HomeMy WebLinkAbout1996-008534 - office remodel �` P�RMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �'��i,���-���'
Crystal Bay, Minnesota 55323 � �}R�r�-��-•-��
(612) 473-7357 Date Issued: ; � ;c�>i i�aF;
SITE ADDRESS: `
w,i yt:f '==Hr�LiyE���j�i� ��
r:H
r . 3 . tJ. � ;�i)-1. 1 7—i':��-1 �—{7I�):�;�.
DESCRIPTION:
�����'T_:� F��t�#t=t?�,')F�
���i 1��i�-��� �'f.:,,t���i t. �'y�:N L:i�t�1—Ai�l3 f R�:�E�=�i�EL
E,�.::. '��ii�,� �3�-����:: 'fv�=� �:i��I�I�E�;t�:I�i_
l lM��: i�tr rt„�r.�t��:� � '
�.����llS�.���r t.j,�_�3 i iY�!== ���
c:�„5s.�� ��:F�:�;� �._.�r A�1' . �V�;�t�kE�_� .
�
,
REMARKS:
:_�E:F`e:-{€���;� �=��±��l."�:=; ��'c�tJT�EC� ��_�f; E���::TF;?'�::�',� �:'�;`;� T�-::� .
FEE SUMMARY:
��+��t�};��'��t�� �1�;::,t�z�7�y
�i=l�Y �F't,' W���T iC! �� ,
� �ct�l �t�:V 1�k► `,�?�''1 . %1
�_�t.�t 1'C�f cl i''�!� ___.__._. 'ss F_:_E}iz?
1"��t.�1 Fe� �.�.�--'=1�. .`�iw,
CONTRACTOR: — �;���:��, �.��,�;�. — °=;i . �_�i: OWNER:
Ufi�iV S r�':;i;��'�i t;�ti;Y 1�7'�r��°�4�1 ��`.��t; i:���`;' �4°E:=�}-i4�€�r�h° _:��tu T`�
���(.:=;�T� �_;[)�:���:It�#���-?F�l� 1:°:t:�t�k '=��-I�;�j`s��:��::if��=i h�_,
�1=L_������ t�lt�� .���=;:�';=: ����°E_��,#t�i rtt•� �,�:�;:=,�
i{-:i : �.��=t—F=,'�id.:; .
_�� , j. .—e ��__'( _,{�5' y-, � . _a.:'� £s � — cr F`= — �. .�'_. `� e t�;� — 'i
[��_._ ? } 'f' {.,�. r
.: �;!L,_ E J�4��i� a._..I.�°i!�'S�I f i"'t�1"iS..L.�} �i.... . �.'.,. _. . _ . �T'4. 7_ ... _. f i_�I� 3 �� i'�C?�'•.L.. E ! -�i" ��C"F..._.., �.i . .� . �.. .r..3u � �w
-��-`i=?_r� '{ � ) �1 : .�' {� . --'-F i.! 3, 1� F T�y. ,` 7'� 7t: t'€-�{�i �ti�� �" s'3' _ } �.T-� �')i=
�.., a_ �t 4L 1[�..�_�..: f�i�..s �.�. '.�.C..•.�.� .'�......._ �. ,.. . . . � �ti { 11 I. � : "' i i���..�f". .«...._ .. .. . . . . ..�_. r 1 d � _
�;�s:�f�`�f!'I !�;[��}T}�1�}.�( �;��.;' _' I- f . _ : F �: �`� �';-ts� �-i*'is-rw��'.-
_ __ . _ " ..._ ri yt ('
� _. _ _. .. 1��� 1 lE� :�+�.' �... �w� i .'� t .... �.i Z�i�,:[jv7�f'�'.���„� �� ri4_�.E3.._f..�_��9 �._�...FL, ., .,... . ... . », . �
. �C
APP CANT%PERMITEESIGNATURE ISSUEDBY:SIGNATURE 'c�•
��'
Total Fee: $ �/<� �� Date Received:
Entered By: .,�� . Permit#: �'_�-;���
CITY OF ORONO - BUILDING 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��ACTO
JOB SITE ADDRESS: , �+C�L� - n JC G'` ZIP: ��� � 1
�r�� �-Z_ !�t S� I
NAME OF OWNER: �+ �� � ��'�t'Ht�NE: (home)
—T �., (work)
MAILING ADDRESS�.S�G .5�� • �CITY: ZIP:�3 /
CONTRACTOR:C��iti ��tsl�+` ;(�G�/" PHONE: �� �`� �
CONTACT PERSON: t MOBILE/PAGER: o? Q • �'-/T�� i
MAILING ADDRESS:�`y�' ��t�- CITY: �Gr�v�) ZIP: ���
STATE LICENSE: # �� �'� �F� S•�
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 detai�: —�rv.` l � � °
STORIES: SQ. FEET OF EACH FLOOR: �t r�,jc � .'7�'
NO. OF BEDROOMS: '�� GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $�,�, �y�1�
I hereby apply for a building pernut 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 accordanc� with t e approved plan.
