HomeMy WebLinkAbout1999-011600 - stairs/pump house � . PERMIT
:IT'��F ORONO PERMIT TYPE: Y
'S0 Ke y Parkway- P.O. Box 66 Permit Number: `"t ` ` ^ �
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.;rystal Bay, Minnesota 55323 i:;. i ;�.i�;i�
(612) 473-7357 Date Issued: ;_f_ ,_ _ .^+_,
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,E ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — �:;�::;::_ ._ -, . . _ —
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE
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• Total Fee: $ �g � • G-Sc Date Received: ���a 9- y
Entered By: c� _ Permit#: '` � �
CITY OF ORONO - BUILDING PERNIIT 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
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JOB SITE ADDRESS: j��� ��2ov '��1�1 � �- � • ZIP: >5 ��C �
NAME OF OWNER: �P�v�e-�t �� 1�adzd. i`�Y�1 e� PHONE: (home) �7 5�' �5 3
(work)
MAII.ING ADDRESS: � `���1 I 5�v� (1�e I.��z. CITY:C'7 r?��Y2� ZIP: S S��� �
( � �L�Y��`� PHONE• L{�J S ��� � 3
CONTRACTOR: � � c�ctZ�
�CONTACTPERSON: S/aw�e MOBILE/PAGER:
MAILL�IG ADDRESS: 1 ��'(► S��c�v e ��ti� D�'r • CITY:�"���v1� ZIP: �S -3� /
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New -�� _��� Addition Accessory Structure
Move Remodel/ tt� Land Alteration
�� �,��
PROPOSED WORK(describe in detai�: Sn�� ���nc l��� �4� f g�`-�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
��,
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 5��
I hereby apply for a building permit and I acknowledge that the information above is cor�plete and
accurate; that the work will be in cf ance with the ordinances and codes of the City and with
the State Building Code; that I u�clerstand his is not permit and work is not to start without a
permit; and that the work will be'in accor ance w'xh pproved plan.
' / � �
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APPLICANT'S SIGNATURE•� �� �G�=-� �°z DATE: �� ��
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Couneil 60 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 sl�all be as set forth in this secrion.
Subd.2. InformatIon required to be�ven indiv[dual. An individual asked ro supply private or confidential data concerning himself
shall be informed of: (a)the purpose a�irne�ed use of the requested data within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally requ'ued to supply the requested data;(c)azry lmown consequence arising from lris supplying or
rofiuing to supply privaoe or confidetrtial data;azd(d)the dentity of other persons or enades authorized by state or fedetal law to roceive the data.
This requirement shall not apply when an iudividual is asked to supply investigative data,pursuant to section 13.82, subdivision 5, to a law
enforcement officer.. -
The commiesioner of revernie mav nlace the notice reauired under this subdivision in the individual income taic or nrocern tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsibte 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 confidential. Upon his further request,an individual who
is dx subject of soored private or pablic data on individuals shall be shown the data without a�charge to him and,if he desires,shall be informed
of t�content aqd meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disctosed to him for six months thereafter imless a dis�wte or action pursuant to this section is pending or addieonal data on the individual has been
collecLed or ccraoed. The respons�(e aud�rity shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authority may requiro the requesting person to pay the acwa(costs of maldng,certifying,and compiling the copies.
The�espontible suthority shalt comply immediately,if possibte,with any request made pursuant w this subdivision,or within five days
of the date of the request,excluding Sanu�days,S�ndays and legal holidays,if immediate compliance is not possible. If he camot comply with
the request within that time,he shall so infotm the individual,and may have an addidonal five days within which to comply with the request,
ezcluding Saturdays,Sundays and legal ho6days.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
privaoe da�w�erning lvmself. To ezeroise this right,an individual shall notify in writing the rosponsible authoriry describing the nature of the
disagree��. The responSible suthority shall within 30 days either. (a)correct du data fa�nci to be inaccurate or incomplete and attempt to notify
past recipiec�u of inaccurabe or incompleoe data,including recipients named by the individual;or(b)iatify the individual that he believes the data
to be correct. Data in dispux shall be disclosed only if the individual's statement of disagreement is i�luded with the disclosed data.
Tl�detecminadon of the cesponsiible authority may be appealed pursuant to the provisions of the administrative procedure act relaang
to conusted 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 furnish certain
private or confidential information.
You aze 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 acdon 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.
CL�C �fe� ��!`I£'t�
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Ciry State Zip Phone
I ders y,�igh ve.
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Signature
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• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ���i / ��F��L�� /J /�
PID:
DESCRIPTION OF WORK: (L�Pi4 r� v,.,,,(I �sQ �r� s na�,.�,s (�.�
ZONING REVIEW BY: DATE APPROVED: 6•2 9-9 g
BUILDING REVIEW BY: DATE APPROVED: (� -Lg -9 Y
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes �/ No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATER CONNECT�ON
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: �M�= Post Office: [,,i�,� School District: O��✓+�
Lot Area: Sq.ft. M� C«�yC Acres Width Depth
Survey Submitted: Yes No_�� Date of Survey: OiV /-it.<
Proposed Setbacks:
Front(Lake): Right Side: O. (� ,(�,y�
Reaz(Street): Left Side: �� CEfr4r-��
Adjacent Structures: Wetland:
Building Height: Def. Hgt. dV /� Peak Hgt.
Lot Coverage: /�/�
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # � Resolution: # '— Resolution Date: —
Shoreland District: yt�S
Avg. Setback: /v/�- Bluff Setback: — Lot Coverage: "—
Existing Proposed
Hazdcover: 0-75'
75-250' yt/D C F'�►'�
250-500'
500-1000'
Hazdcover Vaziance Required: Yes No � Date of Council Approval:
REMARKS(in house):
7
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BUII.DING REVIEW CHECK LIST
UBC: — V—! CONSTRUCTION TYPE: tilN
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ S v�o�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
eL Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
oC__Fina1 � Grading/Filling Electrical(State Permit)
Other
REMARI�S(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
RF,MARSS (TO BE NOTED ON PERMIT�:
8
, � !9 04:27 6125457424 ENS INC PAGE 02
�inar Nelson & 5ons (nc. ES��mC�t
2049 Indian Road West /
MiririetoilkR, (V�,�1 SS34S �, DATE I ESTIMATE#
545-7424 � 6/8/99 221
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RONO COP
� NAME/ADDRESS �0�1-� �tr��� ��'^.��Z
k p.K � � (�SlJ►^•-°`.�"' G'Z g- q�
1„ancaster Management Co. ,y(�
4I OH RGd QAIC IZI(�F;L' �9
�Minnctonka,Mn. 55345 �
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� � PROJECT I
� ' I Kiernan/13
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� ITEM � DESCRIPTiON
lioat t�iouse
I Patching concrete patch xround doors e�r windows tu�d wa11s
tu �
Dcmo/labar Ftempve raitings:u�d 12"}wrdcr on tc�p of boathouse along with the crld roof C.,7e:'d'
�Labor 'fo put falsrwork inside boathouse to sunpnrt ncw tlovr
�Patio I 4"of concrete with rcinforcing poured over flasework to form new ceiiing
�Concrete cu[b o�er bUa[hou5c:4"x12°lc�reinytall railings
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iTt�ank yau for tho chance to bid on yvur work TOTAL I
� S2,670.00 I
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