HomeMy WebLinkAbout1999 - 011949 - remodel PERMIT
Ci* OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66
Permit Number:
Crystal Bay, Minnesota 55323
Date Issued:
(612) 249-4600 / /
SITE ADDRESS:
. -
. .
DESCRIPTION:
, .
R-3
REMARKS:
FEE SUMMARY:
$2, 673 75
94
Surcharge uf.)
Total Fe,2
CONTRACTOR: - ::Ti OWNER:
INC 71.E;2.:::24&j
GIW)
17
: SS:-71;91
THE UNDERSHNED HEREPY
- ; ET-; PERMiSSION TO MAKE THE REAL IMPROVEMENTS
SF.ECIFIED ANC! AG1REES 10 ALL IN SIRICT COM:tiANCE WITH ALL CITY OF
fl;RONO ORDINA-'4ES f-1ND STATE MINNESOTA t7-5UILDINt:i CODE REQUIFcEMENTS .
APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE ad494,,N.
Total Fee: $ y 1 (Ql i . (oq Date Received: 94,7 h9
Entered By: Permit#: 1 I q Li9
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 ORCONTRACT
JOB SITE ADDRESS: 2.L) W oo iL-t,(, El ZIP: 5.55,1
NAME OF OWNER: &1Jf1- i4Aktuo_oLL
PHONE: (home) X957"6-'n 55
(work)
MAILING ADDRESS: 3Z bze.scJ 11 i CITY: Oto ZIP: 553
CONTRACTOR: d�,E.0 f'cer- - f,`f tc PHONE: SZ. - 3`QST
CONTACT PERSON: 1: 1.c s _ o,o B 1 OP AGER: q/?- 5332_
MAILING ADDRESS: i 9-4$ f J Icnl, yet' 4.t) .._S CITY: ItqpS ZIP: ,'54(d ci
STATE LICENSE: # 5z/ 2,
ARCBITECT/ENGLNEER: L4t,uWijmi) PHONE: 3-7-1 -V.5
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X Land Alteration
PROPOSED WORK(describe in detail): 011-.s.,.4-0>cry\, Q $c_Aesf r
4- Tia r(�se:s-7--
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTLMATED CONSTRUCTION VALUATION (excluding land): $ Lt oo, o o J 1111
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 bVt
dance w' the approved plan.
APPLICANT'S SIGNATURE: - DATE: 9 —4 -"
NOTE! Parade of Homes events require separate permit approval by Police Department and
Ciiy Council 60 days prior to the event. Non permitted events will not be allowed.
9
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 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 required 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.
Nt.iFirst y N--�° d `e ast
Address F/.�±_ ,4
M�5 5'5— o9 6/2.
City State Zip Phone
I und- . my rights as stated above.
Si:. ture
10
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: azo o It l�-
PID:
DESCRIPTION OF WORK: (2 -14,1.0 0-e L. t4A4s rs✓C s v rLT
ZONING REVIEW BY: /U f/ DATE APPROVED:
BUILDING REVIEW BY: „eye 664.4__. DATE APPROVED: /0-!- 9 g
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes 1/ No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No ✓ PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC.Units OTHER (specify)
ZONING CHECK LIST Zoning District: No C-/#011"15-e
Fire Department: Post Office: School District: •
Lot Area: Sq.ft. Acres dth Depth
Survey Submitted: Yes No ate of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetlan.:
Building Height: Def. Hgt. Peak H:t.
•
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 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: t2- ' CONSTRUCTION TYPE: V r•-i
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x _
2nd Floor x =
Garage x =
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site x Plumbing Fire
Hardcover Removal ,� Mechanical Water Connection
Footing Septic Sewer Connection
yL Framing Fireplace Lawn Irrigation
I( Insulation (Masonry) Other
a( Wall Board (Mfg.) Well (State Permit)
`-Final Grading/Filling pc 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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CITY OF ORONO . I•
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BUILDINC.i 'EROT PLAN REVIEW
INSPECTOR
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DATE TIME
CITY OF ORONO CALLED IN 1--13-co /,' Oa
INSPECTION NOTICE, SCHEDULED Oma' ` 0
PERMIT NO. //97 COMPLET D 'j ' - -'
ADDRESS 3vZ 0 v)OWNER cQ CONTR. R u P
TELEPHONE NO. %9 p (GII 5-4 o
DESCRIPTION C���` til 7t c ' L� 9c '
lu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
QiCP— _ 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION > 24/25 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
1,• 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
IL 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
oy COMMENTS:
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W� ORK SATISFACTORY:PROCEED i_ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
Li 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 inspection 24 hours in advance. 249-4600
Owner/Contrac r on site:
Inspector./ e6.--e-"C
White Copyllnspector's File Canary Copy/Site Notice