HomeMy WebLinkAbout1999-011985 - remodel 2 baths PERMIT
"CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66j €74L
Permit Number: J r
Crystal Bay, Minnesota 55323 Date Issued:
(612) 249-4600
SITE ADDRESS:
DESCRIPTION:
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FEE ENT 1AL-
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: TOWNER:
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THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE kgo,
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IFIED AND AGREE' TO 00,�r'ALL W1 IRK IN STRIC
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IHLINCI ORDINANCES AND.1�ST411E',tfF -M l 14.NESOTA BUILDING CODE RE,
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APPLICANTPERMITEE SIGNATURE ISSUED BY:SIGNATURE
` Total Fee: $ �7'"l - q" Date Received:
Entered By: Permit#: (a
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 1L 76) S7 W�1_-rcks Aer ZIP:
NAME OF OWNER: ?DQ zoo k i�- w/c z- PHONE: (home) 4171-- `f
(work) WA
MAILING ADDRESS: M CITY: 17k6 ti?-) ZIP: r
CONTRACTOR: 7-SPc&ALIS(' PHONE: 7,2- e10?
CONTACT PERSON: .&NA!£V/C L MOBILE/PAGER: Z 2 1 — 3?&>
MAILING ADDRESS: 6ao 1yDD GE CITY:&u& Sr-A ZIP: S,5 Y
STATE LICENSE: # �2p/ 7 60 Z 3
ARCHITECT/ENGINEER:_ MA4E PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration _ Land Alteration
PROPOSED WORK(describe in detail): 02 348s > rQcrA/r
�- 609,A16 WALL 5ois7"S oaf' iPA�rEP H A/I"K,E
STORIES: SQ. FEET OF EACH FLOOR: `A
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�o
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 02S,57449
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.
APPLICANT'S SIGNATURE: DATE: /0/
NOTE! Parade ofHomes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
Sec.13.04 RIGNI'S OF SUBJECTS OF DATA
Subd. 1. Type ofdata. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential 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 identity of other persons or entities authorized by state 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 may place the notice reauired under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,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 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 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 authority shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual costs 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 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 authority 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 determination of the responsible authority 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 departments 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 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.
& ,.1) - &NEUIULE
First Middle Last
6200 W100 ED6 E �
Address
�j�iV�tlE �Q�s r �I�tl X536 y7 2 ye? -
City State Zip Phone
I understand my rights as stated above.
744,1T
Signaturd W-
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2.-10,5 UJ A L. Tc--t-s ,pp fL-r
PID:
DESCRIPTION OF WORK:
---------------
ZONING REVIEW BY: /V f tv DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED: !v -/Z-�i�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes i/ No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
-----------------------------
ZONING CHECK LIST Zoning District: //0 C-tt&5r
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres M'dth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wedan :
Building Height: Def. Hgt. Peak H
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # R olution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUILDING REVIEW CHECK LIST
UBC: • 3 CONSTRUCTION TYPE: V/V
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage X =
x =
TOTAL
0
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site A_Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
.� Final Grading/Filling O 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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PLANUS -CoAjrkACT0e
SEE ATTACHED SHEET
HOME IMPROVEMENT SPECIALISTS w^LK t�kj FOR ww""` "McA-m-�
6700 WOODEDGE ROAD cLosET CODE REQUIREMENTS
MINNETRISTA, MN 55364 NEu/-EttH/NhTE
PHONE: (612) 472-4092 6 31y 8A'r14
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PROVIDE PUMP AND/OR NEw !
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THROUGH TILE-UNACCEPTABLE /
CITY OF ORONO
BUILDING. PLAN REVIEW iN D c S N awE�
INSPECTOR5
DArE O-7L• PER11,17 NO.
❑ APP'F0Vr_:r)A-S U�,"t irD GLp►SS
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❑ i APP" O ED u RES�S8 AIT
77,—,se COrnTem;are iGr ycur in'Cf'i c Cn. All Ncrk shat{to dorm
In lu!! complian.e .vim a!1, ap ii'.231s bua Jng and zoning code.
Requirements including items rot sp.c i;�u,i ncted in this review.
KEEP THIS Pact SET ON SITE AT ALL TIMES
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED _"�-�� /
PERMIT NO. 1 T- COMPLETED — �
ADDRESS Z-?G
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
LL 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
12 WATER HOOK-UP 17 SITE INSPECTION
0n>LBD.
14 SEWER HOOK-UP 06 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTO OMEETYOU: YES NO
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W 11 WORK SATISFACTORY:PROCEED ElPROJECTCOMPLETE
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W XCORRECT WORK R PROCEED E, ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
F. CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site: /V/b
Inspector 7z 4�I-f
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE :- SCHEDULEDf �
PERMIT NO. / `� S COMPLETED 7:6_n C) r
ADDRESS7�� �i /f Pr' �fy2o�C
OWNER CONTR. �yh�
TELEPHONE NO.
DESCRIPTIONS
Lij 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA 14 SEWER HOOK-UP 06 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W(- ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTEQ.CALL INSPECTOR CI CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector. lya_ 4 ✓1 j
White CopylInspector's File Canary Copy/Site Notice
Z-yif,'
DATE TIME
CITY OF ORONO CALLED IN /6 �
INSPECTION NOTICE SCHEDULED ` w
PERMIT NO. Jl q C-L COMPLETED 1� �-
ADDRESS
OWNER CONTR. �e
TELEPHONE NO. a_(4 G Q
DESCRIPTION
W 01 F G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 0 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 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
Q OWNEFIXONTRACTOR TO MEET YOU:_YES_NO
Z
COMMENTS:
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aVORKSATISFACTORY:PROCEED ElPROJECTCOMPLETE
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CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contracto it .
Inspector.
White CopylInspector's File Canary Copy/Site Notice