HomeMy WebLinkAbout1996-008037 (Addition) � PERMIT
. CITY OF ORONO PERMIT TYPE: , ;a: � . _.
2750 Kelley Parkway- P.O. Box 66 �'�_.£:.i..�..-1.I'yiv
Crystal Bay, Minnesota 55323 Permit Number: ,.;�_;��._.,._;:,
(612) 473-7357 Date Issued: �V��,;;;:y��;�Wj�,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -� �t����l ?r�.�3t� -- OWNER:
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE �'�!,
Total Fee: S j l,/� �� DateRecei��ed: 5J' �� %��
Date Approved:
Entered B��: ��� Permit�: ,���'1
CITY OF ORONO - BUII�DI�1G PERivIIT �PPLICATION
:�LL I��tFOR�1�TION l�1UST BE SUB�ITTTED IN FULL BEFORE PL��t REVIEW tiVII.L
BE ST�RTED
- - - --------------------------------
_____- ---------------------------------- - - -
THE :�PPLIC:�\T IS: (circle onej OWNER OR C��TRAC�R
JOB SITE �DDRESS:
� �� l� �;�AL����2- �'�r1-� �`�i>ZIP: ��3�Z
�i��1E OF O�V��ER: �1�-��� �-���-��- PHONE: (home) �72-' �07�
(work)
I�IAII.�'G:�DDRESS: ��V�1�== CITY: Z�:
CONTRACTOR: �IAU�I•t�CY'L� �L'- PHOiVTE: i=?-�/-�---� ('���-�
�IpgILE PHO�IE/PAGER:
�4�-FJ �1- < �` �_ . `�,�s(
MAIL�iG�DDRESS: �. � Ei�1 1 'r� CITY: `--�-'t�,�'x� (�.\��
STATE LICENSE: # �3��
�RCHITECT/ENGli�1EER: PHONE:
v1AILI��'G ADDRESS: CITY: Z�:
����: REGISTRATION �
TYPE OF WORK: New Additio� �ccessory Structure
Move emodeU/Alteration Land t'�lteranon
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PROPOSED WORK(describe indetail): �� 2ti� {-��LC� f������i Tl%��r�� �c�a<< �/�`������
,- �� � � :�l )f� �,L���;ti'1 ���IE�T �'�(L`��1t�Y� �-'�1k��Nl� i�T� MR`���Y�
� (�`C'f�
/ _ � ,[ `�'` �i (� �C- �i T�'t=��P� S
i :.a_ I�� (= `� I�-�`�"�1�''v � �-
STORIES: ` � SQ. FEET OF EACH FLOOR: �,2F��� l(�..�'�' -
�10. OF BEDROO�IS: '' G�RAGE STAI.LS: ATT. DET.
��,
� ESTL�I�TED COi�1STRliCTIO�i V��,I.UATION(escludingland): S ( �'��c^Y i��'
I hereby appl�� for a buildin� permit and I acknowledae that the intormatiun above is complete
and accurate; that the work will be in conformance �vith the ordinances and codes ot che Ciry
and �vith the State Building Code; that I understand chis is not a permit and work is not to start
wi�hout a permit; and that the wo.r will be in acco�dance with the approved plan.
�1T'S SIGNATURE�: � ��� � �� �� DATE: ~����i �`�G'
\\ :�PrLIC� �
NOTE! Parade of Homes events require separate permit approval by Poliee Department and
� City Council 60 days prior to the event. Non-permitted events will not be allowed.
� �`.� ri?��` +�1,��'�t'(`,''�; 1 =, �;� ;;,_,_�(�:�f�1 y�l`=1.�!''�.. "'�('� C� r'�12�
'��� �i�"-S NC�T� ���C_T `7lrt C �-!�-5 C�'t'� ����`��-�'�:S 1�'�� l-�c�- -`�C'��>P��,
Sec.13.04 RIGHTS OF SUBJECTS OF D,�T?�
Subd. 1. Type of data. The righ[s of individual on whom the data is scored or to be scomd shall be as set forth in this secrion.
Subd.2. Information reqirired to be given individual. r1n individual asked to supply private or confidenrial data couceming himself shall
be informed of: (a) the purpose and in[eoded use of the requested data wi[hin the collecting'state agency, polidcal subdivision,or sracewide rystem:
(b)whecher he may refuse or is legally required to supply the requested data;(c)any imown consequence arising from his supplying or refusing to supply
pnvace or co�denna!dara:and(d)ehe idendty of other persons or enddes authorized by snte or federal law to receive the data. This requirement chall
not appty when an individual is asked [o supply investigarive data, pursttant[o secvon 13.82, subdivision�, to a faw enforcement o�cer.
"I�e commissioner of revenue mav place the noace re uired under this subdivision in the individual income tax or orovem caz refur.d
instrucnons ins�ead oi on rhose forms.
Subd. 3. Access to data by individual. Upon request ro a responsible authoriry,an individual shall be informed whecher he is che subjec[
of stored data on individuals, and whether it is classined as public, private or confidendal. Upon his further request, an individual who is the subjec[
ot stored private or public data on individuals shall be shown the data wi�hout any charge to him and, if he desires, shall be informed of rhe contenc
and meaning ot�hat dara. After an individual has bee�shown the priva[e data and informed of ics meaning, rhe da[a need not be disclosed to him ior
six monchs�hereafter unless a dispu[e or action pursuant to this secdon is pending or addidonal data on[he individual has been collecced or crearEd.
The responsiblz authoriry shall provide copies of the privare or public data upon reques[by the individual subject of the da[a. The responsible au�hori[y
may require the requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible auchonry shall comply immedia[ely, if possible, with any request made pursuan[ro[his subdivision,or within five days of
the date of the request, excluding Saturdays,Sundays and legal holidays,if immediate compliance is no[possible. If he cannot comply wich the request
wichin chac time,he shall so inform the individual,and may have an addiaonal five days wi[hin which to comply with[he request,excluding Saturdays,
Sundays and leeal holidays.
Subd.�. Procedure when data is not accurate or complete. An individual may contest the accuracy or comple[eness of public or private
data conceming himself. To exercise chis right,an individual shall nocify in wriang[he responsible au[horiry describing the nature of the disagreemenc.
The responsible authority shall wi[hin 30 days eicher. (a)correcc the data found to be inaccucate or incomplete and attempt to nodfy past recipienrs of
inaccurate or incomplete data, including recipien[s named by the individual; or(b) notify the individual thac he believes the data to be correct. Da[a
in dispute shall be disclosed only if[he individual's sratement of disagreement is included with che disclosed data.
The determination of[he responsible auchority may be appealed pursuant to the provisions of the administradve procedure ac� relanng to
contesred cases.
DATA PRIVACY ADVISORY
In accordance wi[h M.S. 13.04, Subd. 2, "Rights of subjects of data", we wouid 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 no[ified 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 [he 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 permi[ or license requires Council action to approve, some information may become
public.
�. You have certain rights under :v1.S. 13.04 (available upon request) ro review private data on yourself.
(. Your iull name is required to process t ' application or permit.
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Address ^ ,{ �
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City \`' Sta[e Zip Phone
I �derstan my rights as ated above.
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` CHECb OFF LIST FOR ISSU�iCE OF PERI�IITS
FOR OFFICE USE ONLY , ,
,� ,, �>- �` i
�DDRESS OR LEGAI.: / � �/.� �, , ; ,_ ..� � ,
, � �� "� �/ ��/'O.�
PID: �'�� " � ° ,
DESCRIY'TION OF WORK: � i�� �l << � f �� r�f�o.� -.r �s r nr �P���
ZO�tII�tG REV1E`V BY: DATE APPROVID: 6 - �-cI�
BUII..DL�TG REVIEW BY: DATE APPROVF�: �- 3 -g b
---------------------------- �No
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER'�1IT Yes
PL�,v ��`� YeS � �o SEWER CONNECTION_
STATE SURCHARGE Yes No WATER COiVNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
---------------------------
ZOVPtG CHECK LIST Zoning District: � Shoreland District :
Fire Department:
Post Office: School Districr.
Lot.�rea: Sq.ft.
