HomeMy WebLinkAbout1998-010053 (building-add./remodel) PERMIT
� GITY OF ORONO PERMIT TYPE: E;i;��;;i�:�;�
2750 Kelley Parkway- P.O. Box 66 Permit Number: �?�=}�-'=����
Crystal Bay, Minnesota 55323 - -
(612)473-7357 Date Issued: i t�I����r`���
SITE ADDRESS:
'�+_�ii� ;:H`.�;t��_� f���.
��`1
�' . I . �� . ; �ir—i j�—:�_'—�:°i—i�ir�.:=;
DESCRIPTION:
�:,;�::7 T�`T i����;r��i=i�,�:i�,�I F:::i."��
L�t�ii}�izz�� �=`��•r��it. Ty��N °=,1=—�(�i]r'�:E�•i►=+���L
�;�.�i �:�ii �-�� �;��;�,�l:: 3yr�>� c:��i[:yjT,(t�iz,,;
i_l�:r: 1�l r C l,ip•�t��'r' �"'=�
i:fw}:l�;}.t'�{_t.},�ts,-� E}'�=r= 1?'��
,�`��s3�i a-�,� ��-1 t=
s:��t���j� C:<<:�F� :1_;.�.. �1L.T , f;'�°_:Tt`�E�d? I 'r'?:._
REMARKS: .
`=:��`r��:�i i�� �'��=i�j i�T°_� �°�c;i:;�h°��;:,� F►+i�: F'E E_+t1i��I±�t�, t�s�L:�-I�t�I�E��il_ s�iw�:; �L?�i:i�°I�_�t_ t.:=�TH TE:� .
FEE SUMMARY: _ _ _ _
���=L����"I���t�i �.���,, s,��t;
�;.�•�� F�= �,_;;��. . -��
F`�.�r; ��.::y i �_�t �.�,:=;t. , t i��:
_�t...il'i�f;•=tt'°�+=' ____. _��a_�.•�,�.i
j�i T...i], �r�r� �1_ , 11::i,`'� . _��
CQ�TBp�TS,�' — :;�:��? i r�ri t. — i:T . �1't: .O
i��t�f�=��Fi'=i �_�_��i�=`�?;�E`7 1�i 1 i_!;::,� -�r._ ;1�I11�1.�,�-s' p t�
r_ � i E { .'t'_ `'` _`1�_ \�i ��•`= i 1 I �•i'�
iii ii ii_� '_�N►_��:�L I I�?E. :�:Fi —=��t;� +�:F;:_;C:l=i F;t,:�
�`'�;I���� Fs�`��': C:,�,; c��«_it'4 i�i;��''ri�j�� i�rJ ��=�'�f
i. 'r_`..�,'`'.i Lf�'1—:;?;����� :1;1—;=;'=I�r�
Ti-{� F�i1�Ls�%z"=.��7���L,� ti�p=;��;`�� (-t'�tril}�`_� I�`� e���tr�'.i.���y y��}-;�.,� � �_{ �"!t—iP�.i� �iii`_ Fl�t�-�E ��'�i'��3_#v,=�'�`{'V]�'_�
— r.,._.. --—. _ ._. _ __ _.__. _ _, : T ..
`���'�t_ , �.. T;_�� :i�Jl} i—ti"'%}"� t" I I_I !;':_I ' ,lt�! IL'��. F�`J — : 1-s` t. :�.5 ;i'}= ' 'Ft_.�„ .� '.';_I, �.� i_�:—
. ,e__.. r�. ._. . ._.. ��•_� E=��..� _ . . _ _ . 3 _ _. . _.�T'3!�4 .. _ ! 7. ._ _ "�'`i>
1_�i l'�f(�[I E t�"`.;t I��r-�(��t_9r:�`• ;-��'Y4J _�1 i-i i� #_=L' t i 1��iti;y`�r[_I;�-1 �:t�i�=f I��'••.3 :�_�41 Eti rz`:;,t`,ylt l 4;�'.�."=�w!`•� i'� .
