HomeMy WebLinkAbout1999-011467 (building- deck repair) PERMIT
CITY OF ORONO PERMIT TYPE: -
2750 Kelley Parkway- P.O. Box 66 _�:-`'�-_"' {�"'
Crystal Bay, Minnesota 55323 Permit Number. _ ' :s,�,:'
(61�) 473-7357 Date Issued: _ _ . . -
SIT� ADDRESS:
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REMARKS:
FEE SUMMARY:
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PPLICANT;PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ 3Q� ��o Date Received:
Entered By: ��j Permit#: l/'�!o'�
" CITY OF ORONO - BUILDING PERMIT 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 OR TRAC
JOB SITE ADDRESS: �������-r,��, Z�: ���J
NAME OF OWNER: � • �aU(ul PHONE: (home) �g(o
(w rk)
MAILING ADDRESS: � GD �4'� �l,_CITY: ZIP:��'�
CONTRACTOR: � d PHONE: ���q-1(o�
CONTACT PERSO : �vr� 1dIOBILE/PAGER:
MAILING ADDRESS: �y�q�(o� �• _ CITY: ZIP:-E�C�
STATE LICENSE: #� z��/
—�--
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/ lteration ✓ Land Alteration
��i4-r2
PROPOSED WORK(describe in detai : �{S'l(r�(o ��C�
� � ►�� �� �K
STORIES: _�_ SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $�n ,(�
I hereby apply for a building permit and I acknowledge that th uiform�atJion�bove is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State 3uilding 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 cc rdance with he approved plan.
APPLICANT'S SIGNATURE: ` DATE: �" �`�
NOTE! Parade o�Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
�
Sea 13.04 RIGHTS OF SLJBJECTS 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 section. '
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming 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 entiries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative data, pursuant ro section 13.82, subdivision 5, to a law enforcement officer.
'fhe commissioner of revenue may place the notice required under this subdivision in the individual income tax or provertv tax refund
instructions instead of 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 whether it is classified as public, private or confidential. 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 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 authority shall comply immediately, if possible, with any request made pursuant ro this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal 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,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 right,an individual shall notify in writing the responsible authoriry 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, including 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 disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 permit 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 shared with other local, state or federal agencies 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 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 application or permit.
First Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
,ADDRESS OR LEGAL: ZSc�v Cr�s� �o�^� �-�
. PID:
' DESCRIP'TION OF WORK: (��.C�= �P�'`
-------- - --- ------------------------------------------:--------------------
ZO.�i'G REVIE`V BY: � � DATE APPROVED• 5 z7-�5
BUILDI�i 1G REVIEW BY: DATE APPROVED: ,�-2-�-�5
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes c/ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONI��1G CH�CK LIST Zoning District: N o C�-
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submi[ted: Yes No Date of Survey:
Proposed Setbacks`.
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetlan :
Building Height: Def. Hgt. Peal:H t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # R solution Date:
Shoreland District:
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMA.RKS (in house):
7
BUII.,DING REVIEW CHECK LIST �
�C: 2 • 3 CONSTRUCTION TYPE: tlti
Sq Footage $Per Sq Ftg
Basement x _
lst Floor z =
2nd F1oor x _
Gazage x _
R c
TOTAL
Estimated Construction Value: $ I (�,C7��
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�Footing ` Septic Sewer Connection
_�Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Board (Mfg.) Wetl (State Permit)
� F�� Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE): � . ~
--------------------------------------------------------
RE'VIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
-----------------------------------------------------
RENIARKS (TO BE NOTED ON PERi�IIT�:
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o�7F s-z?-5 F��;;�,T„o. Rev 5/11/99
.�1Pr;sOVt�AS Su'��lri f7�:�
�J' P�C.IAL l�+�TE � �G K ���'L�G�M �1�T �' �;P??;OVED t"J�T�i COFi�:_CTIOP�IS AS�JC�TED PAGE
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� These pians are the �'�
propreltary work produ�t and YV?�►L D E NY�100 D M rS. R u sty P a u ru s
-n { c7 , n property of Waldenwood. 24925 Gien Road,
N � � � ? � Use of these drawings and 5horewood, MN 2500 Gasco Pt. Rd,
rn _, rn rn concepts by others w(thout 55331 Orono 553q 1
� the written permission of
� Waldenwood is prohibitcd.
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t � These plans are the --� �'
propreitan,Jworkproductand WA�LDENINOOD MrS. �US� �dUl"US
� { c7 Z n propert�of Waldenwood. 24925 Glen Road,
(� � � � 3 D Use of these drawings and 5horewood, MH 2500 Gasco Pt. }ZG��
rn _, r" `D rn concepts by others without 55331 Orono 55391
� the written permission of
� Waidenwood is prohibited.
AT TIME
CITY OF ORONO CALLED IN 6 2�Z
INSPECTION NOTICE SCHEDULED 1�'30 u�'''t
PERMIT NO._QI I�}C�7 COMPLETED �^ ``
ADDRESS 2� CRS�O �7l�11' �
OWNER CONTR.4�i�A�Y1 (A1LF�C.� LT�
TELEPHONE NO. LI^I4 — ���oS — �lYl �Iri�ilOr1 .
� DESCRIPTION _ �l�'�A.I De!�.�t.
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANiCAL FINAL 19 LAKESHORE/WETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 LL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINA 14 SEWER HOOK-UP O6 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� '�wORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED '-� fSSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r o � :
Inspector.
White Copyllnspector's File Canary CopylSite Notice