HomeMy WebLinkAbout1998-010274 - interior bath remodel ,
° PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �;t;���i a�si;
Crystal Bay, Minnesota 55323 Permit Number: a��;.��;�
(612) 473-7357 Date Issued: -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — �����_� ; ��,;-�t. _ :�:T . !;i: . OWNER:
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APPLICANT PERMITEE SI ATURE ISSUED BY:SIGNA E
CHECK OFF LIST FOR ISSUANCE OF PERNIITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: / 7 r d �� �j�c,.��� �.z���' <c��
rm• /�-���_ ;� 3 �z1 ���,� '�
DESCRIPTION OF WORK: �:�z�1 �2_�-2- ��.�/� ,/`� -,J�r•--�:��
---------------------------------------- ------ ----------------------------------------------------------------------
ZONPi 1G REVIEW BY: DATE APPROVED: N��-
BUILD�G REVIEW BY: � DATE APPROVED: 5•2� -S w
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes � No SEWER CONNECTTON
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPEC'I'ION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: �v 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:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff rlpproval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: I.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENiARKS (in house): -
7
BUILDING REVIEW CHECK LIST
UBC: !Z" 3 CONSTRUCTION TYPE: VN
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ �,C�� ""
Inspections Required: `i�ork Requiring Separate Permits:
Site OL Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_�C Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling O`Electrical (State Permit)
Other
REMARKS (Pi 1 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 PERiVIIT�:
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Total Fee: $ 1 � €�� " Date Received: �� /S% `��
Entered By: , Pernut#: ,'• � �`�,�'
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CITY OF ORONO - Bi.TII..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 O ONTRACTOR
JOB SITE ADDRESS: � �90 �'�.�w�o� �rP: �3 �'/
NAME OF OWNER: �O�/��� v���•c.PHONE: (home) �7l'-d�7.3
(work)
MAILING ADDRESS:�79a J��`��'�� CITY: G�^��v ZIP: 55���/
CONTRACTOR: ��52"��'�v' �����'�'-�HONE: S�S 7- o�6 8
CON'TACT PERSON: �,,Z� �,�6A�OBILE/PAGER: �7� /?L 7
MAILING ADDRESS:/74��v'E�"'��' CITY: �'��oL-�/ZIP: ���5��'i''
STATE LICENSE: # 2�0�`�5'��
ARCHITF,CT/ENGINEER: ����- PHONE:
MAILING ADDRESS: CITY: ZIP:
NA1�IE: REGISTRATION#
TYPE OF WORK: N�w Addition �ccessory Structure
I�1ove Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: .��'�*�'� ���o��G-�' ��T��
..r �i5 T�-tz •�-�
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STORII:S: � SQ. FEET OF EACH FLOOR: ���� -� '�
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET.
ESTIRZATED CONSTRUCTION VALUATION (excluding land): $ �000�-
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 with the approved plan.
APPLICAI�T'S SIGNATL --�� DATE: �/� ��
4
NOTE! Parade o�Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
5
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given indiridual. An individual asked to supply private or co�dentia!data concerning himself
shall be informed of: (a)the purpose and inte�ed use of the requested da[a within the coUecting state agency,poliacal subdivision,or sratewide
system;(b)whether he may refuse or is legally required to supply the requested dara;(c)any known consequence arising from his supplying or
refusing to supply private or confidendal data;and(d)the identiry of other persons or entiaes authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to suppiy investigauve data,pursuant to secaon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revernie mav nlace the norice rewired under thi subdivision in the individual income tax or orocertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a.responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or co�dential. Upon his further request,an individual who
is the subject of swred private or public data on individuals shall be shown�e data without any 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 its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or acaon pursuant to this section is pending�or addiaonal data on the individual has been
coUected or created. The respo�uible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authoriry may require the roquesting person w pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediauly,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request,excluding Saardays,Sundays and legal holidays,.if unmediate compliance is not possible. If he cannot comply with
the request within that ame,he shall so inform the individual,and may have an addirional five days within which to comply with the request,
excluding Samrdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private data conceming himself, To exercise this right,an individual shall noafy in writing the nsponsible authoriry describing the nanue of the
disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found oo be inaccurate or uxomplete and attempt to noafy
past recipieenc of inaccurate or ir�omplete data,ic�luding recipients named by the iadivrdual;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 digagreement is included with the disclosed data.
The deternunaaon of the responsible authoriry may be appealed puisuanc 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 �iry 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 determ.ine 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 eztent necessary to
_ process the permit or Iicense. �� �
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.
��i4 i��•y �v►�'��t�... �r' c_�'I-�E"C....
First Middle Last
/��.S� �v`�2G'.�.t�.. '�'"/�.. �tr ,
Address
�f�Y�vt---r.ti► /jt,�' SS^�S�/ �^� �Z��3
C�ry State Zip Phone
I understand my righis as stated above.
Signature �"_ � ^ Q�"E..-5���' T
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Gustafson Remodeling Inc. __._, _ _
1505 Evergreen Lane N. _ -- --- -
Plyrnouth, MN 55441 I 4 � Sho�es �
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Urban Residence o __ _ _ —_ _. .___.�.._._ �I I
Master Bedroom —� t
I \ Pocket door
Revised F�loor Plan #2 �
^�,,� (��--� Dresses
l 790 �"'"'"7Gvr�� � -- ��_---- Sky Light
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55�3`� �
Shirts
Undies � ^����
Shi�t� ��� Suits,4V-- ���
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Focket door �
`�Bench Seat
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" �������� ����• ��suitcases-under bench
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� CITY UF ORONO
_,�__,_ BUILDIN P R i�l T P�AN REYIEW
__ iNSPECtOR (SL�w..-� j
DATE S-2�•�� PERMIT NO. I
Sweatera T,9 .P1"APaRpV�U.aS Sti3i�l�IT(rt�
❑ APPP.O'�'FD 1;'t�17F1 t�GR�EGTiC�NS�.�NOTrD�
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Ttx3so ccmm�ns�,re tor yeur ir`omrtio�.Ail uro�k,hail be done
Lh rt in ��;� co�rpiiarce with aii e�plicable buitding and zoning coda I
J r�'ol?.'`fE4.'ifi,>�!t'inc'uding<<�ms i70t$PB;ificaHy.noted in this review.
KLt�' Tti1J Fi�afJ S�T OfJ �iTE AT ALL 71MES
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Wear
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Gustafson Remodeling Inc. � �
1505 Evergreen Lane N. � �7—
Plymouth,MN 55441 � �
T� OWe�g� Sportswear N
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Urban Residence � `-- ��"
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Master Bed�oom "�"�
�xisting Floor Pian ct,eg� M
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! 75'0 ��.� .._..._
6�'v�i-i1i'O ��'� �
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Suitcases
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DATE TIME
CITY OF ORONO CALLED IN �y
INSPECTION NO/TICE SCHEDULED Q 3:3�
PERMIT NO. ` � � COMPLETED �'�d
ADDRESS
OWNER CONTR. —
TELEPHONE NO. ���' ��� �
� DESCRIPTION �D�-�p�QJ
� 01 FOOT 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
Z04 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
v 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q WNER/ ONTRACTOR TO MEET YOU:�ES_NO
� COMMENTS:
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� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PAOCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pH0T0 TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
OwnerlContra n si :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice