HomeMy WebLinkAbout1998-010351 - deck repair A PERMIT
l;IT'�( OF ORONO PERMIT TYPE:
2750 KE;ley Parkway- P.O. Box 66 �-�:_!����,����vt;
Crystal Bay, Minnesota 55323 Permit Number: �:��_}:_;:��
(612) 473-7357 Date issued: �a�;� ; �:._,;-;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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A LICANTiPERMITEE SIGNATURE � ISSUED BY:SIGNATURE
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'Total Fee: $ ��,�5 Date Received:
Entered By: ,� Permit#: /p,�S�
CITY OF ORONO - BUILDING PERNIIT 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 R CONTRACTOR
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JOB SITE ADDRESS: �-��{�g �U��S� �-��fj�ZIP: � ��
NAME OF OWNER: '�l �V` � 1 � � PHO�iE: (home) `�7 z -ZZ3 �
(worlc) Y 7y- 3 2�Zr�
MAILING ADDRESS: �,��;Llr� crrY: �i��f���u,�.0 z�:���
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C0�ITRACTOR: ] �� L-� l i t2 PHO�iE:
CONTACT PERSOPW:' MOBILE/PAGER:
MAII.,ING A.DDRESS: CITY: Z�:
STATE LICENSE: #
ARCHIT'ECT/ENGINEER: �'`�' � � � PHONE:
MAILING ADDRESS: CITY� Z��
N�: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPO ED V�ORK(d cribe in detain: ��� .�1�� I �cX � '� �� �� �� ���
G'�� �� �/G' ��-
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�IATED CONSTRUCTION VALUATION (excluding land): $ �?`�-�='��
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 Buildin� Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be a cordance wi e approved plan.
APPLICANT'S SIGNATURE: jl ' DATE: �'''•���_
NOTE! Parade of Homes even 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 SLfBJECTS OF DATa
Subd. 1. Type of daca. The riehcs of individual on whom[he data is stored or to b�scored shall be as set fonh in this secrioo.
Subd.2. Informalion reqirired to be given individual. An individual asked to supply privare or confideadal dara coacerning himself shall
be informed of: (a) the purpose and in[ended use of the reques�ed daea within che collecdng"stat�ageacy, polidcal subdivisioa,or srarewide system;
(b)whe[her he may refuse or is legally required to supply the requested data;(c)any Irnown coasequence arising from his supplying or refusing to supply
• privace or confidenrial data;and(d)the idenary of ocher persoas or enanes authorized by stace or federal law to receive the data. This requiremenc shall
no[apply when an individual is asked to suoply invesdgadve dara, pursuan�to secoon 13.82, subdivision 5, to a law enforcemen�ofFicer.
The commissioner of revenua mav lace the noace reauired under this subdivision in the individual income tax or orooer[v tax refund
insrrucdons insczad of on chose forms.
Subd. 3. Access to data by indi�idual. lipon requesc to a responsible au�horiry,an individual shall be informed whe[her he is the subjecc
of scored dara on individuals,and whecher i�is classified as public, priva�e or confidenrial. Upon his fur[her request,an individual who is the subjecc
of stored private or public daca on individuals shall be shown�he data wichouc any charge to him and,-if he desires, shall be informed of che contenc
and meaning of chat data. After an individual has been shown the priva[e data and informed of iu meaning, the data need no[be disclosed to hun for
six mon�hs chereafter unless a dispute or acdon pursuanc to this secrion is pznding or addiaonal da�a on the individual has been coflecu.d or created.
The cesponsible auchoriry shalt provide copies of the private or public data upon requese by the individual subjecc of�he data. The responsib(e authoriry
may require �he requesring person to pay the accual coscs of making,cerafying, and compiling the copies.
The responsible au�horiry shall comply immediacely,if possibl�, with any request made pursuant to chis subdivision, or wirhin five days oF
the da[e of che requesc,excluding Sacurdays.Sundays and legal holidays,if immediace compliance is noc possible. If he canno[comply wich the reques�
wi[hin cha�cime,he shall so inform�he individual,and may have an addidonal five days wirhin which co comply wi�h the request,excluding Saturdays,
Sundays and legai holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness oF public or pri�•ate
data concerning himself. To exercise this riehc,an individual shall nodty in wriang the responsible authoriry describing the nature of the disagreement.
The responsible auchoriry shall within 30 days either: (a)correce the da�a found to be inaccurdte or incomplece and attempc to nodfy pasc recipienu of
inaccurdte or incomplete data, including recipienes named by rhe individual; or(b)nocify the individual that he believes che data to be cocrect. Data
in dispute shall be disclosed only if the individual's stacement of disagreemenc is included with[he disclosed data.
The determinarion of the responsibte authoriry may be appeatzd pursuant co the provisions of the admiruscradve procedure act relaang to
contes[ed 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 permi[ or license from the Ciry of Orono or any of its departments may require you to furnish certain priva[e 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 da[a, but refusal may require that the City deny the perm.it or license.
3. The informa[ion may be shared with other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested pernu[ or license requires Council ac[ion to approve, some informa[ion may become
public.
j. You have certain riQhts under M.S. 13.04 (available upon reques[) to review private data on yourself.
(. Your full name is required co process this application or permit.
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I under�tand my ri;hts stated above. i �
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5ignature
< CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: '�2 O 5 �Q f�3� G�4-�l.� QR
PID:
DESCRIP'i'ION OF WORK: p�U� (�,�,hc(Z �/2 nxcdl S !?�P�eesr�,�
-- — -------------------------------------�-----�--�--�--
ZO�G REV�W BY: � DATE APPROVED• G 9 �
BUII,DING REV�W BY: DATE APPROVED: 6 -� -Q�
F'EES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r/ No
PLAN REV�W Yes • No f SEWER CONNECTION
STATE SUR��IARGL Yes � No WATERCONNECI'ION
INVESTIGAZ'ION FEE Yes No PARK FEE
SAC Y::s No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZOiVI�i 1G CHECK LIST Zoning District: �-> �(� C'�.f A/�J� �;
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depch
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): _ Right Side:
Rear(Street): Left Side:
Adjacent Structures: �Vetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Gradin�: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoni.ng File; # Resolution: # Resolution Date:
Shoreland DisL-ict:
Avg. Setback: Bluff Setback: LotCovera�e:
• Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
• 26
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BUII.,DING REV�W CHECK LIST �
usc: l�-3 co�rs�rxucTTo�r�E: �!ti
' Sq Footage $ Per Sq Ftg
Basemenc x =
lst Floor R =
2nd Floor R =
Garage x =
R =
,
TOTAL
Estimated Construction Value: $ C./,�Jpv"r--
Inspections Required: � `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�C Footing Septic Sewer Connection
_� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Ocher
Wall Board (Mfg.) Well (State Permit)
_Q��� Grading/Filling Electrical (State Permit)
Other .
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REi�IARKS (Pi 1 HOUSE):
---------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By; '
REiI�IARKS(TO BE NOTED ON PERiI�II'1�: �
27
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CERTIFICAT� OF SURV�Y
FOR:_ ,.JERRY � LEMERE �
CITY OF O�d�O
� SITE PLA�J G���Ii�G PIAN
�APFF�C?VED (.�cG� R,���2
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LEGAL (aESLltiPTION
LDT S, 13�OCK Z�
. FUREST ARI�S C�N�lTRY CLuQ ADDITIDN�
NEN�tE��N CvuNTY, M1NN
I hereby certify that this alan, aurvey or JOB �l
SCHOBORG Feport was prepared by me or under my direct 3���
supervision and �hat I a�n a duly Registered
� .!`d�J SURVEYING Land 5urveyor undec t��e 1���:� cF t�ie 5tate ot e�ok - P+�
�N C. Minnesota. � i � �7 _,4c�
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Date: ��tn,lF 7/,. iq9n RnnioFrn nn �Jn tr,�nn `���