HomeMy WebLinkAbout1998-010632 - deck PERMIT
, a F �RONO PERMIT TYPE:
275v Kelley Parkway- P.O. Box 66 �,t_:�( i i:t���,
Permit Number:
Crystal Bay, Minnesota 55323 i t 1�_t�,�:;:;:
(612)473-7357 Date Issued: ���;f�;:;f,�_;
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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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� ' Total Fee: $ ,��;�, ��/ Date Received: v�'',f�-�,�
Entered By: Permit#: /t--� ��Z
CITY OF ORONO - BUILDING PERMIT APPLICATION =
All information must be submitted in full before plan review will be started.
(please print all in ormation)
THE APPLICANT IS: (circle one) NE R CONTRACTOR
JOB SITE ADDRESS: ���� ����-- ZIP: � ���J�
NA1V� OF OWNER: �� ]'� /" � ���5� PHONE: (home) ��`� ����
� (wark) ���"���
MAILING ADDRESS: � ��� �-' ��U�/V CITY: Lr.�n.y��L W '"� ZIP: �`5 35 .�
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
.
TYPE OF WORK: N�w Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: � �-��-�!'� �/•�� �C ,� ��7�
G
STORIES: � SQ. FEET OF EACH FLOOR: y �C,��-��� �� _
NO. OF BEDROOMS: `� GARAGE STALLS: ATT. r- DET. �-
��>
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �j G�� ��
I hereby apply for a building pernut 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 Ciry and wi�.ti
the State Building Code; that I understandx�is is n �'a �ermit and work is not to start without a
permit; and that the work will be in accer he approved plan.
,;=: / 9�
APPLICANT'S SIGNATURE• �� DATE:
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent�r��'
City Council 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 shall be as set forth in ttus secdon.
Subd.2. Infotmation required to be given individual. An individual asked to supply private or confidential data conceming himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting srate agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requesud�ata;(c)any lmown consequence arising from his supplying or
refusing to supply private or coafidential data;and(d)the identiry of o�iie'r'�ersons or entities authorized by srete or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesdgaave data,pursvant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The co�m;ssioner of revernie mav�lace the ratice reauired under this subdivision in the individual income tax or oronertv tax refund
instrucrions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an i�lividual shall be informed whether he is the
subjcet of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who
is the subject of stored private or�blic data on individuals shall be shown the dara without any charge to hun 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 it�meaning,the data need not be
disclosed to him for six mo�hs thereafter nnless a dispute or ac6on pursuant w this section is pe�ing or additional data on the individual has been
collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the dara.
The responsible authoriry may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible suthoriry 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 6olidays,if immediate compliance is not possible. If he cannot comply with
the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,
excluding Sariirdays,Sundays and legal holidays.
S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
privaoe data concemiog himself. To exercise this right,an individual shall notify in writing the responsible suthoriry describing the nature of the
disagreement. The responsible suthoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt w notify
past r�ipients of inaccurnte or icxomplete data,i�luding recipients named by the individual;or(b)notify the individual that he believes the data
w be correct. Data in dispute shall be disclosed only if the individual's staument of disagreement is iacluded with the disclosed data.
The determinauon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
W 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 Gity 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 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.
��o�
First Middle Last
Address
Ciry State Zip Phone
I understand my r' as ve.
Sig e '
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' � CHECK OFF LIST FOR I5SUANCE OF PERMITS
FOR OFFICE USE ON�,Y
ADDRESS OR LEGAL: �=5�:�•� �� >�' ��-���, /�,.;
PID: -�'- - i � �� :� =��� rF,� _ ., :
DESCRIPTION OF WORK: � r- ��>j
--------------------------------------- ------ ------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: � -l 7-R 41
BUILDING REVIEW BY: DATEAPPROVED: g� -r�.-q,�
FEE5 TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No �
PLAN REVIEW Yes �' No SEWER CONNECTTON ;
STATE SURCHARGE Yes _� No WATERCONNECTION �
INVESTIGATION FEE Yes No PARK FEE �;
SAC Yes No SITEINSPECTION ,
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: �Qn — (�
Fire Department: �u� Post Office: School District: OILOrN I
Lot Area: Sq.ft.��Acres Width Depth
I
Survey Submitted: Yes pL No Date of Survey: �.t � ,
Proposed Setbacks: ,
Front(L�dee): 2�'� � Right Side: � ��� t'
Rear (&�eety 87� � Left Side: �O5� �' i
I
Adjacent Structures: �Q-r�Y�►G/f�� Wetland: �t/(�
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage: I
Grading: Staff Approval Date: By: Council Approval Date: �'�
�
Septic: Staff Approval Date: By: • -
� Zoning File: # Resolution: #� Resolution Date: I
1"�
Shoreland District:
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
s:'— ' '
BUII.DING REVIEW CHECK LIST .
