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HomeMy WebLinkAbout1998-010726 (addition/remodel) -� T - - -T—T _ PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 `'�'���'-��`���' Crystal Bay, Minnesota 55323 Permit Number: :;; f;;�;-, (612) 473-7357 Date Issued: �;�;�� �;:��;�; SITE ADDRESS: _.�} ; �<<=�`� _;�;i� �;°;'t .�; '-`+t . €'�f . . i i.��--i �. . __-��:t.1—e ii i i ;� DESCRIPTION: �';vi �:i,:;:�°`L =�;r%_ i�?�E 1 �.i71.1i'� �`i=t'C�;�i. 3'p-'��;a '_:j=--?-i'1t'i1:'t'•'.;=�'�s„I��'7_�_ r.;�—.T-y 3 i—i I�7 �i_�3 i�l�� �F S i i:, i t'�.°_�_ �—.�;�f 1 i �f_�:'�7 � �_�_��� 4��I�3_�,�i(�'ri�..i' ?'l,'�_� _.i)?��+ . _ _�.:+ _ .. . s.it�,= . . . .i.. e.� . r . ' ''' — .. .._�.j'.= �; :� � �. . � . � e' i ._�'a,._ , . .._, , . ' � .... � I REMARKS: -x:-�;--. - : � ii J s_i�- !-•t'�:..k=a E_f�_�'�� �'`�h.hl I T . '_���'r�h:�_': i � �'�.�;;;:,�' ! `.-, �,i-{.Fc J T�,,r t'� F-t_t�; t-•E_L�t,: i=��:_.1�s , ,.;;{: ��Tr;#` !�L;.�.�!`°'i�_��-1!_ l-"`�r'I; f . FEE SUMMARY: :_E_!i�{ i,,i�°,i ��:�, i_itii_i _. ._,.. _. _ _� _.._ . . _ - cs: -s::i.:; -�;�. - _ _:i i }i�`,:i �:r�j , _. . . _: ' .�l'+��'t•il''�� �__.._.._._. �W;:�_:a"�.-� �"-.r � �._s,� - . .._.� . .. . - - - . `-`��! I I , CONTRACTOR: — r��=L=? i c�.#-;t� — r� . __+� .OWNER: 1 -,� ( _ - �=�';�'; ' - ��=r°� ���� � -,�1._,_ Fi,`}`•�4�{:`_'?� �•�'t�.f�. . .� _. _ .� �.�.�'—t�i �+_''J _ _ 'f���.ft��._'._ �i'7.��{ ;�:-;_:=_i �;,��`.� ;'i,�r;l'r r,i; _:�.�1 # r;���;:_.j zi� �,°Zi k,����-,^�;E�::. E�l;,� c�_,y,� �;�,�i:C�,ii� i'�;Cv ��=;�i�� j•�I� .. ._ . .=� _ - - - - - - ,�.fJ�=_. °���:�_;;:=_�:_i " l ;t:vl:^�.`—.il��ilf—�7 ::{'-tt�:—`,—•;�L' t;`t-;,�';!-'`-.�— �',`S`�:_ _ _��:_�E`� I �_[ ^`�i-:'t�:;�t- i�`:i.". �"`,�".r-1=. i,i'�:..'�;`:_I�:�_i�iL't:j- !i-�:- _: ._�. ._ _ _. .---. _._. .._._. . . ._.. , ..__ _ —'-`f'.�� '�S 1 V�_: ;;�;� i—�—=; ! _ _ ';,;i4_':I;'t�.. ¢ _.? '�f � 4_1_li� �i t_,.__ i.` S -�"� . .�.._� _ _ . � �^f� _. _ i Hi �`.,___ ��_ 'i��..�._ ��' ��• s"_1�i+w��i� . ,� �. ,� _ __._ _ ,_.. _.. , _ ___.�.. � i "F- iii_i i_i�i°_J i('s�ti��i:%:_; �;f�,�_s `-: i�:Y s ;_ sa:€- '"' F ?i-_'-�[,�!!r., �-z#_#T�,_I+i iiii; i;iu�:.r�- k-4�_;,� ._ s�_ . � AP LICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE Fr-�=�rn : I:EF! Lil_IF'F' F'HO�dE �l�-�. : r,1� _+�� � '_''� -��F�. G=t� 1-���=� 1�-i:-1;Hf'1 F't-�� (:11Y �F UR9NG � 6124/.SU51U U�/��15�Ei '1S:�S � :U�/U� N[�•hK� '�'atal F��: $ Y l�'�_/ AB�te Rcceived:�� �`7�� Er►tered $Y� ...._...: ,..__,�.�,�. Aer�nnkt�►: ,/,()��?(o ...�. GITY Q� Q�Q�VCJ - BUI�,.DING PERMYT AI�YL�CA'��QN A,11 �nfo��m�tjon mu.�t be su�tinlitcd in i��ll bek'ore plan revfew� will bc sta.rtec�. (please�r�n��r611�'ormr�rtan) --r___w.�l� _�y____��_�.... �.__-�_��___�_�_�_.��_..---...._�.�r._._�------- ----------- -------�_�.�_.---- '�"Hk: APPI,ICANT 13: (circic ane) OWNE�t O �OhT7'1ZAC'X'C}R-`--- Jl?Ii �YTE ADDIt�SS: , �� � t �. ���o-�,,,,,r "L1Y: � I 1'riAltii� OF �WNPR:-.�c� �-. �-.-w It ---- PHO�'F: (harne). wti c� c�w. -- — ___---- .. - - --- _ _ . . �work) �_ M,A.�.YNG ADr1RFS5: �Z t 1 �a.��i,s�._..�� CYTY: . C�`�o ti sZ..�. � ZI�'; -- T : r � �'HbNE: R J��_ � C�NT�tA C 4�X -�. r�w y � �,.�,..,. ,� :,7 ^7.cj�_� .�.... ,�.�.��a_�_.�._.s.�- f�_..___ CONTA�TP�RS�N:___�,.�y_�'.�.�� I1�IOBQ,E/Pr+,.C���t: - - -- �. MAILIN�AY}I�R�SS: �'�a �,-E-�,#E..