HomeMy WebLinkAbout2001-P04393 - addn/remodel/repair ` � PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P04393
Crystal Bay, Minnesota 55323 P@r1111t Typ@: Addition/Remodel/Repair
(952) 249-4600 Date Issued: �iili2ooi
SITE ADDRESS: 2617 Casco Point Rd
Wayzata, MN 55391
PID: 20-117-23-24-0035
DESCRIPTION: UBC Occupancy R3
Consriuction Type VN
Proposed Use: fcesidentiai
Buildin Census Code 434
Permit Class: g
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#: 2644
Separate permits required: riumoing iviecnanicai rirepiace r,iecu�icai�siaie j
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 2,393.75 Valuation: $ 350,000.00
Plan Review Fee: $ 1,556.03
State Surcharge Fee: $ 175.00
TOTAL FEE: $ 4,124.78
APPLICANT: David Nitz,Inc. OWNER: Gary&7oan Marquardt
P.O.Box 6678 2617 Casco Pt Rd
Wayzata, MN 55391 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERNIISSION TO MAKE TIIE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
. � `J /�_ � � �
o�-!���t".rn C.�,r� �/�`�'�''�-
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I AN IT I NA URE ISSUED BY SIGNATURE '
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
- i � � , � `, �� �' _ �,�
-.� Total Fee: $ � , � %- / Date Received: �
Entered By: -� ��'7 � ,� � ;;���-��� Permit #: -� �;U_� ?�;
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: ZC'� I� C�c�C� ��� �� ZIP: � 5 •''� �
� �z 7 r � �l�l 6 �-'��
NAME OF OWNER: ��r� �- ��;� �,r. � t( ��'�k��T-PHONE: (home)��Z- ��I�4-� �
� �..r �� (work)
MAILING ADDRESS: Z-�� � ��` SC �' r CITY: � ZIP: '��.3�� �
CONTRACTOR: �G�� i � I�i 1�Z � ( J�� PHONE: �� Z� `-I�� 6 -�Iz 9
CONTACT PERSON: a U i c� ti � C z-- MOBILE/PAGER:
MAILING ADDRESS: P,D, �X U1 S� CITY: �'��?u � ZIP: �5 3�
STATE LICENSE: # Z�� 'l � �S�
ARCHITECT/ENGINEER: �� � w� �" ��'S��� PHONE: �I�Z -�� �� "�3I�
MAILING ADDRESS: CITY: 1�4�it( ; � �,�ZIP:
NAME: �� L�> �'�c{ � �i`-Z REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration j� Land Alteration
PROPOSED WORK(describe in detai�: (`��'�i�z"� ��a �'� G� j S�t i'�b��� ,�--�� ���'� � S�
'�- 2..�, � � )��: �' � �.� c� c� v'1��' S�t +��raQ�'� �� �"� h , I�e�o��-e � u ra�� �
��� � b �-v�r •�..; ��fe r��;� i��+"�
STORIES: �— SQ. FEET OF EACH FLOOR: C = �, ��7 � � = I i �Z �
NO. OF BEDROOMS: Z GARAGE STALLS: ATT. �— DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �j`� G J �'G' �='
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: DATE: � � C'I
NOTE! Parade of 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
Sec.13.04 RIGHTSOFSUBJECTSOFDATA , ; '
, l,.
`!
Subdivision I. Type of daf¢ The rrgh[s of individual on tivhom the data rs stored or to be stored sha!!be as set forth in this sectron.
Subd.2. Injormation required to be given individuaL An individua!asked to supply privare or confidentral data concerning himselj
shal!be rnformed of.� (a)the purpose and intended use of the requested data within the collecting state agency,politica!subdrvision,or statetivide
syslem;(b)whether he may refuse or is legally requrred to supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or conf dentia!data;and(d)the identrty ojother persons or enlrties authori=ed by state or federal lativ to receive the data.
This requirement shall not apply when an indivrdual is asked to supply investigative dala,pursuant to section /3.82, subdivrsion S, to a lmv
enforcemen!o�cer.
The commrssroner o(revenue may place the notrce requrred under this subdivisron in the rndividual income tczr or propertv tczx refund
rnstructions rnstead ofon those torms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an indrvidual shall be informed whether he is the subject
of stored data on indivrduals, and whether it is classifred as public,prrvale or confrdenlial. Upon his jrrther request,an indivrdua!who is the
subject of slored prrvate or public data on individuals shal!be shoivn the data without any charge to him and, if he desrres,shal!be informed of
Ihe content and meaning of that data. Af[er an indivrdual has been shoivn the private data and rnformed ojils meaning, the data need not be
disclosed to him jor six months thereafler unless a dispute or action pursuant to this section is pending or addilional data on the individual has
been collected or created. The responsible authoriry shall provide copies ojthe private or publrc data upon request by the individual subject oj
the data. The responsible authority may require the requesting person!o pay the actual costs of making,cert�ing,and compiling the copies.