UBC: IZ' 3 CONSTRUCTION TYPE: V/v
Sq Footage $Per Sq Ftg .
Basement x =
1 st Flooi x =
2nd Floor x =
Garage x =
� i0op x 10•oa = t�.000
TOTAL
Estimated Construction Value: $�('� (�tjc]�'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
< Footing Sepdc � Sewer Connection
�Framing Fireplace . Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
�Final Grading/Filling Electrical(State Permit)
Other
REMARKS(IN HOUSE): . � �
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT�:
8
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-`Om''�' Depot #28Q8 , 1705 ANN�POLIS LANE, PLYMOUTH, I�Il�I� 554�4
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_ .i s Price does not include ar_-- _'�ecial Order I 4�Tns . Pleas �
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'i;;r.�;;�o�*��,�;:ts ar�f;Y your iniorrn2tior.Ril��n�ark shall be done � :,. � �I ,
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DATE TIME
CITY OF ORONO CALLED IN �� �'
INSPECTION NOTICE a j� Z SCHEDULED %i � �d ��
PERMIT NO. ��" COMPLETED � �
ADDRESS /� 5 � �r�• �'
OWNER ���2%2,c.�'�, CONTR.
TELEPHONE NO. �S��'I -� l � �
� DESCRIPTION ��J
ty� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
QFRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVA�
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING FI 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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W ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. n pHOTO TAKEN
INSPECTOR WILL RETURN
C� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECT�ON REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-7357
Owner/Contr r o ite:
Inspector.
W te Copyllnspector's File Canary Copy/Site Notice
DATE .T/ IM��
CITY OF ORONO CALLED IN � -�
INSPECTIONNOTICE SCHEDULED `- -�f f'�3 �
PERMIT NO._ G �� COMPLETED � �—
ADDRESS j� �5 (U�.,,�� ��� ,� �
OWNER� r �,�� �2-?0-� CONTR.
TELEPHONE NO. �-f�f �l � � �l
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FOOTING _ 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
QP 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� OWNEHICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑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. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i s ection 24 hours in advance.473-7357
Owner/Contr ct r site
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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62684-001 306/73
SURVEY FOR: SCOTT & SHERYL MORRISON ���_88�
- - - - - - - - - -�
ao o ao eo �2o Feet /� � SCHOELL & MADSON, INC. �
' ENGINEERS � SURVEYORS • PLANNERS ' 1
I SOIL TESTING • ENVIRONMENTAL SERVICES �
� 10580 WAYZATA BOULEVARO, SUITE 1 �
����� ��q�� � I MINNETONKA, MN 55305 I
� ( I (612) 546-7601 FAX.546-9065 I
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DESCRIPTION: � .
Thot part of Lot 2. "ALBEE'S LONG LAKE ADDITION", occording to the
recorded plot thereof� Hennepin Co. Minnesota� lying north of a line
drown at right ongles to the west line of Lot 1 in soid oddition� through
o point in soid west line 292.71 feet south of the northwest corner This drowing hos been checked and
of soid Lot 1. reviewed this /9 �Gj day of
� BENCHMARK: � Ll vJ` � 19 � ,
� Top of iron monument os shown b �Q y ,v�r�_
� Elevotion = 997.71 (NGVD-1929) y
m
m GENERAI. NOTES: . I hereby certify thot this survey wos
S 1. o — Denotes iron monument set. prepared under my supervision ond that
m 2. • — Denotes iron monument found. I am a Licensed Lond Surveyor under the
� 3. x890.0 — Denotes existing spot elevotion. lows of the Stote of Minnesoto.
LL 4, x(890.0) — Denotes proposed spot elevotion. /
.
N 5. �.•-- - Oenotes direction of surfoce droinage. _ __ d'lL
� 6. Proposed goroge floor elevotion = 998.2. Theodore D. Kemna
m 7. Proposed bosement floor elevotion = 988.5.
; Dote: Aug. 14� 1997 License No. 17006
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