HomeMy WebLinkAbout1999-011321 - ramps PERMIT
CITY OF ORONO PERMIT TYPE:
2750 K�Iley Parkway- P.O. Box 66 ;�=,j i o i„�:�;.�vi;
Permit Number:
Crystal Bay, Minnesota 55323 �;:'s�. i:�=:;:+
(612) 473-7357 Date Issued: �;�j t :=;:A�,^�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: __ �,c,�,� � �_��;T, _
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APPLICAN / E E ATURE ISSUED BY:SIGNATURE
Total Fee: $ J�7• �`� Date Received: ���=/`�i�
Entered By: �cUJ, Permit#: /� .�
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� CITY OF ORONO - BUII,DING PERMIT APPLICATION
A11 information must be submitted in full before plan review will be started.
(please print all infornlation)
------------------------------------ -------------------------------------------------------------
THE APPLICAI�'T IS: (circle one) .:" OWNER�R CONTRACTOR
JOB SIT'E ADDRESS: - :�,r'���;���,��� ZIP: ' _
, , _> ;, - � �,�_ — ,._
NA1�TE OF Oti�fi�R: _ ' - PHONE: (home) � _ ' ' -�,
(�vork)
MAILING ADDF.ESS: - " - CITY• ' = Z�• -� '��
CO�t�'RACTOR: PHOi�tE:
CONTACT PERSON: MOBILE/PAGER:
MAII..I�'G ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/EI\TGII�TEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure �
Move Remodel/Alteration Land Alteration 1
ED WORK(describe in detai�: ` �1'-�% ` � - '-� � " �J\i���l
PROPOS . _.
STORIES: - SQ.FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET. ,�,
, � ", �, vo�
EST .Il�i IATED CONSTRUCTION VALUATION (excluding land): $
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 Buildin� Code; that I understand this is not a pernut 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: ,� �. , , ����;..�� ��;� DAT'E: � .
NOTE! Parade of Homes events require separate perm7t approval by Police Department and
Ciiy Counci160 days prior to the event. Non permitted events will not be allowed.
. Sec.13.04 RIGHTS OF SLTB,JECTS OF DaTl. '
Subd. 1. Type of data. 'Ihe righ�s of individual on whom the data is stored or to be scnred shall be as set foRh in chis secrion.
Subd.2. Information reqirired to be given individual. An individual uked to supply priva�e or confidendal dara concerning himself shall
be inform:d of: (a)the purpose and inrended use of the requurcd data wi[hin the collecang statt agency,poliacal subdivision,or sracewide rystem;
(b)wher�:e:he may refuse or is.legally tequir.d ro supply the requesud data;(c)aay la:own coasequence arisiag from his supplying or refusing W supply
privace or conndenaal data;and(d)che idenciry af o�her persoas or enrides au•:^ocized by sc�te or federal law to receive[he dara. This requiremeac shall
not apply when an individual is asked to supply iavesdgadve daa,pursuant ro secdon 13.82,subdivuion S,[o a law enforzement o�cec.
'Iha ccr�missioner of revenu- mav ptac- �he nodc- rauird und^r chis subdivision in [he individua! income rax or oropem taz refund
instrucuons inscead of on chose forms.
Subd. 3. access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whecher he is che subject
of stoced daca on individuals,and whecher ic is class�:d as public, private or confidenrial. Upon his furcher request, aa individual who is the subject
of stor:d private or public data on individuals shall be shown che data wichout any charge to hitn and,-if he desires, shall be informed of the content
and mcaning of[hat dan. Aher an individual has be:n shown the private dara and informed of its meaning,che data need not be d'uclosed to him for
six monchs thereafter unless a dispute or acaon pursuanc to this secdon is pcnding or addiaooal dara on the individual has beea collected or crcated.
'Ihe responsible authoriry shall provide copies of the privace or public data upon request by the individual subject of the dam. Tha responsible authoriry
may requir the requesdng person to pay the aceual costs of making,certifying,and compiling the copies.