��,�.d GITY: rn ,w N�:��,�.w ZIP:� �S 2 5 STA.'!'� LI+CENSE: JI ���g . . . - r1 h ,n / ARC'Hi"�'E�'�`J�:NGIS�k,R: C,r�[.� �.JP �? PHON�: ���..-.��.�� MA�I.�INC A,.'DI)R�SS: _ CITY: ���'�-�� c , ZIP: �` Nt�ME: � ___ _ REGISTR-A�TION# ! -J`�`` .� � �____,�...�� 7'YPE �F W'ORK: New - -- _..,_ Additian Acc�s�ory S�ucturc Move �� Remodel�Attc�ation �_ Lt�nd Alt�ratiort „ , PR�POSE'U WQRK (de,�rribe rn d'et�iF}' ��� r»��c� ,�"���?�t..��- ,,�[c'r���?.�l� ��r���-�-�►-�-�-��.= �/y'� ��.....��r''��1 � a���')11 .,,,-� -- -- -- .,-�.._ ST(�RIES: r� SQ. FEFT�F$AC�FLObR: ._...�.._.._ NO. bF BE�11RC10ri�S: ___ _ ____ �ARAGE STALLS: AT`�'..,,,,� _ ��T.� ��1Iri'YA'I�17 Ct�1V5T2�UC�'Yl7N VAx.UATICyN (exciuding li�ad�: $_ � J � ._ . ,�. I hcr�by apply for a building prrmit and � acknowledge th�t the infor�r��t�u���l.�ove is camplc�e and �cCurate; that the wr�rk will bc in canformB�nCe wlth the ordinances ancl co�l�s c�t`tlye C`ity ar�d with 111a Statc k�uilcling ���dc; t��at 1 u�►�czstarid thip is r10i � �c=tmit and w�rk is n�t to F���+rt witlti�u� t� germit; and tha[ the w�rk will bc it� ��cot'cfa e with the approv�d ptan. r�►PPLIC:AN'1"5 5�.[iNA7'Uli�:: '! � ,t�.•� DA'1�+: �- �fj LL' `�� �a�� t� /.�� NO'�'E! �,���,� evenrs require sepa ate permtr ap,�rovnt hi� Pvlice Department and G't�v G'aun�il f,U dQyS prior 1p th� ever�t, NPn p�rm�tted evertts wi11 rto! be ullawcd. - CHECK OFF LIST FOR ISSUANCE OF PER11�1.�TS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: _ �32► i (3��I S 1��., �2 0,�� . PID: DE.SCRTPTION OF WORK: _ Z ni�.P �`�-o(�� f4/J,�� r� �� �XO��sr��✓ Ur= �/�y�'vio�s (1.�,�:- ZONING REVIE��BY: ,� _�~_ DA'I'E APPROVED: q �-�-��~_ BUrLD .T�i TG REVIE�'Y BY: . DATE APPROVED: c, _Z -�� FEES TO BE CHARGED: � � Misc. Fees Calculated By: � PERMIT Yes t/" No ' PLAN REV�W Yes � No SEWER COVNECITON STATE S UR�H�,RG c Yes � No �AT�R CO�NECTTON INVESTIGAZTON-'�EE Yes " No �/' PARK FEE SAC Yes No SITEINSPEC'ITON Number of SAC Units �OTHER (specify) ZONING CHECK LIST " zoning Districc: N� C Hy4�/V�L N _� M Fire Deparcmenr. Post O�ce: Schovl District: � � L,ot Area: Sq.ft. Acres 1�Vidth Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (La.�Ce): . Right Sid : � Rear (Street): - Left Side: Adjacen[Structures: ti etland: Building Height: Def. Hgt. p �t�Ho�, Lot Coverage: Gradin�: Staff Approval Date: � y: Council Approval Date: Septic: Staff Approval Date: y• • . Zoning File: # � Resolution:# Resolution Date: � Shoreland Disc:ict: � � Avg. Setback: Bluff Setback L,ot Coverage: � � ' E���� Proposed � Hazdcover: 0-75' 75-250' . . � - 250-500' . • 500-1000' Hardcor•er Vuiance Required: Yes No Date oF Council Approval: � REI�ZA.RKS ('in house): � z - _ . - . • ''' 26 . �tA . . _ BUII.,DING RE'SrLEtiV CHECK LIST � � : UBC: . 12- 3 CONSTRUCTTON TYPE: �(/U � . Sq Footage $ Per Sq Ft� . Basement x . � . .. . lst Floor . � X . . — � - .. � 2nd Floor • - • . .z .. _ . . � .' Gara�e , X . : — � • � � x TOTAL Estimated Construction Value: � y� M - Uu � V v Q - - -- Inspections Required: • Work Requiri.na Separate Permits• Site .