HomeMy WebLinkAbout1995-007017 (addition/remodel) PERMIT
Ci`TY OF ORONO PERMIT TYPE:
. 2750 Kelley Parkway- P.O. Box 66 :�.,i-.�
Crystal Bay, Minnesota 55323 Permit Number: '�`,:.�`:�;'��
(612)473-7357 Date Issued: _ _
SITE ADDRESS:
_ _ _ - _.-3°= : _ �= -, .
:-��� I
-. : : _;;. � _ _ -
_ ..,
:. �..: ,_. . : :_. _.. _
.:. • . ; ...'�..:,' _r':i';:'3�+
DESCRIPTION:
_f,;;...� ; :,_
.. _. .�_`•�=•..�
.. ._ ._ ...�....i I'-i s :.'��fjl: l• v !�-�` .lt� �""�'v.r;I1 r�iZ:..ETli,�ji.:f;L!._. .
tj€;i j:'t i���� °:!i;i i'�:. f i _. f"'���''�i,,,i„`f; ; i_f�.':-` i!_ii)3-,! ,
�
REMARKS:
���f�' L� :.�rk'u�t;
i i i�T+fif44 ili_��u�
i..�i�.�if%v�r}vv �
FEE SUMMARY: ti- �J�"`� „! .L�
i iL.i.f.t 4�C�1/Y �
�7 C j}
. . ..�_. . . _ _. . .- ._ _ , . . . y y �f,}i� .l r T�
'�i'''J��r:�t� �
i�i.?i v v
=:i•"",_ ' - _ _ :•i i i Cii i ie"� •:�
i�— . ' �j L'1 VLIt 1L�! �Lp�J'{
_.�. ...�.}.,_, - ._ , _ _ . . .-,._ L 1lLLf�[ � !L +.}f.t.�{t!s 1V
:��€s. _. ._... '=!�: . _. . _. . i.�r�i•C7<'.T._+"i:A'i'� Yi:?I
�'� . -.,,� .
- � � '_ - -- - i � i � 7�
� ��-;•._:;a•�.;�,+.:_e,:�= { `�.': - L{ry �vG�irne�iv�i 'li��7i
_ �� -`iy _._._.�......_. � ,.+� ra _
iii�_
: �is:�iu+
�r=
_ _. .' . .. . _ � .� . .' v�'�i��ir�}f.�
CONTRACTOR: OWNER: - `�'=-F°= �� s ==�����j=� �
__ .. . _.. . ���`. 'T�t
.- -. ._ .. . ._ _.��_i _.i�` .
_-,_.,tif� t.'•:_ .:C'= ,.
�r, ,� : .. � _, � ; - - - `=f ; �:` Z
_;v-;,-,•.,,:
t:_ .
E i i._ .�'. r ....� ... .., . ._:.. t ._...'....'_: [ ., . . __ .. .. ... _ . .. . ,. . ,... ..� . . . _ r ..._. ...._. . . _
� 'v . , i_' "-�
s:,t $
_.. .M _". . ... �_. _ . ' '
'. .
.» .. ... . _.e
„., 3 , � , : ' �. - ,_..�..�� i : i ., ` * ---- -. _ .'.r. _. . .. . . .._ _. .. ._�:C _.._. .. _.__. .. �': _ _ - _. i _ .
i : b '. -. ; ' i
,s €:t. . v. � 3 _ .. . . . . .� .
: . _. .r.;
� .+..: r•,:._ .. . .: ... . . . . .. _. . :_ :_._.._ ._ �'i �.-. .__... .. ._ '_ _ .
L ._. . . . _ _ _ �
6 V �>�u/r��,/,_ l rJ
�C/�/
APPLICANT%PERMITEE SIGNATURE ISSUED BY:SiGNATURE '
�
� Total Fee: $�,�'� �� DateReceived:
Date Approved:
, Entered B Permit#: J�/�
y= ,t�.�
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL Pi 1F'OR��-iATION l��UST BE SUBi�1IT'TED IN FULL BEFORE PLAN REVIEW`�II..L
BESTARTED
----------------------
THE APPLIC�'V�'T IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 3 I 3 I , � C� G/� ZIP: �`�J��/
N��tE OF OW�'ER � v� �� rv� � � PH0�1E: (home) �/ � r��J
(work) i�i'y
l�1AII.ING ADDRESS: � I 3 / '�J S ��� ��ITY: (`;',�G itJ 0 ZIP: �5-����
CONTRACTOR: � Sr�S�/'�C� ���T/'�c'TO�i�r PHONE: f�� -�6'0,,�
NIOBILE PHONE/PA�ER: /�'r;�;/e �G�y
NIAL
Ti�IG ADDRESS: � -.,-�` ST CITY: G(/�,-�:�� %�a ZIP: �s �
STATE LICENSE: # 004 `%/ `�'/
ARCHITECT/ENGI�i IEER: PHONE:
MAILING ADDRESS: CITY: Z�:
N��: REGIS7'RATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �/_ Land Alteration ✓
PROP�SED WORK(describe indetail):
STORIES: �— SQ. FEET OF EACH FLOOR: ����� �`��
NO. OF BEDROOi�IS: ,5 GARAGE STALLS: ATT. DET.