The cesponsible auchoriry shall comply immedia[ely, if possible,wich any request made punuant to chis subdivision,or within five days of
the dace of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc
within chat dme,he shall so inform the individuai,and may have an addidonal five days within wtuch to comply wi[h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. P.n individual may con[est tht accuracy or completeness of public orprivate
data conceming himself. To exercise this right,an individual shall nodfy in wridng rhe responsible auchoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccurate or incomplete and aaemp[to nodfy past recipiencs of
inaccurate or incomplete data, inc(uding cecipien�s named by the individual; or(b)noufy the individual that he believes che dan to be correcc. Data
in dispuce shall be disclosed only if[he individual's sta[er,.znt of disagreement is included wi[h the disclosed data.
The decerminadon of[he responsible auchoriry may be appealed pursuanc to the provisions of the adminisaarive procedure act relaaag to
contesced cases.
DAT:� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hcs of subjects of data", we would like to inform you tha[your request
for a pernut or license from the Ciry of Orono or any of its departments may require you to furnish certain private or
confideatial 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 da[a, but refusal may require that the Ciry deny the permit or license.
3. The information may be shazed wich ocher local, state or federal a�eneies to the eztent necessary to process
the permi[ or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permic.
-- , � ,, .
First �tiddle Last
i��' _
Addcess ; - :..._.
_, ,. -. , ,
-, _� ,
Ciry Sate Zip Phone
I understand my ri;hts as stated above.
� - ��_
Signacure �
CHECK OFF LIST FOR ISSUANCE OF PERMITS
` FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: 3`�"7� 5 N o czx.�-��'�►� ��z���
PID:
DESCRIPTION OF WORK: RPwv�(�
ZO�TING RE'VIEW BY: � � DATE APPROVED: �/-/Z-�8
BUILDING REVIEW BY: DATE APPROVED; y -i z.-g�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
pLpN REVIEW Yes� No SEWER COrfNECTION
STATE SURCHARGE Yes _�/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: LR-/L
Fire Department: �M o vn�✓� Post O�ce: l,v A`I 7�4Tf! School District: w�7'o r�Icth
Lot Area: Sq.ft. �uo cN.4n�� Acres — Width — Depth —
Survey Submitted: Yes �c No Date of Survey: o N �-�U::
Proposed Setbacks:
Front(Lake): Righ Side:
Rear(Street): Left ide:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff etback: Lot Coverage:
Ezist g Proposed
Hudcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house): pi uO c �s o� s I'�� S�� °'-
I-�o u s� AQort��e� �AS �a r�o�s --wt`�t.o A ui r���
7
BUILDING REVIEW CHECK LIST
UBC: �Z- 3 CONSTRUCTIOYTYPE: �JN
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd F1oor x =
Garage R =
R -
TOTAL
Estimated Construction Value: $ 1,(��d �-'
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_�Footing ` Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�_F�� Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE): � . �
-------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
--------------------------------------------------
REMARKS (TO BE NOTED ON PERiv1IT�: _12A w� ��v ��r�-L 7 s � � /k P(Lo�e�
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,EYAPPRC�Y��'v'�i�N�C'��R�.CTiUPi5 a5 NOTEq
p NOT A4'FROV:D--•t;'��3�'�Lj°t�ESUBh11T
jTiese canmenis are fc;you�i�`�t ab{e}b�.�����i v;�3 zon'n�code.
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in tull compl�znc�r•���t� �;' �w'„"
qequiremen,s including"��>no;�Py"'ific?�'�Y noted in this r�view.
ls,�:�P l'1;�15 Pt,A� SE.�'7iv SITE AT ALI.SIME�t` I—�v 4 0 v i (�T'��F�
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� �� DATE TIME
CITY OF ORONO / CALLED IN 5 12 `{ �j�4'S.
INSPECTION NOTICE ,/. SCHEDULED 5 �3 9�i �1�30
PERMIT NO. � �,�2J �T COMPLETED
ADDRESS 357-7 �I'lp(F.�irLQ, D�
OWNER � CONTR. ��� ��"e�'��
TELEPHONE NO. �4 3— 2-1 5
� DESCRIPTION w� C.�.c�� ��n''t�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
y 03 INSULATION 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 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
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
c�., COMMENTS:
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W WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance.473-7357
Owner/Contractor
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
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