� J
APP A PERMITEE SIGNATURE ISSUED BY:SIGNATURE '�+C,
�
' Total Fee: $ /� �LC' -�. -)�� Date Received:
Entered By: ,��j . Permit#: ��U��"3
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
• ---------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: t����r C� 5�� ,�t J', ZIP: �S��j �
NANIE OF OWNER: ��i-tc,{/1 r`��S� �r�� fi� PHONE: (home) `�7y'— �� 7�
(work)
MAILING ADDRESS: �(�,�� C�X U �c%., CITY: ���,< ZIP:_1��'
CONTRACTOR: `� ��^ PHONE: � � .�
CONTACT PERSON: " �tr/` MOBILE/PAGER: E ,Z j�y
MAILING ADDRESS: �- ll� � ' � CITY: �'- `,� ��r ZIP:��_;�_���
STATE LICENSE: # ��
/^^
ARCHITECT/ENGINEER �� �"� t v� �- l�'l�r►.� ONE: ��7���y/
MAILING ADDRESS: CITY� ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: �- = ,� '
. , �
(` _ r/ t�_ i !� L
STORIES: SQ. FEET OF EACH F'LOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�
EST iMATED CONSTRUCTION VALUATION (excluding land): $ ���!� ��—
I hereby apply for a building pernut 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 accordance with th appr ved plan.
APPLICANT'S SIGNA AT'E: vZ —< s
NOTE! Parade of Homes ev ts 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 SU'BJECTS OF DATA
Subd. !. Type of data. "Ihe riehts of individual on whom[he data is stored or to be stored shall be as set focth in this secdon.
Subd.2. Information reqirired to be given individual. ?�n individual asked to supply private or confidenaal data concerning himself shall
be informed of: (a)the purpose and iatended use of the requested dara within the collecdng"state ageacy, poliacal subdivision,or statewide rystem;
(b)whe[her he may refuse oi is legally required to supply the cequested data;(c)any Irnown consequence arising from his supplying or refusing to supply
• private or confidential data;and(d)[he idenriry of other persons or enrides auchorized by state or federal law to receive the data. This requirement shall
noc apply when an individual is asked to supply invesdearive dara, pursuanc ro secdon 13.82, subdivision 5, to a law enforcement o�cer. -
The commissioner of revenue mav pface the nodce reauired under[his subdivision in the individual income tax or propertv tax refund
instrucrions insczad of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subject
of scored data on individuals,and whe�her ic is classified as public, priva[e or conFidenaal. Upon his funher request, an individual who is the subject
of stored private or pubtic data on individuals shall be shown the data wichouc any charge to him and, if he desires, shall be informed of the concent
and meaning of that data. Af[er an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to [his secdon is pending or addirional data on the individual has been collected or creaced.
The responsible authoriry shall provide copies of the private or pubiic data upon requesc by[he individual subjec�of[he data. The responsible authority
may require che requesring person to pay the actual costs of making, certifying,and compiling the copies.
The responsible authoriry shall comply immediacety, if possible, wi�h any request made pursuanc to this subdivision, or wichin five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immedia[e compliance is not possible. If he cannot comply wi[h the request
within[hac tune,he shal(so inform che individual,and may have an addirional five days within wluch 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 pri�•ate
data concerning himself. To exercise chis righc,an individual shail nodfy in writing the responsible authority describing the nacure of che disagreemenc.
The responsibte authoriry shall wichin 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to noafy past recipients of
inaccunte or incomp(ete data, inctuding recipients named by che individual; or(b) notify the individual thac he believes rhe data to be correct. Data
in dispute shali be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The de[erminarion of the responsible au�horiry may be appeated pursuanc to the provisions of che admuusaarive procedure act relaang 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 pernut or license from the Ciry 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 pernut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain ri;hts 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.
