HomeMy WebLinkAbout1999-011838 - screen porch window PERMIT �
CITY OF ORONO PERMIT TYPE:
2�50 Kelley Parkway - P.O. Box 66 _ _ _ .
Crystal Bay, Minnesota 55323 Permit Number: _-;:..;_,: ;:; ;�.�:;;
(612) 249-4600 Date Issued: ;:;�, �:�;::;=;
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: _ -.�;: � ; .�,;;-�;. --
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APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE
, Total Fee: $ �`f `�,�� Date Received: " � �`
Entered By: � Pernut#: % �.3�
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` CITY OF ORONO - BUILDING 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
JOB SITE ADDRESS: �,3iC� �f�s,% ;y�i� L�,J ZIP: �, . (�
� �:,11�)-�� , i7,�.�
NAME OF OWNER: ��?i� ��f�1�Hr2; PHONE: (home) �-/ �� -�Zc�
(work)
MAILING ADDRESS: ��;C- ���:S� �'T � � CITY: v,2��;=,�> ZIP: �, � � . �-�
CONTRACTOR c� w N-c�. PHONE:
CONTACT PERSON: 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(describe in detain: �j ; �c � c�r' .3 SF.���::� ��»�rf � �iv» _
i -�:��� � � ��,;��;�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excludin land): $ , ``�J
g ��C/Ci .___-_.
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 wi tlie proved plan.
APPLICANT'S SIGNATURE: DATE: �/����
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.
5
� �
Sea 13.04 RIGHTS OF S[JBJECTS OF DATA
S�bd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in ttris secdon. -
Subd.2. InformaHon required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the pu�pose and inteaded use of the requested data within the wllecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing ro supply private or confidential data;and(d)the identiry of other persons or endties authorized by state o�federal law to receive the data.
This requirement shall not apply when an individual is asked to supply.investigative data,pursuant to secdon 13.82, subdivision 5, to a law
enforcement o�cer.
The com�++�ssioner of revernie mav nlace the notice rewired under this subdivision in the individual income taz or oronertv taz refund
instr�ctions instead of on those forms.
Subd.3. Access to data by indivfdual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of sWred data on individuals,a�whether it is classified as public,private or confidential. Upon tus further request,an individual who
is the subject of soored private or Iublic data on individuals shall be shown the data without azry charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need�t be
disclosed ro him for s'vc monihs thereafter unless a dispute or acrion pursuant oo this section is pending or addiaonal data on the individual has been
collected or created. The responsffile authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual costs of maldng,certifying,and compiling the copies.
The responsble suthoriry.shall comply immediately,if possble,with any request made pursuant to this subdivision,or within five days
of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediau compliance is not possible. If he cannot comply with
the request within that time,he shall so inform the individual,and may have an additional five days within wluch to comply with the request,
excluding Saturdays,Slmdays and legal holidays.
S�bd.4. Procedure when data is not accurate or complete. An individual mag cbntest the accurncy or completeness of public or
private data conceming himself. To ezercise dris right,an iffiiividual shall notify in writing the responsble authority describing the nature of the
disagreemeirt. 'The responsible authoriry shall within 30 days either: (a)correct the daffi found ro be inaccurate or i�omplete and attempt to notify
past recipiems of inaccurate or incompleoe data,iacluding recipients named by the individual;or(b)notify the i�lividual that he believes the data
to be cornct. Data in dispute shall be disclosed only if the i�lividual's statement of disagreement is included with the disclosed data.
'Ibe denermination of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating
to contested cases.
UATA 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 Gity of Orono or any of its departments may require you to fumish certain
private or confidential information.
You aze 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 local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council acrion to approve, some information may become
public.
5. You have certain rights 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.
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First Middle Last
l 3i� �FS� OI— i� ti
Adaress
�2o,�v /`'�'l I� �'S 3�� ,`' �� -fs'o Lc�
City State ip Phone
I understan my righ s above.
Signawre
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, � CHECK OFF LIST FOR I5SUANCE OF PERMITS .
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I 3 l U Rx3r Po,n,-► (��� -
' PID:
DESCRIPTION OF WORK: S c�x�w �RC N -4-0 �t s�s��
----------------------------------------------- ---------------------------------------------------------------------
' ZONING REVIEW BY� DATE APPROVED: ci • 9 - 9 5
BUILDING REVIEW BY: DATE APPROVED: Q - S - 5 5
--------------------------------•------- ------ ---------------------------------- - ------------------------ .
FEES TO BE CHARGF�D: Misc. Fees Calculated By:
PERMIT Yes ✓ No '
PLAN REVIEW Yes �Y No _�� SEWER COrfNECTION
STATE SURCHARGE Yes t/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify) '
------------_---_________________________�______�-----------------------------------------------------------
I
ZONING CHECK LIST Zoning District: N c� ,'
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth '
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Reaz(Street): Left Side:
Adjacent Structures: Wed d:
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
. �,
Zoning File: # Resolution: # Resolution Date: '
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-10�0'
Hazdcover Variance Reqlured: Yes No Date of Council Approval:
REMARKS(in house):
7
BUII.DING REVIEW CHECK LIST �
UBC: 1�•3 � �- � CONSTRUCTION TYPE: `(/J
• - � - Sq Footage $Per Sq Ftg
Basement x =
�Ist Floor x =
2nd Floor x =
Garage x = �
R =
TOTAL �
Estimated Construction Value: $ �,�Ov
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Inspections Required: Work Requiring Separate Permits:
Site Plumbing. Fire
Hardcover Removal Mechanical , Water Connection
Footing �Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
Insulation (Masonry.) Other
Wall Board (Mfg.) Well(State Permit)
�_ Final Grading/Filling Electrical(State Permit) �
Other
REMARI�S(IN HOUSE): . _.. _
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERNII�:
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO CE � ����
Mt� �SCHEDULED �
PERMIT N0. �coMP�ErEo r ; Uc�
ADDRESS 1��J 1 0 �S�" ��l t' � �--�
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION -�r�C�.%��
L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WAL�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
� 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
D COMMENTS:
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O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
�TOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
inspector. !vl a.����vI J
White Copy/lnspector's File Canary Copy/Site Notice
DAT� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �
PERMIT NO. 6�..l�3� COMPLETED � � �U
ADDRESS_ I3I O �S'�' � L-�G✓�.
OWNER CONTR. ��•
TELEPHONE NO. �74` ' �O a0
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL 8D. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
fl COMMENTS:
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d �110RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
� INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwneriContractor on site:
Inspector.��. ��-+/I S
White Copyllnspector's File Canary Copy/Site Notice