E
STII�fATED CONSTRUCTION VALUATION(escludingland): $ ( ����
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 p�an;
� �
APPLICANT'S SIGNATURE:- � DATE: �� l i �
-- /
,
NOTE! Parade of Homes events require separate permit approval by Police Department and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
9
�
. O ,�.',,,
� ,
;�4 ���;�.
�! ---; _ ��� C ITY of ORONO
�� � �,������-;�:r� �,,'� h���o�
� ,k, • - -%" �, ; Post Office Box 66
� ��'. �' ���t `�, ;j� Crystal Bay,l�iinnesota 553Z�-0066
,�i: ,r
\'t �i . ,�:1•, -�,�'�G -/
;,_
�9kESIH���'�,
�������
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2,lc�ae tfroms the Cityj of Oro oe or�any lofe its
inform you that your request for a permit or 1
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 ;�our qualification for the
permit or license requested.
?. 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 aQencies to 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.
5, You have cenain ri�hts under M.S. 13.04 (see followin; paQe) to review private
data on yourself.
(, Your full name is required to process this application or permit.
PLEASE PRIl�'T
��� �� �� iti G�)J /t,�� !`_
First Midd e Last
�� 3 l C-� Sc� C�►-
Address
�i rb N ; 1l� c�j 5� 3`1 � �7/- 7 �'S-S-.
Citv
Stace Zip Phone
I understand my riahts as stated above.
�
� �rn
SiQnarur
� TELEPHO!YE—473-7357• F.�+..Y-373-0510
1�
.
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision 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 section.
Subd. 2. Information required to be given individual. An individual asked to supply
private or confidential data concerning himself shall be informed of: (a) the purpose and
intended use of the requested data within the collecting state agency, political subdivision, or
statewide system; (b) whether he may refuse or is legally required to supply the requested data;
(c) any known consequence arising from his supplying or refusing to supply private or
confidential data; and (d) the identity of other persons or entities authorized by state or federal
law to receive the data. This requirement shall not apply when an individual is asked to supply
investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav lace the notice re uired under this subdivision in the
individual income tax or ro e tax refund instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an
individual shall be informed whether he is the subject of stored data on individuals, and whether
it is classified as public, private or conf'idential. Upon his further request, an individual who
is the subject of stored private or public data on individuals shall be shown the data without any
charge to him 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 its meaning, the data need
not be disclosed to him for six months thereafter unless a dispute or action pursuant to this
section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the
individual subject of the data. The responsible authority may require the requesting person to
pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made
pursuant to this subdivision, or within five days of the date of the request, excluding Saturdays,
Sundays and leQal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five
days within which to comply with the request, excludin� 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 hi.mself. To exercise
this right, an individual shall notify in writing the responsible authority describing the nature of
the disagreement. The responsible authority shall within 30 days either: (a) correct the data
found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or
incomplete data, includin� recipients named by the individual; or (b) notify the individual that
he believes the data to be correct. Data in dispute shall be disclosed only if the individual's
statement of disaareement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions
of the administrative procedure act relating to contested cases.
11
DATE TIME
CITY OF ORONO cA��Eo iN 1> -�r :'�--� ��'+�����i
INSPECTION NOTI� � � scHEou�E� ���i�� ;�= /!�' �=j��'��'�
PERMIT NO. /L I � COMPLETED
ADDRESS � � 3 � ��������' ��
OWNER -�'���� CONTR. �������� �- ��--�_
TELEPHONE NO. � 7/ - �' �`� :�
� DESCRIPTION ���k-
Ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMWG ' 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
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMB�NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
v
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
� �
� e
�
J
� C�(A, � �G�.(/�
�
0
�
W
�
Q
�
z
w
�
w
�
�
d C,WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
� �ORRECT WORK&PROCEED I' ISSUE CERTIFICATE OF OCCUPANCY
W
Q G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR 'l CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for ne t i s ction 24 hours in advance.473-73�J7
OwnerlContra to n site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice