HomeMy WebLinkAbout1999-011952 - remodel .
R PERMIT
CITY OF ORONO PERMIT TYPE: _ _
2750 Kelley Parkway - P.O. Box 66 '�-�!�-�=� � �'u��
Crystal Bay, Minnesota 55323 Permit Number: y -
(612) 249-4600 Date Issued: -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: _.. ;.:.-.,..,:: i ,_ =,..;;. ..... :=� ' . __.. _ .OWNER:
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APPLICANT%PER EE SIGNATURE ISSUED BY:SIGNATURE GL.�
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�Total Fee: $ ���' 3� Date Received: � /���--
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Entered By: ��L�-- Permit#: ���}-
CITY OF ORONO - BUII.DING 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 OR�ON RACT
JOB SITE ADDRESS: �(�S� �`1 i�Y�� �sL �Y ZIP:
NAME OF OWNER: �/( ��r i�� ,-,��-, PHONE: (home) ��3 ����
(work)
MAILING ADDRESS: ,ZOS� �'�-�.�jt.�,a �,r CITY: ,?`�,���.: ZIP:
CONTRACTOR: � - ��, " rs -L N� PHONE:_ S�-I � g � ���_
CONTACT PERSON: �� �' �,-C,x,�� MOBILE/PAGER: 3(,g - ►�'�,�
MAILING ADDRESS: "� l S 1=(d� ,�. �2 CITY: C o(GG�e �.�(�IZIP: z�
STATE LICENSE: # �S"7� �''
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�: ��� ,�� /��t 5� ��(���,a-(���t,
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $��,,�-T7>
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.
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APPLICANT'S SIGNATURE: �-u�—��v-o- DATE: /0 /��
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[JBJECTS 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.
Subd.2. InformaGon reqirired to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose az�d intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
sysrem;(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 confidential dah;and(d)the idenuty of other persons or enddes authorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav nlace the norice reauired under this subdivision in the individual income tax or provertv tax refund
instrucrions 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 conf'idential. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the 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 ro him for six months thereafrer uriless a dispute or action pursuant to this seclion is pending or additional data on the individual has been
wllected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible auihoriry may require the requesring person to pay the actual cosu of making,certifying, and compiling the copies.
The responsible authority 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 time, he shall so infortn the individual,and may have an additional five days within which to comply with the request,
excluding Saturdays,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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and 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 shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant ro the provisions of the administrative procedure act relaung
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 �ity of Orono or any of its departments may require you to furnish certain
private or confidential information.
You are notified that:
i. 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 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 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.
First Middle Last
Address
C��y State Zip Phone
I understand my ri ts as stated above. "
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z� S(' �t�ott��.t Ne �2
PID:
DESCRIPTION OF WORK: ��tt f�,rvw�A�t L
ZONING REVIEW BY: /��A DATE APPROVED:
BiJII.DING REVIEW BY: DATE APPROVED: /o-s-S 9
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)
ZONING CHECK LIST zoning District: �� c lf�h�,�
a
Fire Department: Post Off e: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes N Date of Survey:
Proposed Setbacks:
Front(Lake): Ri Side:
Reaz(Street): Left ide:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grac:;.,: Staff Approval Date: By: Council Approval Date:
Septi�: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff etback: Lot Coverage:
Eaist' g Proposed
Hardcover: 0-75'
75-250'
. 250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARSS(in house):
7
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BUII.DING REVIEW CHECK LIST
UBC: �?'�j CONSTRUCTION TYPE: '�1ti
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage z =
z =
TOTAL
Estimated Construction Value: $ �7j,O o0
Inspections Required: Work Requiring Separate Permits:
Site �( Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
o( Insulation (Masonry) Other
� Wall Boazd (Mfg.) Well(State Permit)
� Final Grading/Filling K Electrical (State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI'1�:
8
DATE TIME
CITY OF ORONO �..-- CALLED IN - - ` /�_ °�
INSPECTION NOTICE 1�� �� SCHEDULED / .�3 '�
PERMIT NO. COMPLETED �
ADDRESS ��J~ -�.c� �� � '�:
OWNER � '� CONTR. - � �
TELEPHONE NO. � 4^ � // �,�
� DESCRIPTION
� 01 FOO i____�` 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O SI164IJ(JA1-_ 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR OMEETYOU: YES_NO
� COMMENTS: � ��/1�-� �S � �S
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W� }❑�.W.�O� RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W �dLTARRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, PHOTO TAKEN
INSPECTOR WILL RETURN
C7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473�73�J7
OwnerlContractor on site:
Inspector. /���-��
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION OTICE SCHEDULED � ��y /��
PERMIT NO. � COMPLETED � ��- [ q l-� p 4
ADDRESS �('?SC� �f�l''tL�II n-2- ��'
OWNER CONTR. -F��� �1�G12'�S
TELEPHONE NO. -�
� DESCRIPTION ��'�� r � I ��' ��jn�t�,�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
O � A�LL—BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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 MEEf YOU:_YES_NO
� COMMENTS: �
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� CJ CORRECT WORK R PROCEED �
W i ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN C PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECT�ON REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra or on site:
Inspector. ����'`C—��
White Copyllnspector's File Canary Copy/Site Notice
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TERRY RESIDENCE
2056 SHORELINE DR.
WAYZATA, MN, 55391
48, 8..
-.141,114111114
- - 21'2" --- -
FLAG BUILDERS
715 FLORIDA AV S STE 100
GOLDEN VALLEY, MN
55426
(612) 540-9407
MN. LIC. #8565
M
EN
ANDREWS & ASSOCIATES
RESIDENTIAL DESIGN & DRAFTING
891012th Avenue South
Bloomington, MN 55425-1907
Phone (612) 854-7992 Fax (612) 854-7454
THIS DOCUMENT IS THE PROPERTY OF
ANDREWS & ASSOCIATES
ANY DUPLICATION OR USE IS STRICTLY PROHIBITED
WITHOUT EXPRESS WRITTEN CONSENT.
NO REPRESENTATION OR WARRANTY IS MADE AS TO
DESIGN OR DRAFTING. ALL DIMENSIONS AND
STRUCTURAL DETAILS MUST BE VERIFIED PRIOR TO
CONSTRUCTION.
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TERRY RESIDENCE
2056 SHORELINE DR.
WAYZATA, MN, 55391
48, 8..
-.141,114111114
- - 21'2" --- -
FLAG BUILDERS
715 FLORIDA AV S STE 100
GOLDEN VALLEY, MN
55426
(612) 540-9407
MN. LIC. #8565
M
EN
ANDREWS & ASSOCIATES
RESIDENTIAL DESIGN & DRAFTING
891012th Avenue South
Bloomington, MN 55425-1907
Phone (612) 854-7992 Fax (612) 854-7454
THIS DOCUMENT IS THE PROPERTY OF
ANDREWS & ASSOCIATES
ANY DUPLICATION OR USE IS STRICTLY PROHIBITED
WITHOUT EXPRESS WRITTEN CONSENT.
NO REPRESENTATION OR WARRANTY IS MADE AS TO
DESIGN OR DRAFTING. ALL DIMENSIONS AND
STRUCTURAL DETAILS MUST BE VERIFIED PRIOR TO
CONSTRUCTION.