HomeMy WebLinkAbout1997-009187 - deck ,- r. PERMIT
�ITY OF ORONO PERMIT TYPE: —
2750 Kelley Parkway- P.O. Box 66 Permit Number: -��-`""�-'�w��'
Crystal Bay, Minnesota 55323 � - - _ _ _
(612)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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PPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE .GfC,
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• Total Fee: $ .�7�,.'�� Date Received: �/�/U�q�7
Entered By: _ Pernut#: ,�7
CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR NTRACTOR
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JOB SITE ADDRESS: -�1 D(� �����WO(� �1 R GL�' Z�: �S 3�3
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NAME OF OWNER: �� I✓1 G�-S l�f� PHONE: (home)
�����: (work)
MAILING ADDRESS:3�0 D �� �(� w00� CITY: 0 Q�j�up, ZIP: S,�3 z3
CONTRACTOR: /� �2�7 �L�9-1��F CD w���o, PHONE: q_�� �4�,�3
CONTACTPERSON: Qp(r-F� t�cG��(L�� MOBILE/PAGER: � - R�dL
MAII.ING ADDRESS:�Q(�S Gr��'L 1?)�'�l t�.-J UtJ. CITY: p�� � �rz1�IP: �53�6
STATE LICENSE: # �'��
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ARCHITECT/ENGINEER:�U I-iJ►�'1� ���5(�,-��F PHONE: ��� -y 3r�
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure �� •
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �c,�lL� � L� v F L �F� /�-3 ��K
_P a,� o o�� � � O��✓�. �ss s a �r. _
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ /j o a�• UD
I hereby apply for a building pemut 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 pemut and work is not to start without a
permit; and that the work will be in accordance with the approved plan. �
APPLICANT'S SIGNATURE: , � DATE: �:-� - 9 sI
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
S�bd. 1. Type of data. The rights of i�ividual on whom the data is swred or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be inforn�ed of: (a)the purpose a�i�nded use of the requested data within the collecting state agency,polidcal 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 to supply private or confidecrtial data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5,to a law
enforcement officer.
The c�rt�micsioner of revemie mav nlace the notice req�ired under this subdivision in the individual income taz or nronertv taz refu�
instrucdons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an i�ividual who
is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed
of the content and meaning of�at data. After an individual has been shown the private data a�informed of its meaning,the data need not be
disclosed to him for siz months thereafter unless a dispute or ac6on pursuant to dvs section is pending or addidonal data on the uxlividual has been
collected or created. The responsble sudvority shall provide copies of the private or public dara upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request,excluding Sawrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,
ezcluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An i�ividual may contest the accuracy or completeness of public or
private data co�eming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the namre of the
disagreement. The responsible audwrity shall within 30 days either: (a)corr�t the data famd to be inaccurate or i�omplete and aaempt to notify
past tecipients of inaccurate or i�omplete data,including recipients named by the individual;or(b)notify the individual that he believes the data
to be correct. Data in dispute shal(be disclosed only if the i�ividual's statement of disagreement is included with the disclosed data.
The determination of d�e responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
to contested cases.
DATA PILiVACY 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 City of Orono or any of its departments may require you to furnish certain
private or conf'idential information.
You aze notified that:
1. The information you fumish 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 shazed 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 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.
First Middle I-ast
Address
City - State Zip Phone
I understand my rights as stated above. .
Signawre
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �i C o 2 i�Q tu G'�=�%���=� C-,��::
PID:
DESCRIPTION OF WORK: ia� �„Cac.
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ZONING REVIEW BY: `- �,�„�,_._ DATE APPROVED: 7 -t� <<?
BUILDING REVIEW BY: _ � ' 4�.��. DATE APPROVED: > -��. `7'�
-------------------------------------------------t --------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes v" No
PLAN REVIEW Yes Y— No SEWER CONNECTION
STATE SUR`I�ARGL Yes �/ No WATERCONNECTION
INVESTIGAT'ION FEE Yes No PARK FEE
SAC Y�s No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST zoning District: 1���' iL�
Fire Department: - � � C.� Post Office: (�c:,.� L�-1cA: School District: L�/C.t:.,�-t��
Lot Area: Sq.ft. /L�;� L.Ih4�-�'Acres — Width I/L��=�-�•�� Depth
Survey Submitted: Yes � No Date of Survey: G "��'' ���'
Proposed Setbacks: r
Front (Lake): _ Six` � � Right Side: `{� �
Rear(Street): ��� Left Side: i 2.�- ` r
Adjacent Structures: 0�'T'T�C if2.3� Wetland: t�+' 1/�-
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 Dis�ict: .
Avg. Setback: Bluff Setback: Lot Coverage:
� Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
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BUILDING REVIEW CHECK LIST
UBC: �2 � � CONSTRUCTION TYPE: ��1i
' Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gazage x =
x =
TOTAL
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Estimated Construction Value: $ !�, ������
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
+�Footing Septic Sewer Connection
uG Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
OC Final Grading/Filling Electrical (State Pemut)
Other
REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE NOTED ON PERMIT):
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existinF bi.it:�in��s, if any, thereor., r:n�; tP;r.� � � •
. .pro�sed location of a prox��ed builcin�;. It ,a�es 'a:3Z �
not purport to sl:ow oLher impro>>ements or encro�r..h�:�ntn. ¢�" �
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Scale: 1" - 6U' c:or,c� ;'. Co�'fir, :te�'. . .<;05l�
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DATE TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE SCHEDULED � -�> 7 v�' c.���
PERMIT N0. �� 7 COMPLETED � lo�
ADDRESS / ` � `�'� �
OWNER��� ._�� CONTR. � ��r-��
TELEPHONE NO. ���'S�- �7��3
� DESCRIPTION �1.r./?/"
� 01 FOOTI 1� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
y 02 FRAMING 13 MECHANICAL FINAL 19 L4KESHOREJWETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= 05 FINAL 14 SEWER HOOK-UP 06 PROGFESS
~ 07 DEMO�ITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED
W� PROJECT COMPLETE
W C CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR - CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra o it�:
Inspector. '
White Copyllnspector's File Canary CopylSite Notice
�7 DATE 7 TIME
CITY OF ORONO CALLED IN / �� ���/
INSPECTION NOTICE SCHEDULED �_3� �. 3 G
PERMIT N0. ���� COMPLETED
ADDRESS 3��� /�4t� �-c,v-t � (�
OWNER ��A�,/'..t� CONTR/� ` �fu-2, ��7'1.�Z�`
TELEPHONE NO. _ �7 3 7 � ��dZ�
� DESCRIPTION _ 1'��-t-f�'�--
� 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
� 04 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
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Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d ORK SATISFACTORY:PROCEED - PROJECT COMPLETE
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WC'. CORRECT WOFK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. — pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ^ CITATION ISSUED
� INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac r 'site��
Inspector. �f"�-���
White Copyllnspector's File Canary CopylSite Notice