING '� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOp TO MEET YOU:_YES_NO
h COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�/ERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract on ',�,�te:
Inspector. U'✓""'-�`
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN ��_�� _ �,�
INSPECTION NOTICE__ � scHE�u�Eo // - ��' /- -��
PERMIT NO. J' ``� ✓�� COMPLETED
ADDRESS ����t �c�'_�,f %-��:<,:.:� Ll�
OWNER��i,�./% %u� /% '�'� CONTR. l���:f';,: ; ,� ��4.��d C;;,:.'j'
TELEPHONE NO. `�~�r �- /���5��
�
� DESCRIPTION � �� y��
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q03 I Sf�ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z�4 WALL BD 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTiC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ,- pHOTO TAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR r' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contract it :
Inspector.
White Copyllnspector's Fil Canary Copy/Site Notice
DATE TIME
CITY OF ORONO � CALLED W l / '
INSPECTION NOTICE�'`�� SCHEDULED � � � : ��7
PERMIT N0. COMPLETED �� iC
ADDRESS �3--�`t ��-�-�'�`���1�« '
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� DESCRIPTION �,Q.�-zaz�c,�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 W BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� f� O-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUM � � 36 FOUNDATION/REMOVAL
� OWNE ICONTRAC R TO MEET YOU:�' YES_NO
� COMMENTS:
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d �ORK SATISFACTORY:PROCEED �PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r' PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOPORDER POSTED.CALL INSPECTOR r' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7357
OwnerlContracto ite
Inspector. �
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