HomeMy WebLinkAbout1998-010257 - storm damage repair PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66Permit Number: 'i_j T F t'1�'
Crystal Bay, Minnesota 55323 `-
(612) 473-7357 Date Issued: -SITE ADDRESS: ii
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - P`P`1 i,�. t. — ==;T . LIC . OWNER:
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: G '> C 9 z v �nt'r n� /r =•.i�„!1
PID:
DESCRIP'T'ION OF WORK:
— ------------ --------------------------------------------
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: r ' DATE APPROVED: S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
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: �� �1�► 1 ' �'� -'l-�
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): _ Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hat. Peak Hgt.
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):
26
BUILDING REVIEW CHECK LIST
UBC: CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x
2nd Floor x
Garage x =
x —
TOTAL
Estimated Construction Value:
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
—d Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
AC
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):
27
WNW
Total Fbe: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(pl ase priall in
-- ----u— ----------------------------------------
THE APPLICANT IS: (circle one) OWNER OR TRAC
JOB SITE ADDRESS: �36 � S ZIP:
NAME OF OWNER: PHONE: (home)
(work)
MAILING ADDRESS: 3a -3 j CA-,"Lo CITY: 0/e.0jy0 ZIP:
CONTRACTOR:5'r'-/-J -Y p
�'�""1 `� �v�.�cLt.,l�,..� /�-r- PHONE: 3 're 41
CONTACT PERSON:�3k, ` MOBILE/PAGER:
MAILING ADDRESS: �f/Uy �,<<Qlsi J� /� CITY:S/"% 4a ��t f'i� 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`YORK(describe in detail): 5%� -14A4:P,/
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ -, 4�--s-0
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 o c with the approved plan.
APPLICANT'S SIGNATURE• DATE: 5 -
i
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 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 dam;(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 dam. This requirement shall
not apply when an individual is asked to supply investigative dam,pursuant to section 13.82,subdivision 5, to a law enforcement officer. -
The commissioner of revenue may place the notice recuired 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 dam on individuals shall be shown the dam without any charge to him and;if he desires, shall be informed of the content
and meaning of that dam. After an individual has been shown the private dam and informed of its meaning,the dam need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending or additional dam 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 dam. 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
dam 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 dam 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 dam 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.
First Middle Last
Address
City State Zip Phone
I unders n ated b ve.
Signature
We hereby submit specifications and estimates for: 0 � , G� `" k/No. �' of �lja Pages
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Notes: See Reverse Side For Important Notice.
All jobs are scheduled on a weather permitting basis.
Contract includes all permits and applicable taxes. Acceptance of Contract—The above prices,-specifications and
Contractor to clean-up&remove all debris from entire yard. conditions are satisfactory and are hereby accepted.You.are authorized to do the work
Contractor to magnetize yard&driveway. as specified.Payment will be made asouttined afi6ve_ '.
Contractor not responsible for damage to trees,bushes&shrubs during normal reroofing operation. _
Contractor not responsible for sheetrock or plaster cracks due to normal reroofing operation.
Contractor not responsible for dust and debris in attics during roofing.Sela recommends Date of Acceptance:
homeowners cover their belongings.
Contractor not responsible for driveway damage. A late fee of 5%will be imposed on any balance not paid within five(5)days of when
Contractor not responsible for interior damage due to condensation,ice damming or ice backup. due.Owner shall pay all Contractor's collection costs,including attorney's tee's,if Owner
Contractor to provide mechanic's lien waiver upon receipt of full payment of above work. defaults on payment.
Seta to provide Year Manufacturer's Warranty to original owner.
%! S gnat ru e
Seta to provide�_Year Labor Warranty to original owner. ( J
DATE TIME
CITY OF ORONO CALLEDIN
INSPECTION NOTICE SCHEDULED
PERMIT NO. I CU ?'� COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION S iZ «'rte 4).'`trvwE L_ >. �-�: { d A (Z
w 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
0RAMING 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 05 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
Q
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES NO
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w II WORK SATISFACTORY:PROCEED PROJECTCOMPLETE
CC 1 i ORRECT WORK&PROCEED 7J ISSUE CERTIFICATE OF OCCUPANCY
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O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r PHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED_CALL INSPECTOR F1 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrgetorpn site:
Inspector. {`Lk_C
White CopylInspector's File Canary Copy/Site Notice