HomeMy WebLinkAbout1997-009308 - finish office space � PERMIT
CITY �F ORONO PERMIT TYPE: , ; :�;;
27�0 Kelley Parkway- P.O. Box 66 ;`;:',�__�=;1_;;.;`�v��
Cr stal Ba , Minnesota 55323 Permit Number: _ _ _
y y Date Issued: �-�°= � � =�� " '
(612)473-7357
SITE ADDRESS: '
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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, Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information musR be submitted in full before plan review will be started.
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(please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: S�� �YL� 1y ZIP:
NAME OF OWNER: � /�d� u>�a� PHONE: (home) �l' /���
(work)
MAILING ADDRFSS: �'.�.y�-� CITY: ZIP:
CONTRACTOR � � LPHONE: ��u'—�3g��
CONTACT PERSON: � MOBILE/PAGER: d �0-9�'!� �'
MAILING ADDRESS:�� - � ./�'4� CITY:��4�vn ZIP: 5�3.��'
STATE LICENSE: # � ���
ARCHITECT/ENGINEER: �//� PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New � Addition Accessory Structure
Move , RemodeUAlteration � Land Alteration
PROPOSED WORK(descri�ie in detain: ` E �,, ` s
;
STORIES: _� SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ o�O. � ' `
I hereby apply for a building rmit and I acknowledge that the information above is complete and
accurate; that the work will in conformance with the ordinances and codes of the City and with
the State Building Code; tha I understand this is not a permit and work is not to start without a
permit; and that the work w 1 be ' ccordan with the approved plan.
APPLICANT'S SIGNA DATE: �� "
NOTE! Parade of Iiomes vents re uire separate permit approval by Police Deparhnent and
City Council 60 days prior the event. Non permitted events will not be allowed.
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Sec.13.04 RIGATS OF SUB.TECTS OF DATA
Subd. i. 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 req�rired to be given individual. t1n individual asked w supply private or confidenaal data conceraing himself shall
be informed of: (a)the pucpose and inrcnded use af the requesmd data within the collecting§tate agency,polidcal subdivision,or statewide system;
(b)whether he may refuse ot is legally required to supply the requested data;(c)any known wnsequence arising from!us supplying or r�fusing to supply
privau or confidential dara;and(d)the idenary of other pe�soas or entities suthorized by state or federal law to receive the data. This requirement shall
aot apply when an individual is asked to suppty invesrigarive data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav alace the nodce rcwired under this subdivision in the individual income taz or vrovertv taz refund
instrucdons inscead 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 class�ed as public,private or contidenaal. Upon his further request,an individual who is t6e subject
of stored private or public data on individuats shall be shown the data widiout any charge to him and;if he desires,shall be informed of the content
and mr9��ng of that data. Afur an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
siz months thereafter unless a dispuu or acdon pursuanc to this secdon is pending or addi6oaal data on the individual has been collected or created.
The responsible suthority shall provide copies of the privau or public 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,certifying,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 compliance is not possibte. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the request,excluding Saaudays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeaess of public or private
data conceming himself. To exercise this right,an individual s6all notify in writing che responsible authority describing the naturo of the disagreemenG
The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurace or incomplete and attempt to nodfy past recipienu of
inaccucate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data to be correct. Dara
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authority may be appealed pursuant to the provisions of the adminisaadve procedure act relating to
contesud 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 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 refusal may require ihat 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 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.
Fitst Middle ��
Address •
City State Zip Phone
I understand my rights as stated above.
Signature
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in accordance with Section 713.9.T'he total area of all openings,other than doors,in any portion of ��
an interior corridor shall not exceed 25 percent of the area of the corridor wall of the room which it is ,�
separating from the comdor.For duct openings,see Sections 713.10 and 713.11. �
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. � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z�v�� �ifi�-�'��� �.:C::•:� i�..,�„�
PID:
DESCRIP'I'ION OF WORK: ��-r��. i 2.�.`�-�-�.:��
ZONING REVIEW BY: �vy'� DATE APPROVED:
BUII,DING REV�W BY: , „ l,� _ DA'ITE APPROVED: � I�t -i )
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes �` No
PLAN REVIEW Yes '-�' No SEWER CONNECTION
STATE SUR�HARG�. Yes t--�" No WATER CONNECITON
INVESTIGA'I'ION-�EE Yes No �--� PARK FEE
SAC Yes No �-- SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post O�ce: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Lefr Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
�� �. � Lot Coverage:
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� Grading: Staff Approval Date: By: Council Approval Date:
� Septic: Staff Approval Date: By:
� Zoning FIle: # Resolution: # Resolution Date: �
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Shoreland DisLict:
Avg. Setback: Bluff Setback: I,ot Coverage:
� Existing Proposed
Hardcover: 0-75'
� 75-250' � �
s 250-500' - .
�� 500-1000'
; Hardcover Vaziance Required: Yes No Date of Council Approval:
. �
RE1�24RKS (in house):
• 26 .
BUII.DING REV�W CHECK LIST '
�C: r� CONSTRUCTION TYPE: lj�''
� Sq Footage $ Per Sq Ftg
Basement x =
lst Floor R = -
2nd Floor x =
Garage x =
z =
TOTAL
Estunated Construction Value: $ Z�;c�cx:�"`
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
_�v Wall Board (Mfg.) Well (State Permit)
r�Fina.l Grading/Filling o�Electrical (State Permit)
Other
---------------------------------------------------
REMARI�S (IN HOUSE):
---------------------------------------
RE'VIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
REMARKS(TO BE NOTED ON PER1vLIT): � � �� � � �M
27 .
DATE � TIME
CITY OF ORONO CALLED IN �G+ --�-- �
INSPECTION NOTICE SCHEDULED 7C'-� _���_
PERMIT N0. ����� COMPLETED A�_ �
ADDRESS • ��G C1' G�� _ ` } d; ` �
OWNER � " � �ONTR.�c�ui �(? (,rLcx.�v-t'�
TELEPHONE NO. �S S — �f��
,
� DESCRIPTION ���%r��-4'-��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
y 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
= O5 FINAL � 14 SEWER HOOK-UP 06 PROGRESS
~ 07 O�ITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� i 1 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WI�L RETURN
❑STOPORDER POSTED.CALL INSPECTOR CITATION ISSUED
C7 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n ection 24 hours in advance.473-7357
OwnerlContract it
Inspector.
White Copyllnspector's File Canary CopylSite Notice
rt D�� �f�IM
CITY OF ORONO CALLED IN
INSPECTION NOTICE��Q � SCHEDULED
PERMIT NO. COMPLETED
ADDRESS
OWNER P ���'' O TR c_
TELEPHONE NO. SS� ��5� �
� DESCRIPTION �
� 01 FOOTI 11 MECHANICALRI I 18IXCAV/GRADINO/FIWNO
�Q � 13 MECHANICAL FINAL I 19 LAI�SHORENVETIAN�S
Q INSULATION 24/25 WOOD BURNER/FIREPLACE i 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP I 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWEFi HOOK-UP I O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPIAINT
J
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES NO I
� COMMENTS:
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O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN `
❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in tion 24 hours in advance.473-7357
OwnedContractor ite
Inspector.
White Copyllnspector's File Gnary Copy/Site NWice
TE � T M
CITY OF ORONO CALLED IN C� '"CZ
INSPECTION NOTIC SCHEDULED • /���/
�--�'7
PERMIT N0. ��Jh ?� COMPLETED i��
ADDRES� �
OWNE CO R. -a��-3� . �-�2.c�p.�-�.�
TELEPHONE O. ��5� 3����T
� DESCRIPTION
� 01 FO_ 11 MECHANICAL RI 18 EXCAV/GRADING/FILLWC�
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 MOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 2t COMPLAINT
J
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 2$CEDAR SHINGLES 36 FOUNDATION FiEMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING pERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR - C�TATION ISSUED
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for next inspection 24 hours in advance.473-7357
OwnerlCont r on si e-
Inspector. ` �`'
White Copylinspector's File Canary CopylSite Notice