9�(.. G
First �tiddle Last
_� ///^
(�' � � f' d
Address / �� , �
,- , �-, � -DSr
City State Zip Phone
I understand �; as stated ove _
�
Signacur �
` CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ��Sc, c�5c.o A v�,
PID:
DESCRIPTION OF WORK: 14�� �� o n� ��?,t—�b� k�T-c��c� �✓1-Lr t400•
— -----____—__ ______--- _ ------------------------------------------:--------------------
ZONL�G REV�W BY: C,�� DATEAPPROVED• 3- 2s-��6
BUII.DING REV�W BY: DAT'E APPROVED: 3 -2-s-�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
pLAN REVIEW Yes � No SE`VER CONNEC"fION
STATE SUR`�IARGE Yes �/ No WATERCONNECITON
INVESTIGA'I'ION FEE Yes No PARK FEE
SAC Y;;s No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning Disuict: 1.2 - I C
Fire Department: (1r,.o v+v(� Post Office: t�1 A�Z,v4�tY� School District: W�STO N1�A
Lot Area: Sq.ft. 3`�'> Acres • �1 Width I 2fZt��u��- Depth —
Survey Submitted: Yes C No Date of Survey:
Proposed Setbacks:
Fre�t (Lake): _ I2.► ' t Right Side: 9`�� �'
Reer (Street): Z.-1S" � �' Left Side: S3� �
Adjacen[Structures: q�ctt-c..� Wetland: —
Building Height: Def. Hgt. c9�k . Peak Hgt. o .«•
Lot Coverage: b 1�-
Grading: Staff Approval Date: l�! 1 A By: ' Council Approval Date: —
Septic: Staff Approval Date: /v ( ✓� By: -
Zoning File; # 2.3-Z..o Resolution: # tf0 35 Resolution Date:
Shoreland Dis�ict: �_C 5
Avg. Setback: U,c�R.��.rvc.c: Bluff Setback: N(� L.ot Coverage: N�i4
� Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500' NO GF(�q�
500-1000' �J
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house)•
• 26
BUII.,DING REY�W CHECK LIST �
�C� �Z' 3 CONSTRUCTION TYPE: �/N
' Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x =
Garage x =
R -
TOTAL
Estimated Construction Value: $ �1 U,C900�
Inspections Required: `Vork Requiring Separate Permits:
Site 0< Plumbing Fire
Hardcover Removal o< Mechanical Water Connection
< Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
_�o Insulation (Masonry) Other �
_�p Wall Board ___'_ (Mfg.) Well (State Permit)
a`- Final Grading/Filling Q� Electrical (State Permit)
Other .
----- -------------------------------------------
REi1ZARKS (IN HOUSE):
-----------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
-------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ON PERMIT�: �
27
DATE TIME
CITY OF ORONO CALLED IN �� �`��
INSPECTION NOTICE .„ � SCHEDULED 'S�i � �3" %i:`` `•3C�
PERMIT N0. �G�s COMPLETED � ��
ADDRESS ����C�� C��� ( .�..�-r .
OWNER CONTR.��,_� s-
—�.
TELEPHONE NO. _� 7 % • (`��� �
� DESCRIPTION�
� 01 FOOTI 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVA�
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
w
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d
W WORK SATISFACTORY:PROCEED PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
W
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITION WITHIN HOURS. -- pHOTOTAKEN
INSPECTOR WILL RETURN
' CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
f_� INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra o it :
Inspector.
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �/.��/1`�
INSPECTION NOTICE � ` j� SCHEDULED �/ � �' � � � �
PERMIT NO. �� COMPLETED
ADDRESS �
OWNER CONTR.
TELEPHONE NO. "7' 7 I - C���J-Zi
� DESCRIPTION _�a.��2�,,,��
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAOING/FILLING
� 02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q INSULATIO 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� ALL 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
w
a
�
J
O
�
�
O
�
W
�
Q
ti 1
Z
W
�
W
�
�
� �WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W
� f� CORRECT WORK 8�PROCEED [- ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
f l CORRECTUNSAFECONDITIONWITHIN HOURS.
INSPECTOR WILL RETURN � PHOTO TAKEN
f] STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
f 1 INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra�t�s+fte:
Inspector `� x
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN y�7/9��
INSPECTION NOTIC �7� SCHEDULED 'S� J'�r ^ /lI`� 3 c�
PERMIT NO. � COMPLETED
ADDRESS ���C;� � ��..�—c .
OWNER CONTR. �'��
TELEPHONE NO. �? � � C�' S 3 y
� DESCRIPTION �����
� f�4--F99�� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING ��c.�' 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATIO 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a �t�l P_S
�
J
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
j
d �ORK SATISFACTORY:PROCFED i=" PROJECT COMPLETE
W
� l 7 CORRECT WORK&PROCEED '7 ISSUE CERTIFICATE OF OCCUPANCY
W
O C I CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. , PHOTO TAKEN
INSPECTOR WILL RETURN
�; STOPORDER POSTED.CA�L INSPECTOR '-- CITATION tSSUED
�� INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContracto i
Inspector.
White Copyllnspector's File Canary CopylSite Notice