� `
APPLICANT'S SIGNATURE: DATE: - �— � '
NOTE! Parade o Homes events reg ire separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
�
Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The righcs 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 individual. r1n individual asked to suppiy private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the coliecting'state agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
priva�e or confidendal data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesagaave data, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertv tax_refund
insuucrions 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 whe[her it is classified as public, priva[e or confidential. Upon his furthec request,an individual who is the subjecc
of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he desires, shall be informed of the content
and meaning of tha[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 action pursuant to this secaon is pending or addiaonal data on the individual has been collected or creaced.
The responsible authority shalt provide copies of the private or pub(ic data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making, cerrifying, and compiling the copies.
The responsible authoriry 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 compiiance is not possible. If he cannot comply with the request
within thac time,he shail so inform the individuat,and may have an addidonal five days wi[hin which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure w6en data is not accurate or complete. An individua(may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days eirher: (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual; 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 determination of the responsible au[horiry may be appealed pursuant to the provisions of the administrarive procedure act rzlating to
concested 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 pernvt or license from the City 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 determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusai may require that the City deny the pernut or license.
3. The information may be shared with other local, state or federal agencies ro 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.
$, 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 viiddle Last
Address
C�ry State Zip Phone
I understand my rights as stated above.
Signature
� ` ,�!.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: :� ��� ��-i�-.��i ;_;.��.�=:�'� ��
PID:
DESCRIPTION OF WORK: �;1"=;� t� �'��.�.�,�,;;-Z
------------------------------------------------------------------------------------------------------------------------
ZONING REVIE�J BY: � DATE APPROVED: ,+�,��!�
BUILDING REVIEW BY: DATE APPROVED: ���..� —y L
�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r/ No
PLAN REVIEW Yes r.�� No SEWER CONNECTION
STATE SURCHARGE Yes ��No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
-------------------=---------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
Fire Department: Post Off ce: chool District:
Lot Area: Sq.ft. Acres Width De�t�i
� �
Survey Submitted: Y s �_ No_� Date of S rvey: �!J
f �
it
Proposed Setbacks: 1 i
Front (Lake): Right Si : j� ;�
i '
Rear (Street): Left Sid : f�r
;
r :
Adjacent Structur s: Wetland:
Building Height: Def. H . Peak Hgt.
Lot Coverage: � � ; ;��
-� � 1
Grading: Staff Approva�Date: By: Council Ap�roval Date:
�
� � ; ,�----�
Septic: Staff Approval ate: By: i
Zoning File: # Resolu�ion: Res lution Date:
Shoreland District: �
Avg. Setbac : Blu f Setback:
'Ex' ting Proposed
Hardcover: 0-75'
75-250'
250-500'
0
500-1000'
"
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
.�t:.� ♦
BUII.DING REVIEW CHECK LIST
UBC: � CONSTRUCT'ION TYPE: VG�J
Sq Foota�e � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
<-t,,
Estimated Construction Value: $ �Z,��'��
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_ !C Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Pemut)
�Final Grading/Filling �_ Electrical (State Permit)
Other
RENiAI2KS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
REV�ARKS(TO BE NOTED ON PERi'�1IT):
27 �
gf� +E;�:��'cy �lr �� -- •,?' Lr1CG _ - - - .__ . . _ ^ P.4�1
��o�a copY
� U S r� �� ►�a�� �-�-�- .
�6a2S � �
�0�"�
-� ,���,� �
. . S� �
,
�
:
� .