__�Y___plumbing • � Hardcover Removal Fire . . _ __�Mechanical Water Connection Footing Septic Sewer Connection �_ Insu�Iaton Fueplace Lawn I�riaation . _�Wall Board C�'1as°nry) Ocher . . _� F�� . (Itiff�.) Well (State Permit) . � Gradin�/Fillin� �_Electrical (State Permit) Other . REil2ARb'S (IN HOUSE): . -------------- � ---- -------------------------DATE ------ - VIEtiY BY OTHERS: . �--�'------ Access: Ezistin� � Ne�y ' - • Access Approval: Date . -------------------------------- $y� _'----------- REi1�IARKS (TO BE NOTED ON PER1tiIXT); . -�" - � . „� . 27 , ..-' '. . �-�. . . � . . ...:. � . � .\ . . . _ . .."""'_ ' , . . • ' . . ' . . . . "_'_"" '_..-.... .� . . " ' _ "'_"_ _ . . . . ' . \ . � "'"""""' ' � .. . _ .. . ._- "' ' , '- '_ _ ._ .. ..... ___. __.._._ ... . .. . � . � � '-ti.� . � � - o �� PROOF OF WORKERS' COMPENSATION INSURANCE COVERAGE Minnesota Statute Section 176.182 requires every state and local licensing agency to withhold the issuance or renewal of a license or permit to operate a business in Minnesota until the applicant presents acceptable evidence of compliance with the workers' compensation insurance coverage requirement of Section 176.181, Subd. 2. The information required is: The name of the insurance company, the policy number, and dates of coverage or the permit to self-insure. This information will be collected by the licensing agency and put in their company file. It will be furnished, upon request, to the Department of Labor and Industry to check for compliance with Minnesota Statute Sec. 176.181, Subd. 2. This information is required by law, and licenses and permits to operate a business may not be issued or renewed if it is not provided and/or is falsely reported. Furthermore, if this information is not provided and/or falsely reported, it may result in a $1,000 penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry payable to the Special Compensation Fund. Provide the information specified above in the spaces provided, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. Insurance Company Name: (NOT the insurance agent) Policy Number or Self-Insurance Permit Number: Dates of Coverage: ,----. OR I am not r ired to have workers' compensation liability coverage because: (� I have no employees covered by the law. V ( ) Other (Specify) I HAVE READ AND UNDERSTtj�MY RIGHTS AND OBLIGATIONS WITH REGARDS TO BUSINESS LICENSES,�.P�tMITS AJ���ORKERS' COMPENSATION COVERAGE, AND I C�1�TIFY�THAT THE INFOIj�ATION PROVIDED IS TRUE AND CORRECT. =�� ,,;�, - � ; � _ � �� y�� ig � re) - (Date) n ` � —C,�� C 7 (� Q �, y�v �_ � �� •� I (Company) (Business Phone Number) DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE ; SCHEDULED - �-� PERMIT NO. 7�� COMPLETED c Z G� ADDRESS �- OWN CONTR. TELEPHONE NO. � DESCRIPTION � '� ' '� � �� LL Ot FOOTING 11 MECHANICAL RI 1 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 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 J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: � , � �c�c�C -�c�t�/ �r E'v-eu�:�/' /�5 !� � � O � � O � W � Q � Z W � W � � y� d X7 YVORK SATISFACTORY:PROCEED �ROJECT COMPLETE W � „ � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITNIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �, CITATION ISSUED ❑ INSPECTION REQUIREO.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnerlContractor on site: Inspector.��v� ��-�_�// J White Copyllnspector's File Canary CopylSite Notice