The responsible authority shall comply rmmediately,rf possible,with any request made pursuant to thrs subdivision,or ivilhin frve days
of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ijhe cannot comply tia�ith the
request within that time,he shall so injorm the individual,and may have an additional five days lvithrn iehich to comply with the request,excluding
Saturdays,Sundays and legal holidays.
Subd 4. Procedure when data is not accurate or complete. An rndividual may contest the accuracy or completeness ofpublic or prrvate
data concernrng himselj. To exercise thrs right, an individual shall no[�rn writrng the responsrble authoriry describing the nature oj the
disagreement. The responsible authority shall within 30 days either: (a)correct the datafound to be inaccurate or incomplete and altempt to notify
past recipients of inaccurate or incomplete data,including recrpienls named by the individual;or(b)not�Ihe individual that he be[ieves the data
to be correct. Data in dispute shall be disclosed only if the rndividua!'s statement of drsagreement is included with rhe disclosed data.
The determinalion oJthe responsible authority may be appealed pursuant to the provisions ojthe administrative procedure act relating
to contested cases. �
DATA PRIVACYADVISORY
/n accordance wrth M S.13.04,Subd.2, "Rights of subjects of data",ive would like to inform i ou that your reguesr jor a permit or license
from!he City of Orono or any ojits departments may require you to furnish certain prrvate or confrden(ia!information.
You are notrfied that:
1. The informalion you furnlsh ivill be used to determine your qualification for[he permit or license requested.
2. You may refuse 10 supply data,but refusal may require that the Crty deny the permit or license.
3. The injormation may be shared with other local,state or,federa!agencies!o the extenJ necessary to process!he pennit or
license.
4. If your requested permit or license requires Council action to approve,some informatron may become publrc.
5. You have certarn righls under M S. 13.0�1(see folloivrng page)to revieiv private data on yourself.
6. Your full name is required[o process thrs application or permit.
PLEASE PRLNT
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Firsf Middle Last
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Address
�ti� �� y�� f�t � � � �-5� ��l
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City Slate Zip Phone
I un nd my ri h!s s stat ove.
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Signature
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Job 3ire►\ddress: � Ci of Orono
�� ty
O O P.O.Box 66
"CATEGORY 1" ALTERNATE FOR �,�f� Crystal Bay,MN 55323
ONE & TWO FAMILY DWELLINGS ��������' �952)249-4600
EeA
INSTRtiCTIO\S: This alternative ma�� be used for one- and two-famih- d�vellings built to meet the Categon' 1 requirements of
�Iinnesota Rules, Chapter 7670. Complete Parts A, B, and C. Clearly mark plans �vith: insulation R-�•alues; window and skylight U-
�•alues; size and type of equipment; equipment controls; and location of �•apor retarder and �t ind�vash barriers. More detailed
information can be found in the�Llinnesota Energy Code summarv sheets available from the Miruiesota Deparnnent of Commerce.
Part A. BUILDING ENVELOPE
.._ __ _ _ . . __.__ _ . �
. , _ .___ _._.. �_..__. ____�_
Check proposed envelope joint sealin�option � ❑ Prescriptive(caulking,gaskets,etc.) ❑ Performance(test per 7670.0470 subp 7.C.)
Check thermal energy calculation option used� ' "Cookbook" com lete worksheet below '
� � P ) ❑ 1�1nCheck method(attach report)
❑ Performance (attach U-valu:calculations) ❑ Systems Analysis method(attach analysis)
��Cookbook" WOrriSheet �iI�I�IU�IREQUIREl�1ENTS
(for��Cookbaok"option onlv)
� Ceiling Insulation: Minimum R-38 with 7'h"energy heel; or
IvsTxuCTrotis '�finimum R-44���ith low truss heei; or
Step 1. Check item(s)that design meets on.Lfi�iin�ctm Requirements list ,�Iinimum R-33 «�ith R-5 shea[hing when no attic.
