HomeMy WebLinkAbout1999-011969 - garage . PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 Permit Number: �-. `=�4�'�`�`
Crystal Bay, Minnesota 55323 - - ��=�`�
(612) 249-4600 Date Issued: - - --
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -�� .�,- . � i =_�����. — -� . ��i": . OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: $ l/�� �< Date Received: �� ' `'1
Entered By: Permit#: ��'�,�
CITY OF ORONO - BUII,DLVG PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please prinr all information)
------------------------------------------------------ -- ------�.-..��:.:�_�...__------------------------------
THE APPLICANT IS: (circle one) O�VNER OR CONTRACTOR
�_____..��
JOB SITE ADDRESS: / �C � 1��`A�ETI S �� T. i2 D. zrn: � 5 3 � �
NAME OF OWNER: t)��-��l f, ��w� �w�n o �t- PHONE: (home) 7� " ���
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: L�A� � �J iM . /�9 C�D PHONE: �S�� ���j- �/Z 3�
CONTACT PERSON: �,���. MOBILE/PAGER: G��.- �a�- � �� �
MAILING ADDRESS:;�a�0 CAQ UC1� �4-tlE� CITY: 5Ji f��L Z�: SSII
STATE LICENSE: # �j / � �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure �''"�
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: (�c7 0 !� ��q v� C �� ��X ' E �����
-���v s ti C�!',��-� ��v sc �� �N �n.a ,� � .
STORIES: � SQ.FEET OF EACH FLOOR: / � � '
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. Z--
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��', �� �� � �
I hereby apply for a building permit and I acl�wledge 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 thi� is not a permit and work is not to start without a
permit; and that the work will be� accord with the ap ved plan.
APPLICANT'S SIGNATURE: ��.� '�• � ATE: /C l�
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NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. 14'on pernutted events will not be allowed.
Sec.13.01 RIGHTS OF SUB.TECTS OF DATa
Subd. 1. Tvpe of data. The rights of individual on whom the dara is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqtrired to be given individual. An individual asked to supply private or confidenrial data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency, poliacal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data:(c)any laiown consequence arising from his supplying or refusing to supply
private or confidentiai data;and(d)the idenriry of other persons or enrities auchorized by state or federal law ro receive the data. This requirement shall
not apply when an individual is asked to supply invesrieadve dara, punuant ro section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or property tax refund
instcuccions instead ot 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 wherher it is classified as public, private or confidendal. Upon his furthec request, an individual who is the subject
of stored privace or public dara on individuals shall be s6own the data without any charge to hun and, if he desires, shall be informed of the content
and meaning of[hat data. Afrzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six monchs thereafter unless a dispute or acaon pursuan[to this secrion is pending or addiaonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of che private or public data upon request by the individual subject of the data. The responsible authority
may require the requesring person to pay the accual cosu of makin¢,certifying, and compiling the copies.
The responsibte au[horiry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of
the date of the reques[,excluding Saturdays,Sundays and legal holidays,if immedia[e compliance is not possible. If he cannot comply with the requesc
within that time,he shall so inform[he individual,and may have an addidonal five days within which to comply wi[h 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 conceming himself. To exercise[his right,an individual shall noafy in wriang the responsible authority describing the nature of the disagreemen[.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccunte or incomptete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by che individual; or(b)notify the individual that he believes the data to be correct. Data
in dispu[e shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinadon of the responsible au[horiry may be appealed pursuant ro the provisions of the administradve procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 pemut 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 ro 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.
�. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
!��' f��� � tM p �TT l-t � c•� N O�1Z (J
First Middle Last
'�z �fo C�nJC.Q A-UE
• Address
S7 ���L �'�� �"�%/� �� !- �3� � �z�S'.
C�ry State Zip Phone
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I und rsta�d my rights state,d above.
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Signacure
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY �
ADDRESS OR LEGAL: �y 0 0 62AG�cTrs Po��v-r
PID:
DESCRIP'TION OF WORK: rp�,�. ('�q(1,4co�
Z0�1ING REVIE`V BY: DATE APPROVED: t � � � 'q�r
BUILD�tG REVIEW BY: DATE APPROVED: �n - 3 -��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes �' No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATERCONNEC"ITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZO�tG CHE.CK LIST Zoning District: L2-I/4
Fire Department: nr (�4�c: Post Office: _w AvTa a;-y► School District: o i2o N o
Lot Area: Sq.ft. Acres I 3�AG�-'s Width Depth
Survey Submitted: Yes_ � No Date of Survey: Z-Z�-9 2-
Proposed Setbacks:
F�s�(Lake): I �(o` �' w Right S ide: /7`a�r
LAIc�
R�ar(�&t�eat): 3`8S 3' c Le8 Side: S��� }
Adjacent Structures: �s� Wetland: N�/�
Buildin� Height: Def. Hgt. C�. �� Peak Hgt. �� <<
Lot Coverage: /v �/`� '
Grading: Staff Approval Date: � By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: ..i,P3
Avg. Setback: c9-l� Bluff Setback: N �� L.ot Coverage: --
Ezisting Proposed
Hardcover: 0-75'
75-250' (9�� �
250-500'
500-1000'
Hardcover Variance Required: Yes No lC Date of Council Approval:
REVIA.RKS (in house):
7
BUII..DING REV�W CHECK LIST
UBC: l�-' U-f CONSTRUCT16N TYPE: �/`�
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage R =
x —
TOTAL
Estimated Construction Value: $_ �{(��Vvo "=
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechaniaal Water Connection
p� Footing = Septic Sewer Connection
�o _Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
—�F�� Grading/Filling �Electrical (State Permit)
Other
REMAR]KS(IN HOUSE): . .
---------------------------
RE'VIEW BY OT�IERS: DAT'E:
Access: Ezisting New
Access Approval: Date gy;
- -----------------------------
REVIARKS (TO BE NOTED ON PERMIT�:
8
DATE pTIM
CITY OF ORONO CALLED IN ��^� o ��'�
INSPECTION NOTICE . scHEou�E� �/ '-3 �
PERMIT N0. �3 ��C� COMPLETED ��, ��y �� ���
ADDRESS O� �'�t C � �' ��
OWNER CONTR. �� ��� ICt�►'S
TELEPHONE NO. ����'�G'(G��
� DESCRIPTION S�G�.b �
l� 01 FOOTING 11 MECHANICAL RI 18 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
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
� OMMENTS:
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d /�IORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector. �7Cz-���- ��%�-uI �
White Copyllnspector's File Canary Copy/Site Notice
DATE //TI�EO
CITY OF ORONO CALLED IN �� �
INSPECTION NOTICE SCHEDULED � •6 a
PERMIT NO. I)�I� COMPLETED '��—� C `�C"��'
ADDRESS D 0 `� `
OWNER CONTR. �°t'�"�4G• �
TELEPHON NO. � ��- ! � � � � / �
� DESCRIPTION
lL O1 FOOTING 11 ME ANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 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
05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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 OWNERICONTRACTO O MEET YOU:_YE NO
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W Ci WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
� �ORRECT WORK&PROCEED [ ISSUE CERTIFICATE OF OCCUPANCY
W
� '�CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
C!CORRECT UNSAFE CONDITION WITHIN HOURS. pH0T0 TAKEN
INSPECTOR WILL RETURN
C7 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTIONREQUIRED.CAL�TOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
��
Inspector.'.�lc� �� C�x- �-i`I
Whiie Copyllnspector's File Canary CopylSite Notice