HomeMy WebLinkAbout1999-011612 - replace deck PERMIT
CIT•Y OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 -��,,;;:_.:`�i r��:,=
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: ;��'� '�'T'�'�
(612) 473-7357 i��;;�;:i��'f'°=:�=
SITE ADDRESS:
DESCRIPTION:
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REMARKS: '
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FEE SUMMARY:
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AP CANTiPERMITEE S NATURE ISSUED BY:SIGNATURE
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Total Fee: $ � - Date Received: (�����'�
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Entered By: � Permit#:
----r-.
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: '�7�9 � S`�a h�s���i� �� - ZIP:
NAME OF OWNER: �-��1 r�- �J(Z r N�2� PHONE: (home) ��?1 -13 5 3
(work)
MAILING ADDRESS: �� CITY: ZIP:
�`, ��� ��r� a
n � � :
CONTRACTOR• ��� ' �i.L �i �� ��;�ry� '�_ PHONE: ���5� " �3`�S ,
.� )�
CONTACT PERSON: 1� MOBILE/PAGER:
MAILING ADDRESS: �� ���'l o ��'t!� � � CITY: yb��'j {{(�- . ZIP: ��'1�J � `��rs�f rj
STATE LICENSE: # �c'��
ER: �� . II L��� �, �� PHONE:
ARCHITECT/ENGINE � �
MAILING ADDRESS: CITY: Z�:
N�,�: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: T�e l���`c: o � -�
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED 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 permit and work is not to start without a
permit; and that the work will be in acc a e h e approved plan.
;
APPLICANT'S SIGNATURE: ` DATE: � p
� �
NOTE! Parade of Homes events require separate permit approval by Police De artment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
Sec.13.04 RIGHTS OF SUBJECTS OF DATA •
S�bd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shalt be as set forth in this section.
Subd.2. Information required to be given individual. An individual aslced ro supply privatc or confidenaal daha concerning Ivmself
shall be informed of: (a)the pu�pose and intended 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 known consequence arising from his supplying or
refusing oo supply private or co�idential data;and(d)the ideatiry of ot6er persons or entities authorized by shate or federal law to receive the data.
T6is requirement shall not apply when an individual is asked to supply investigadve data, pursuant to section 13.82, subdivision 5, W a law
enforcement officer. �
The wmmissioner of revenue mav olace the noace reauired under this subdivision in the individual income taz or omnertv taz refund
ins�cdons instPad of on thoss forms.
Subd.3. Access to data by indivIdual. Upon nquest 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 individual who
is the subject of stored private or public daha on individuals shall be shown the data without arry charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an ic�ividual has been shown the private data and informed of its meaning,the data need not be
disclosed oo him for siz mo�hs theceafter unless a dispute or acdon pursuant to this section is pe�ing or addiaonal data on the individual has been
collecud or created. The responsible authoriry shall provide copies of die private or public data upon request by the individuat subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of maldng,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 Saturdays,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 i�ividual,and may have an additional five days within wlilch to comply with the request,
excluding Sauudays,S�ndays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An i�lividual may contest the accuracy or completeness of public or
private data concerning himself. To ezercise this right,an individual shall notify in writing the respoasible authority describing the namre of the
disagreeinem. The respons�le authority shall within 30 days either: (a)correct d�e data fou�to be inaccurate or incomplete a�attempt ro notify
past rxipientv of inaccurate or incomplete data,i�luding recipients named by the i�ividual;or(b)notify the individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determitmtion of ttu responsible authoriry may be appealed pursuant to the provisions of the administradve 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 fumish certain
private or confidential information.
You are 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 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 underM.S. 13.04(available upon request)to review private data on yoursel.f.
6. Your full name is required to process this application or permit.
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Firs� � �I I M dle Last
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Address� !n�N -
1M . b►,� y53�S "71$-�3'-�5
Ciry State Zip Phone
I un rs i ed above.
