HomeMy WebLinkAbout1997-009102 - entryway PERMIT
CITY`OF ORONO PERMIT TYPE: ~ - °�
2750 Kelley Parkway- P.O. Box 66 Permit Number: �-�t'�,i�-`��:����
Crystal Bay, Minnesota 55323
Date Issued: '�'.•''�•��,''_�-°
(612)473-7357
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWI��R, _
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' APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� Total Fee: S a ��� `�� DateReceived:
Date Approved:
Entered By: Permit#: �/da
CITY OF ORONO - BUII..DI�i tG PERMIT APPLICATION
�I.L I�IFORl'�IATION I�IUST BE SUBI�'ITT"I�ED IN FULL BEFORE PLr�uv REVIEW`VII..L
BE ST�RTED
----- ------------------------
THE �PPLIC�vT IS: (circle onej OWNER OR CONTRACTOR
JOB SITE :�DDRESS: I2lPD SP�UC� P�� z�: .�.�3�
� � 471- ��h3
NA:�IE OF OWNER: �✓�'^����� �!l�1.s� PHONE: (home)
(work) 78Z `/3f�cJ
V1AII..Ti�TGADDRESS: �'''`'�C CITY: Z�:
CONTRr�iCTOR: ��'� PH��' i
MOBILE PHONE/PAGER: --
MAILING r�iDDRESS: CITY: �- Z�: —
STATE LICENSE: #
ARCHITECT/ENGINEER: ��� PH0��1E:
vIAILI�IG ADDRESS: CITY: Z��
N�vIE: REGISTRATION #
TYPE OF WORK: New Addition � Accessory Structure
Move Remodel/Alteration Land Alt,erarion
PROPOSED�VORK(describeindetail): E W� R� � � ��E� 5'`'`�'V �'
O�t/F1�/57"/�4 �`dvSc -- /1/�--� DA�. S�,D f
STORIES: � SQ. FEET OF EACH FLOOR:
---�
NO. OF BEDROOVIS: —' GARAGE STALLS: ATT. — DET. —
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ESTLtiI�TED CONSTRUCTION VALUATION(eYciudingland): $ �0D 0 "�— x
I hereby apply for a bu:lding permit and I acknowled�e that the information above is complete
and accurate; that the work will be in conformance with the ordinances and codes of the Ciry
and with the State Building Code; th I unde tand this is not a permit and work is not to start
without a permit; and that the wor ill be cordance with the approved plan.
:�PPLIC:��T'S SIGNATURE:
� DATE: ( — �Z "' �,6
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
. � � �
Sec.13.04 RIGHTS OF SLTB.TECTS OF DAT,� '
�
Subd. 1. Type of data. The righu of individual on whom che data is stored or to be scored shall be as set forch in this secrion.
Subd.2. Information reqirired to be given individual. ?.n individual asked to supp�y private or confidenaal data concerning himself sha11
be infotmed of: (a) the purpose and intended use of the requested dara wi[hin che collecdng'state agency, poliacal subdivision,or sracewide system;
(b)whether he may refuse or is legally required to supply[he requested data;(c)any l�own consequence arising from his supplying or refusing to supply
priva[e or conndendal data;and(d)the identiry of other penons or enriries authorized by state or federal law to receive the data. This requitement shall
no�apply when an individual is asked to supply invesagaave dara, pursuant to secuon 13.82, subdivision�, to a law enforcement officer.
'Ilie commissioner of revenue mav lace the norice re uired under this subdivision in the individual income tax or ro�em rax refund
inscrucnons instead of on those forms.
Subd. 3. �.ccess to data by individual. Upon request to a responsible authoriry,an individual shall be informed whe�her he is che subject
of stored data on individuals, and whether it is c(assified as public, priva[e or confidendal. Upon his fur[her request, an individual who is the subject
of stored private or public data on individuals shall be shown[he data wichout any charge to hun and, if he desires, shall be informed of the conten[
and meaning of that data. .4frer an individuai has been shown the private data and informed of ics meaning,the data nzed not be disclosed to him for
six months thereafter unless a dispute or action pucsuant to this secnon is pending or addidonal data on the individual has been collecced or creared.
The responsible au[honty shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry
may require [he requescing person to pay the accual costs of making, cer[ifying, and compiling the copies.
The responsible authoriry shall comply immediatety, if possible, with any requesc made pursuant to this subdivision, or wichin five days of
the date of the request,excluding Saturdays,Sundays and legal holidays, if immediace compliance is not possible. If he cannot comply wi[h che requesc
wichin thac ame,he shall so inform[he individual,and may have an addidonal five days wi[hin which to comply with[he request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or compiete. An individuai may contes[the accuracy or comp(eteness of public or private
data concerning himself. To exercise this right,an individual shall nocify in wridng the responsible au�horiry describing the nature of the disagreement.
The responsible au[horiry shall within 30 days ei[her: (a)correcc the data found to be inaccurate or incomplete and attempc to noafy past recipien[s of
inaccurare or incomplete data, including recipients named by the individual; or(b)notify the individual tha[he be(ieves[he data to be correct. Data
in dispu[e shall be disclosed only if the individual's sta[ement of disagreement is included with the disctosed data.
The de[erminadon of che responsible au[hority may be appealed pursuan[to the provisions of the administraave procedure act relacing to
concested cases.
DAT� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we wouid like to inform you that your request
for a pernut or license from the City of Orono or any of its departments may require you to fumish cenain private or
confidential information.
You are notified that:
1, The information you furnish will be used to deternune your qualification for the permit or license requested.
?. You may refuse to suppiy data, but refusal may require that the City deny the permit or license.
3, The information may be shared with ocher local, state or federal a�encies to the extent necessary to process
the permit or license.
4. If your requested pernuc or license requires Council action to approve, some information may become
public.
�. You have certain ri�hts under M.S. 13.04 (available upon requesc) to review private data on yourself.
6, Your full name is required to process this application or permit.
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State Zip Phone
City
I understand my rights as tated above.
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Signature
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BUIIrDING PERMIT SURVEY �
FOR:�I//�/v �i���.�SD/V _- �� �i �
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Lot 1� �l�ck 1C, Saga :iill Revised. together uith thatppa t o'f'
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vacated Lake Streec ad,joinin� said Lot 1, Block 10 as shoun on the survey attached �
Lo the notice of vacac_on in 9ook 'ii of Miscellaneous� page 590. Document No. 321358;� '
filed in the office of she ke�rister of Deeds� Hennepin County� Minnesota. �
❑ = WOOD STAKE PLACEO o = IRON MON. SET • = IRON MON. INPLACE
B.M. �
BEARINGS ON PROPOSED INFORMATION
ASSUMED DATUM 1st FLOOR El.EV. GARAGE FLOOR ELEV.
BASEMENT ELEV. TOP BLOCK ELEV.
—� = DRAINAGE 000.0= EXIST. ELEV. �000.4,= PROPOSED ELEV. ���0= EXIST. � PROP. ELEV.
I hereby certity that this plan, survey or report was. � JoBIf
SCNOB ORG prepared by me or under my direct supervision and that!am �775"
a duiy Registered Land Surveyor under the Isws ot the State
ND SURVEYING a( Minnesota � Book -Pags
irvc. � . 3Q—�3
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Scale �,
��'•�- 13� Date: /�DU G• �9g� Registration No. 14700 � ��,,�34
972-37Zt DNano.MN �e
. . �
� CHECK OFF LIST FOR ISSU��iCE OF PERMITS
FOR OFFIGE USE ONLY
:�DB�SS OR LEGAL: ��2(� �` �'.•t`��-`'t /�('�-
PID: L��--:fr�- �'.3 ,3..� c��'�2,
DESCRIP'TION OF WORK: �'L �
----------- ----
ZONING REVIEW BY: � u�� ���.��--- DATE APPROVID: (� - l Z- 9 7
BUII.DIi�tG REVIEW BY: � _ DATE APPROVED: � - t 2!-�?
- -------------------------
F'EES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓� No
PL� ��� YeS ,/� �o SEWER COivNECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE iNSPECITON
Number of SAC Units OTHER (specify)
-----------------------------
ZO�G CHECK LIST Zoning District: G.2-/L3 Shoreland District : �GS
Fire Departmen[: ✓V�Ov N� Post Office: �n buN� School District: �p(�ro���
Lot r�.rea: Sq.ft. l Ct SZ� Acres , Zt� Width S !•�' �� �Depth !�1� � �'�,
Survey Submitted: Yes _�_ No Date of Survey: i[-b-�1 6
Proposed Setbacks:
Front (Lake): ( [�a� � Ri,Pht Side: ZZ� �
Rear (Street): �7 Qj�� I.eft Side: 31��'
:�djacent Structures: �/6� � Wetland: /�.1 i/�
Building Height: Def. Hgt. O�k Peak Hgt. D-(�
Avg. Setback: D •K Bluff Setback: N �� L.ot Coverage:
Existing Proposed
Hardcover: 0-75' S��'�`�-�- `NO ����5
75-250' �t S 3 y�.�3
250-500'
500-1000'
Hardcover Variance Required: Yes X_ :`jo Date of Council Approval: S-Z7-�r'�
Grading: Staff Approval Date: N !/� By: — Council Approval Da[e: —
Sepdc: Staff Approval Da�e: N//� By: —
Zoning File: # .���l Resolution: # ,3�P Resolution Date: "� o�7
RE�'�iARKS (in house):
w •
BUIZD�G REV�W CHECK LIST
uBc: R- 3 co�rs�rxucTTo�r �E: v N
�
Sq Footage S Per Sq Ftg
Basement e —
lst Floor x —
2nd Floor R —
Gara�e Y =
` X =
TOTAL
o�
Estimated Construction Value: � � �4�r _—
Inspections Required: `Vork Requiring Separate Permits:
S i te Plumbing Fire
Hardcover Removal Mechanical Water Connection
Foocing Sep[ic Sewer Connection
}l Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permic)
_� Final Grading/Filling Electncal (State Permit)
Other
REI�IARKS (Tiv HOUSE):
- ---------------
REVIEW BY OTHERS: DATE:
Access: Existing �eW
Access Approval: Date BY�
REviARKS (TO BE NOTED ON PERNIIT):
27
DAT�� TIME
CITY OF ORONO CALLED IN ���
INSPECTION NOTICE SCHEDULED � �r < < �
--�--
PERMIT N0. ���� �' COMPLETED 1A �
ADDRESS /,��cU �.[�_ ��
OWNER �`l{,-r� �'Jr.�� CONTR. "
TELEPHONE NO. �7� ���—�
� DESCRIPTION �C�Z-r1'1c'z�� — ,�.�.,-.,
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADIN�/FILLING
�Q 2 F II�G� 13 MECHANICAL FINAL 19 LAKESHOREIWETLANDS
0 031NSULATION 24l25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HAFD COVER REMOVAL
v 10 PLUMBINQ FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d X;WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� C�CORRECT WORK 8 PFOCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. -, pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �: CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
OwnerlContrac sit :
Inspector.
White Copyllnspector's File Canary CopylSite Notice