HomeMy WebLinkAbout1997-008896 - deck PERMIT
CITY OF ORONO PERMIT TYPE:
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2750 Kelley Parkway- P.O. Box 66 Permit Number: '�����'=`
Crystal Bay, Minnesota 55323 � - - �- • -
(612)473-7357 , -. Date Issued: _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- �����:�� __�:E� -
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ ;�?C f,�� ` ` Date Received: y ��� � �
Entered By: ^,��. Pernut#: �,S'T�.
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: �g`7 `�Lc�p�j ,��, � ZIP: ��3��
NAME OF OWNER: J- JDC�ti�rn� PHONE: (home) �-?ro 10�
(work) _ �7�-y-3��
MAILING ADDRESS: ��� �h{n �_CITY: � �T,,, ,� ZIP:_�
CONTRACTOR: ��,/��� 9'-����lC� ��tn�J PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
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�: G�-�—�--
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII`ZATED CONSTRUCTION VALUATION (excluding land): $ 700�� �
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 ' cordance with the a proved plara.
APPLICANT'S SIGNATURE: �� . /
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.
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or conf'idential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the idendty of other persons or entities authorized by state or federal law to receive the data.
This requirement shal(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 notice reauired under this subdivision in the individual income tax or oronertv tax refund
instructions 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 confidential. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown d�e data without any charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an uidividual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been
collected 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 authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsib(e authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request,ezcluding Saturdays,Sundays and legal holidays,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 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 fourxl to be inaccurate or incomplete and attempt to nodfy
past recipiencs 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 determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
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 City of Orono or any of its depaztments may require you to furnish certain
private or confidential information.
You are notified that:
1. 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 Ciry 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�iy State Zip Phone
I understand my rights as stated above.
Signature
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CHECK OF� LIS'i'.FOR ISSUANCE OF PERMITS
FOR OFFICE USE O LY
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ADDRESS OR LEGAL: `�, ;� ��L�-L>,/� �� ���
PID: �
DESCRIPTION OF WORK: �.j_�- ,�_.�,
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ZONING RE`IEW BY: �z'� C��-<•—_ DAT'E APPROVED: �f -z2-s�
BUILDING REVIEW BY: �" J,; � � 7
-:-�(�L�,t.,,� DATE APPROVED: �,- z z �
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �--� No SEWER CONNECTION
STATE SUR:�IARG� Yes ��� No WATERCONNECTION
INVESTIGAZ'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OT�-iER (specify)
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ZONING CHECK LIST Zoning District: �R"��
�';re Department: 1.��,1.1��u:: Post Office: t�=��������' School District: �;2-�N
- ;�—
Lot Area: Sq.ft. �U,l�c� Acres r�Q � Width 2�,�% Depth 3i G
Survey Submitted: Yes X No Date of Survey: C� � � 7�
Proposed Setbacks:
Front (�ce.}; Z-��� ± Right Side: ���� � �'
Rear(�tFeet): �1� ± Left Side: i c y� '�'
Adjacent Structures: ��-r�ac..,�c-r,� Wetland: !v �fW
Building Height: Def. Hgt. ti(r4 Peak Hgt. -,
Lot Coverage: ���,4
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland Dist:ict:
N-A� Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house): Ch�-T�� Pn.�v r��.r,l -��;,,.� ,�ex��; �-_� !�c� �-,I��J! �.1 ;` —
• 26
BUII.,DING REVIEW CHECK LIST
UBC: � '� CONSTRUCTION TYPE: �(N
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �7,���'�'`'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
iC Footing Septic Sewer Connection
_;� Framing Fireplace Lawn Inigation
�lation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�n Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE NOTED ON PERMIT):
27
� DATEl;y TIME
CITY OF ORONO CALLED IN � i
INSPECTION NOTICE SCHEDULED �� ����`�—
PERMIT N0. �J'�'� � COMPLETED
ADDRESS �{�."�� �'-��-a� ��-i � N
OWNER '�c CONTR.
TELEPHONE NO. � 7G - e����
� DESCRIPTION .[�.2-��
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� G 13 MECHANICAL FINAL 19 lA1�SHOFEM�ETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBIN(�a RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �WOf1K SATISFACTORY:PROCEED PROJECT COMPLETE
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� L CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O :.- CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,� pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspect' n 24 hours in advance.473-73�J7
OwnerlContractor o it •
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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