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Signatur
6
. �
. CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �-7 co c� � ru,r4-,r�c,�w�c.� �n-r�
PID:
DESCRIPTION OF WORK: _����
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ZONING REVIEW BY: DATE APPROVED: 7- � • 4 g
BUILDING REVIEW BY: DATE APPROVED: � -1 -g`i
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERII�IIT Yes ✓' No
PLAN REVIEW Yes _� No SEWER CONNECTION
STATE SURCHARGE Yes v No WA'TF,RCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZOi�1ING CHECK LIST Zoning District: L/� -�L
Fire Department: yv��.,�n,-J Post Office: �-�4,rY-� School District: p�W�
Lot Area: Sq.ft.JQF]n p Acres •2� Width Depth
Survey Submitted: Yes oC No Date of Survey:
Proposed Setbacks:
Frerrt (Lake): �3� � Right Side: �•6•
Rear (Street): 9 Z� � Left Side: 7�0�
Adjacent Structures: qrnqcN-tz� Wetland: N�/�
Building Height: Def. Hgt. /V (/� Peal:Hgt.
Lot Coverage: ('j.��
Grading: Staff Approval Date: --- By: Council Approval Date:
Septic: Staff Approval Date: ^ By�
Zoning File: # 24 9� Resolution: # Resolution Date: (-Lg-9 F
Shoreland District: �,/��
Avg. Setback: m�cc Bluff Setback: '— Lot Coverage: '—
Existing Proposed
Hardcover: 0-75 �►•9� 1 I•9`(
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes�_ No Date of Council Approval: G• Z� '`�`t
REMARKS (in house):
7
— . . .
.
BUILDING REVIEW CHECK LIST
UBC: 2• 3 CONSTRUCTION TYPE: V/l�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
o;
Estimated Construction Value: $ y�UDO
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
pc Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�Final Grading/Filling Electrical (State Permit)
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 PERMII�: N��w� e2 �=����-s /L�'j✓��
8
� STATE OF MINNESOTA �
� .,, ``��t��U"•.. DEPARTMENT OF COMMERCE
$�,, A�'� 133 East geP�g�, STATE OF MN DEPT. OF COMMERCE
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�':i�'+'''� 3k Paul,MN SS101 �� � �
BUILDING CONTRpCTOR (65l)29b-6319 °F`
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BUIT.DER �858 BUII�IIJG CON1ZtACTOR "���,��:1....��;
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INDIVIDUAL PROPRIETOR
Bi7II.DER
F�ires: 03/31�2ppp INDIVIDUAL PROI�RIF.TOR
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MCGALL JEFF'CON3TIt Cp �Pires: 03l31/2ppp
3410 TI�1y1qI,L I JEFF MCCALL
MNTKA MN 55345-0000 ��CE dt�e by 3/31/20pp
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3410 TF�MAI.L
M�TKA MN 5534S-O�O�Op
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-7 DATEG TIME
CITY OF ORONO CALLED IN /'"�� ! �I � � O
INSPECTION NOTICE SCHEDULED �� f/� '�c�
PERMIT N0. ���'�'� COMPLETED
ADDRESS � C �L
OWNER �/Lt.��, CONTR.��� C� C,�P`•
TELEPHONE N0. �� t�— �.3 ��S
�• D l�T.lflN
� �p1 FOOTING � 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 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
� 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_NO
� COMMENTS:
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W� ❑WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑ CITATION ISSUED
C� INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-73�J7
OwnerlContr or on site:
Inspector ' �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �r � g%3�
INSPECTION NOTICE SCHEDULED 7-a-a- O'. d
PERMIT NO. ��(���� COMPLETED
ADDRESS _ I�Lo0 �'�Ac�G w�c�
OWNER ,1,��I�►'lrt�" CONTR. c�� J�Cf a,�L
TELEPHONE NO. �I g ' �c3 Y�
� DESCRIPTION �U�C� T`�Y1 c(�
ly� 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 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAfNT. 21 COMPLAINT
J 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑CO RECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r� pH0T0 TAKEN
INSPECTOR WILL RETURN
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❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next ins ection 24 hours in advance.473-7357
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Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �1
INSPECTION NOTICE SCHEDULED �/����� � o �
PERMIT NO. �� COMPLETED 2 q � ���
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� DESCRIPTION ��i�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 W BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA 14 SEWER HOOK-UP 06 PROGRESS
� EMO-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 PLUMBI 36 FOUNDATION/REMOVAL
Q OWN CONTRACTOR MEET YOU: YES_NO
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
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