Acres Width Depth
Survey Submitted: es No Date of Survey:
Proposed Setbacks:
Front (L.ake : Ri�'ht Side:
/
Rear (Stre ): Left Side:
Adjacent tructur s: Wetland:
Building Heigh[: Def. Hg . Peak H�t
Avg. Setback:
Bluff Setback: L.ot Coverage:
, P�
Ex sting
Hardcover: 0-75'
75-2�0'
250-500
500-10 '
Hardco er Variance Req ired: es No Dat of Council Approval:
Grad' �: Staff Approval Dace By: Council Approval Date:
Sev r. Staff Approval te B �
Zo ' g File: � Resolution: � Resolution Date:
RE�'1ZARKS (in house): '
• y �
BI.TII,DI�i 1G REVIEW CHECK LIST
UgC; �" � CONSTRUCTION TYPE: ��
Sq Foota�e S Per Sq Ftg
Basement x —
lst Floor X —
2nd Floor e —
Gara�e � —
X =
TOTAL
o�
Estimated Construction Value: S ��d.poo
�
Inspections Required: Work Requiring Separate Permits:
Site _� Plumbing Fire
Hardcover Removal /`Mechanical Water Connection
Footing Septic Sewer Conneaion
_� Framing Fireplace Lawn Irrigation
j�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
_�'inal Gradin�/Filling _ �'— Elec[rical (State Permit)
Other
REMARKS (IN HOUSE):
REV�W BY OTHERS: DAT'E:
Access: Existing New
Access Approval: Date BY�
REv1ARKS(TO BE NOT'ED ON PERI�IIT):
��
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DATE TIME
CITY OF ORONO CALLED IN '7/i//i�>
INSPECTION NO ICE SCHEDULED �� �� ��
PERMIT N0. �� � COMPLETED_ �_ -�
ADDRESS � �� ��
OWNEf3 " f� , CONTR.<.�f�'_L,��2�cr�z�
TELEPHONENO. '��'`�- '���' S
� DESCRIPTION -�-/
� 01 FOOTINQ 11 MECHANICAL Fil 18IXCAV/dRADIN�/FIWNQ
�Q 02 FRAMIN�� 13 MECHANICAL FINAL 19 LAI�SHORE/WETIAN�S
Q INSU � 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= p5 FlN/1L 14 SEWER HOOK-UO O6 PROGRESS
E` 07 DEM4—SITE 27 SEPTiC MAINT. 21 COMPLAINT
v
W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBIN(3 RI 23 SEPl1C FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINCi FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
a — e,r- � es �� r �
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d ❑W RK SATISFACTORY:PROCEED _ PROJECT COMPLETE
W
� CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORAFiY
0 BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
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
OwnerlCont ite:
Inspector.
White Copyllnspector's le Canary CopylSite Notice
� /
ATE TIME
CITY OF ORONO CALLED IN � �/�
INSPECTION NOTICE SCHEDULED �/oZ9/�'�i �L� :Ot�
PERMIT N0. ��3 d� COMPLETED �I L �
ADDRESS �,� ��n (����t�v ��'G.L���c�.
OWNER���� CONTR�.6/lc'.��i�.>��L�.�z-z�
TELEPHONE NO. 'S� 7�" `f� �S
� DESCRIPTION ;�„.��-�n�'
� Oi FOOTIN(i 11 MECHANICAL RI 18IXCAV/GRADIN(3/FIWNO
y 02 FRAMIN(3 13 MECHANICAL FINAL 19 LAl�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� FI 14 SEWER HOOK-UO O6 PROGRESS
ti
J MO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOWUP
= 09 PLUM8ING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION HEMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
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d ORK SATISFACTORY:PROCEED PROJECT COMP�ETE
W
� CORRECT WOflK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOUflS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDEFi POSTED.CALL INSPECTOR =�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex i spection 24 hours in advance.473-7357
OwnerlContr ct sit .
Inspector.
White Copylinspector's File Canary CopylSife Notice
�
DATE TIME
CITY OF ORONO CALLED IN � ��o !�
INSPECTION NOTICE SCHEDULED 7-_3 - h ,��
PERMIT N0. COMPLETE �
ADDRESS � 3 9� F�L�U� ����C D
OWNER GfJE7�'T CONTR. GlJA�.d IL�.YI7�[� G�7'
TELEPHONENO. 7 7�`' 7`��D ��
� DESCRIPTION
� 01 FOOTINO 11 MECHANICAL RI 18 EXCAV/dRADINQ/FIWNQ
y 02 F NO }'� '� 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
� ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 yyqLL gp, 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z p5 p� 14 SEWER HOOK-UO 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J _. ,
Q 0 INAL ' �' 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 P MBIN(3 RI U�(.(f�,l 23 SEPTIC FINAL 35 HARD COVER REMOVAL
�+ 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
� ` C� s
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� ❑CORRECT WOfiK&PROCEED G ISSUE CERTIFiCATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. �, PHOTO TAKEN
INSPECTOR WIIL RETURN
C CITATION ISSUED
❑STOPORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
.._��.__.�... ••�.,o..i:.,.,?�hn��rg in arlyance.47.�"7357
�.au w� u � .C. p.......,..
OwnedContract on s e:
Inspector.
Whita Copyllnspector's File Canary CopylSite NWice