�.��
���� �� ����
�t�l'�#..�A�B�1 - �I:AN ���
���'li7'.3::.rw."w�e� � .... rM�+�•wORai+'�!'�"...... ^
��1�Yw.+�.�..�.-�-r ... •�..�.r.n-.o..�...z i—r I�ril�� �VY. ..... �� ��
p �y i
i'�`�, pr,9``;�'�,'V''.'�� ��1:� s�',5��+?it�.�i:._;+ �
�i,+t r:,r�.--.�{� a �"•.��C� {
�:�/� .+��-• « Vi i�=�s.�."(:t�� t�'�'���.�:x,� ''+� NOT'� � �
� �;, � r.�t _D '+ F,��,� C�-��
;,� v d')4'i�{�ttF!) 1e� iGGSo�'✓� �i ��5�1�;4ii� v� �1 +�t) � �
���Y ��� c � - LTA
� � i
.t� ror �n�s>� $�• v your����f'�fT�MUR. AII Lb�ork s�:ad }o �.•��• � i �
� i .^.�..£'s�:s;'.E 1`� ; t c�,'��"': J�� �%.fi��,ETlg �26i4Rk tr''�tt •�' �
1. .ct ...�C�til:.&Ny nOted in tt1f5 feH+� � I-
,- i:�ciue:n !�-' � ' �
. �,.i �i l� A7 .41.t t fN�`�,
. .. . :'l�L' t� . . � �3��.1 .
� s!�...ln�� /i v�S
+�
� s��s ��e x
�- /� �.rc
� .r • " r
� � �
�
'���,� �-...
a b�� �-...,. `. �
'� �� �r`�' � � �/,��� �
++Y ����'y � �I�
�C� 's��� ��' � �,
��j i
� ����j� V�� /�
'�y ��SS
4 ,\
� ��m � ��,�
y'` `�•�\
� � . � � \
,,� > ....-......J,..
� � �
� �����
i'� �
��d✓' .U S��
DATE TIM
CITY OF ORONO CALLED IN / '1 `% :•
INSPECTION NOTICE J SCHEDULED-�/!�/%�'< -. / %��
PERMIT NO. .r��-�'�/ COMPLETED
ADDRESS ��'�%c�� �l�,�,�� t��, �
OWNER - �%' �'� � _�,�1_.- �tCONTR. �-/-r �f��-=
TELEPHONE NO. f�l 7 `� - � J�`f-y
� DESCRIPTION �`;�����
� 01 FOOTINO_ / � 11 MECHANICAL RI 18 EXCAV/(iRADINO/FIWNO
�Q�__Q2 FRAMIN� ' 13 MECHANICAL FINAL 19 LAI�SHORE/WETL4NDS
� 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
2
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
.�
�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINO FlNAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
>.
�
O
�
W
�
Q
�
2
w
�
W
�
j
d WORK SATISFACTORY:PROCEED = PROJECT COMPLETE
W
� �CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPOHARY
� BEFORECOVERING PERMANENT
❑COHRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO AFRANGE ACCESS.
Call for t e ne t inspection 24 hours in advance.473-7357
OwnerlContta r o ite:
Inspector.
White Copyllnspector's Fi e Canary CopylSite Notice
✓
DATE iTjIME
CITY OF ORONO CALLED IN 1 J - 3:�'Ci�. G .;j �fy
INSPECTION NOTICE ' scHEou�E� L'L_;z�;� -a ��'
PERMIT N0. �J � � COMPLETED �
ADDRESS � � -��. �`,�� . '�' �-�i
OWNER , �1_�'_� �.�c:�a�`-C;R-`L. CONTR.� - a ti� .�
TELEPHONE NO. �'I 7�(" Cr� i '7 �
� DESCRIPTION
� 01 FOOTINCi 11 MECHANICAL RI 18 EXCAV/GRADINCi/FIWNQ
y 02 FRAMINO 13 MECHANICAL FINAL 19 tAi�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNEFi/FIREPLACE 34 TREE REMOVAL
Z 04 BD. 12 WATER NOOK-UP 17 SITE INSPECTION
Q
ps�,� 14 SEWER NOOK-UO p6 PROGRESS
J 07 DEMO�ITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTiC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
O C� � ��°i
�.
�
0
�
W
�
Q
�
2
W
�
W
�
�
d MORKSATISFACTORY:PROCEED ROJECTCOMPLETE
W
� ❑CORFECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,-, pHOTOTAKEN
INSPECTOR WILL RETUFiN
❑STOP ORDER POSTED.CALL INSPECTOR
G CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor o ' e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice