HomeMy WebLinkAbout1998-010964 - shed PERMIT
' �"� � �����`� PERMIT TYPE: r: �;;
�7�0 h:� arkway - P.O. Box 66 ���"�������~�'
Permit Number: :�1 S_�`=����
Crys�tal Bay, Minnesota 55323 Date Issued: i �./t i'�s f�'µt:=�
� (�12) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY: _
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PPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE , "��'�
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Total Fee: $ Date Received:
" Entered By: ,�'�� Pernut#: �p 9��
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------------------------------------------------- ----------------------------------------------------
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: 21 �� S�,a,,J��yd l�p ZIP: � S 3`1 /
NAME OF OWNER: ,�,�;�� �,�e v �,`�� PHONE: (home) y`7 J-�( f�y a
(work) y y 2--y�'7 Y
MAILL�tG ADDRESS: 21 �S5 S�c�.(�..�.eod I�J CITY: 1'�n cJ ZIP: 5 5 3 y�
CONTRACTOR: �" PHONE:
COl�'TACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP: �
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAII,ING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �,ff��ti.ti (U n !Z �••,ll�,'„�_v n
r� �'�1-
STORIES: — SQ. FEET OF EACH FLOOR: 1 20
NO. OF BEDROOMS: — GARAGE STALLS: ATT. �--DET. —
ESTIMATED CONSTRUCTION VALUATION (e�ccluding land): $ ��jC��
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 8uilding 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 v plan.
APPLICANT'S SIGNAT DATE: I I-�-��
NOTE! Parade of Homes events require separate permit approval by Police Department and
Ciry Counci160 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 �
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 section. R
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,poliacal 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 to supply private or confidenaal 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 investigadve data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The com�russioner of revenue mav olace the norice reouired under this subdivision in the individual income tax or nrocertv 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 whe[her it is classified as public,private or confidential. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the dara without arry 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
disolosed to him for six months thereafter unless a dispute or action pursuant ro this secrion is peciding or additionai data on the individual has been
collected or�reated. The responsible authoriry shall provide copie's of the private or public data upon request by the individual subject of the data.
The respohsible autt�oriry 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 possible. If he cannot comply with
the request within that rime, he shall so inform the individual, and may have an addirional five days within which to comply with the request,
excluding Saturdays,Sundays ar�d 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 notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)conect the data found to be inaccurate or utcomplete ac�attempt to notify
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 shalt be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administraave 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 Ciry 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 supgly•data, but refusal may require that the City deny the permit or license.
3. � The information may be shared witli otlier 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.
LiGrM.� �Go�"' J'r`:f',vI':��
First / Midc�e Last
2� Sy s I,�J„ �,.�oJ t��
Address
!��-'��r rv�v�/ 5 ti 34/ y 71'���
�i�y State Zip Phone
I understand my rights as stated above.
�-
Signamre
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
r ADDRESS OR LEGAL: 2 I `a`� �1-4�4�b ltiJo o/� �oJ1��
PID:
DESCRIPTION OF WORK: �t-lc��O
------------------------------------------------ ---------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: /�- 9 - �i g
BUILDING REVIEW BY: DATE APPROVED: (I-ci - 5�a
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �/ 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)
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ZO�iING CHECK LIST Zoning Disuict: �' ��--
Fire Department: M,�j�/,r�t/� Post Office: G�/3��t} School District: t.c.�5���✓�
Lot Area: Sq.ft. /L�n G(ths��Acres Width Depth
Survey Submitted: Yes No L Date of Survey:
Proposed Setbacks:
Front (Lake): Zn v Right Side:
Rear (Street): �1�c7 Left Side: S�
Adjacent Structures: � Wetland:
Building Height: Def. Hgt. O - �� Peak Hgt.
Lot Coverage: C�.�
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
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):
7
BUILDING REVIEW CHECK LIST `
UBC: [, �- ( CONSTRUCTION TYPE: �/J
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ SZ�D ��
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 `
Wall Board (Mfg.) Well (State Permit)
O�Final Grading/Filling Electrical (State Permit)
Other
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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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BUILDING �-� � S
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1N5PECTUP.� � P4��t7 NO.___._._----
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T"::�3 c�r;;me�ts are tor your ifi�c`m�`��il�Ang�n'� oni g c de. (,.J�
{r tult ccm;:iiar,ce with ai1 apP � ��,.,�. (f�
,�eq•�irnmen"�inc!udirg i tem s n��t s p a�.ical4 y n�ted i�tnis review. �
KEEP TNtS PLp`N SE7 ON SITE AT ALL TIM�S
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� � BUILDING PERMIT APPLICATION �
.
' CITY OF ORONO
, On the North Shore of Lake Minnetonka
� 2750 Kelley Parkway
,: ,
Post Office Box 66
�" Crystal Bay, MN 55323
� (612)473-7357
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��' - .v '� BUILDING & ZONING
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��� � DEPARTMENT
LYLE OMAN BRUCE VANG STEPHEN WECKMAN
Building Official Field Inspector On-Site Systems
� � � ,
� " INSPECTIONS: OFFICE HOURS:
� CALL SECRETARY - MONDAY-FRIDAY �
GIVE 24 HOUR NOTICE 8:00 AM - 4:30 PM
:�;� � � � �
INDEX: Pa�e
�T =:�' Application Procedures and Survey Requirements . . . . . . . . . . . . . 1-4
3..
Application Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Data Privacy Advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Check-Off List (office use only) . . . . . . . . . . . . . . . . . . . . . . . . 7-8
�:-
REVIEW & PROVIDE ALL INFORMATION REQUESTED TO AVOID DELAY
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CITY OF ORONO CALLED IN / �� / �
INSPECTION NOT E ./Y SCHEDULED / � �'� � � c�
PERMIT NO. ��v� COMPLETED K
ADDRESS ���� ������
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OWNER ��-�-��Y��� CONTR.
TELEPHONE NO. �7l- �����
� DESCRIPTION L.,��vz"� ��
� 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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��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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED �JECT COMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra or n i :
Inspector.
White Copyllnspector's Fil Canary Copy/Site Notice