HomeMy WebLinkAbout1997-009042 (building- entry roof & deck) �, � , PERMIT
CITY OF ORONO PERMIT TYPE: _ : : : :: _
. 2750 Kelley Parkway- P.O. Box 66 Permit Number: �:_�`,i�'�..'��k ti° vt�
Crystal Bay, Minnesota 55323 Date Issued: _ �:°-` `:_��
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(612) 473-7357
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:S�GNATURF
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. Total Fee: $ � :�����{ Date Received:
Entered By: Permit#: ���;f��
CI 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
JOB SITE ADDRESS: �?� � C�-sC� ��� ZIP: SS..��'/
NAME OF OWNER: D 4/V� SCfi�/2f�DF2 pHONE: (home) �7J, S/�S'�
�DON Sc�v2�OfQ --�(work) S7o2 -- S��S`�6'
MAILINGADDRESS: 3�oy G�.Sco �¢v�C CITY: wh?r2�rry� ZIP: 5.3:�F'/
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X Land Alteration
PROPOSED WORK(describe in detai�: I�EpLA GC E�SI TQ`/ d oo,Q R o dF
f�Nd DEcfc
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
00
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ g 0 O "'�
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 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 the approved plan.
APPLICANT'S SIGNATURE: � ����li' DATE: '7
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent 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 SUB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or co�dendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requesied dara within the collecting'state agency,political subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the identity of other persons or enades au[horized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the nocice reauired under this subdivision in the individual income tax or propertv tax refund
instrucrions instead of oo those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals, and whether it is classified as public, private or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wi�hout any charge to hicn and, if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hirn for
six months thereafter unless a dispute or acrion pursuant to this secrion is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, wi[h any request made pursuant to this subdivision,or within 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 with the request
within that time,he shall so inform[he individual,and may have an addiaonal five days within which 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 private
data concerning himself. To exercise this rieht,an individual shall nodfy in wriung the responsible authoriry describing[he nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccunte or incomplece and attempt to norify past recipienu of
inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disc(osed data.
The determinarion of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relating 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 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 pemut or license.
3. The information may be shazed with other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested pernut or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this applicacion or perm.it.
�o N�Ld ,eoY S�yyt.�d,F�
First Middle Last
.��7 t3 y G�s'c o �v�
Address
�i1i.s�YZ�Ti9 /�iJ SS� 9`/ �} ��—�/S
C�ty Sta[e Zip Phone
I understand my rights as stated above. �
�����'�-�!!�/ u�''"��
Signature
CHECK OFF LIST FOR ISSUANCE OF PERIVIITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 37 0`t C bsc.� �V�
PID:
DESCRIPTION OF WORK: �7.�-r2,,, (�,�,� ,q.Mp C�(',,k0� [x.veZ D�`z�c
-------------------------------------- -�----------------------------------------------------------------
ZO�'G REVIEW BY: r- DATE APPROVED: G - 3� 5�
BUILDING REVIEW BY: DATE APPROVED: � _ 3 �5 �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No .
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SUR`HARG� Yes ci No WATER CONNECTION
INVESTIGAZ'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONI�i 1G CHECK LIST Zoning District: L/Z- JC,
�• Fire Department: Post Office: School District:
N�
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes o� No Date of Survey: 9-ZY-9(
Proposed Setbacks:
Front (Lake): G o� � Right Side: `�(�� ±
Reaz(Street): ?D` � Left Side: Z,3� �
Adjacent Structures: J4m►r,l�f� �Vetland:
Building Height: Def. Hgt. N /� Peak Hgt. /V//-1-
Lot Coverage: 0 �,�
Grading: Staff Approval Date: By: Council Approval Date:
p Septic: Staff Approval Date: By:
�"J,
Zoning File: #� Resolution: f� Resolution Date:
Shoreland Dist:ict: �PS .
Avg. Setback: N//3 Bluff Setback: it/'r,� L.ot Coverage: e�,/c
Existing Proposed
Hazdcover: 0-75' •
75-250'
250'S00' n�o c d.K
500-1000'
Hardcover Vaziance Required: Yes No_� Date of Council Approval:
REMARKS (in house):
• 26
BUII..DING REV�W CHECK LIST
UBC: �2-3 CONSTRUCTION TYPE: Vn�
' Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
/�eLK � X //=22�7 x �� �U•UD = Z�'Lpo
--�
TOTAL z,20 0
Estimated Construction Value: $ 2,Zo o a=
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_2C Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�� Final Grading/Filling Electrical (State Permit)
Other
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REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE IVOTED ON PERIVIITj:
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DATE TIME
CITY OF ORONO CALLED IN �U ` G�� Y7
INSPECTION NOTIC. scr,Eou�Eo �� - `i /d
PERMIT N0. �1D�f� COMP�ETED
ADDRESS � I�7' l���-'
OWNER �,��,�t�,,�•�o� CONTR. —
TELEPHONE NO. �7f— ��-r�1
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� DESCRIPTION G��-'��.�Z./
� i FOOTING. 11 MECHANICAL RI 18 EXCAV/GRADING/FILLINQ
y FRAMIN 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 0 ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINd FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -, pH0T0 TAKEN
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR -CITATION ISSUED
� INSPECTION REQUIRED.CALL O ARRANGE ACCESS.
Call fol he ext`in pection 24 hours in advance.47�73 'rJ7
OwnerlCoMra� sit :
Inspector.
White Copyllnspeclor's File Canary CopylSite Notice
DATE, TIME
CITY OF ORONO CALLED IN l G' "�%`�``y J
INSPECTION NOTICE J SCHEDULED %� ' � '� ��- T� :,�-
PERMIT N0. t/ L �� COMPLETED
ADDRESS � -%< <� [ ��.� �_<- �� �_���
OWNER /.1-r'.l'�3/`�t�-�`� CONTR. -
TELEPHONE NO. �{ 7� - ,y�,5 e;
� DESCRIPTION ��,�� - x'�-z��� , � �
� 01 FOOTING 11 MECHANICALRI 1 EXCAV/GRADING/FIWNG
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORENVETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE FiEMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
OS FIN 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
�
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED
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O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
U STOPORDER POSTED.CALL INSPECTOR
= CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next nspection 24 hours in advance.473-7357
OwnerlContr r o sit :
Inspector.
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White Copyllnspector's File Canary Copy/Site Notice