to the rieht. Must meet all items to use"Cookbook"option. Entry Doors: Max. U-value of 0.30 or 1'/,"solid wood with storm
Step 2. Indicate�proposed wall type on table below. ' Rim Joist Insulation: I�4inimum R-19
Step 3. Indicate�Vindow U-value and source. Floors over unconditioned s�aces: Minimum R-2d
Step 4. Verify total window(including area of all foundation��indows) � Foundation Insulation: i�linimum R-10 `;��(,� E^//�„'�;,.�,
and door area is equal or less than allo«�able percenta�e. ❑ Foundation windo���s: '/�"insulated glass,wood or vinyl frame
TABLE FOR DETERlII\ING�1AJ�I�iU1�I��'L\DO�V AND DOOR AREA
�Saximum A1lowable Total�Vindow and Door Area as
a Percentase of Exposed VVall 12% 14% l6% 18% 20% 22% 2�4% 26% 28%
`ti'all T z S�andard Framina :
�'P � �) �Iaximum A��erage�Vindo�v L'-value(except foundarion�r-indows):
� 2x4,R-13 insulation, !l R-7 sheathing 0.5� 0.47 0.41 � 0.36 0.33 0_30 0.27 0?� 0.23
❑ 2x4.R-1� insulation, � R-� sheathin� 0.�2 0.�� 0.39 0.3� 0.31 0.25 0.26 0.24 0.22
❑ 2x6,R-:9 insulation,<R-5 sheathing 0.48 0.�1 0.36 0.32 0.29 0.?6 0.24 0.22 �:21
_x6,R-19 insulation, L� R-� sheathing 0.56 0.48 -0.4� 0.37 0.34 U.31 0.28 0.26 0.24
❑ 2x6,R-�1 insulation,<R-� sheathing 0.51 0.43 0.38 0.34 0.30 0.28 0.2� 0.23 0.22
❑ 2x6,R-21 insulation, b R-� sheathin� 0.�8 U.50 0.� � 039 0.3� 0.32 0.29 0?7 D.2�
Wall Type (Advanced Framing}: `laximum Avera�e Window L-calue(except foundarion window•s):
� 2x6, R-19 insulation,<R-� sheathin� 0.�? 0.4� -0.39 0.3� 0.31 0.2S 0.26 0.24 0.2?
❑ 2x6,R-19 insulation, �s R-5 sheathing 0.�8 0.50 0.� 0.39 A.35 0.32 0.29 0.27 0.25
❑ 2x6,R-21 insulation,<R-� sheathin� 0.5� 0.47 0.�1 036 0.33 0.30 0.27 0.2� 023
❑ 2x6,R-21 insulacion, L• R-5 sheathing 0.60 0.52 0.46 • O.di Q.36 0.33 030 0.23 0.26
WindowU-value: � '>� � Source: � `FRC ❑ ASHRAE 1993 Handbook �
�
, ,
10 0 X ( �"�L� �ii 1 �; ��t � _ � � % < I .�, � %
window&door area gross exposed�vall area DESIG� ALLO«'ABLE (from table above)
MINNESOTA ENERGY CODE - WHICH RULES MAY I USE ?
TYPE OF RESIDENTI�,I,BUILDL�G APPLICABLE RL�LES
Detached R-3 occupancy 1-and 2-family d�ti•e]lings Chapter 7672; or
Examples: singte family,rivin homes,duplexes Chapter 7670"Categon� 1" with statutorv depressurization and venrilarion requirements
;�.ttached R-3 occupancy dwellings Chapter 7674; or
Examples: triplex townhouses and row houses , Chapter 7670 with either"Category 1" or "Cateeory 2" provisions
R-1 occapancr•buildings of 3 stories or less Chapter 7674; or
Examples: condominiums or apartments Chapter 7670 with either"Category 1" or "Ca[eeory 3" pravisions
R-1 occupancy buildings over3 stories high Chapter 7676 .
Examples_ hi�h rise condos or aparhnents �.;� �
11
. , �, . .
�'art B. DEPRESSURIZATION PROTEC�'ION� �}'�'��� ��� ,'
C',ieck option used: ❑ Fuel burning equipment (complete schedules belo�v) ❑ No fuel burninQ equipment
INSTRUCTIONS EXH_AUST/blAh'E-UP AIR SCHEDULE*
Scep 1. Complete the Combustion Equiprnent Schedule belolv. Only equipment Eschaust devices over 300 cfrn FIoR�
«�ith a Y(Yes)may be selected under the"Cate�ory 1" alternate. cfm
��ep 2. Complete Exhatrst/�t�fake-crp Air Schedi�le on the;iQht if direct or power cfm
vented or solid fuel atmospheric vent space heatin�equipment is selected. cfm
COIIBUSTIO\EQUIPI�NT SCFIEDULE
(check all types proposed)
' Space heating—nonsolid fuel Sealed combustion Y Hearth — nonsolid fuel ❑ Sea'ed combustion Y
- ❑ Direct or power vented Y* ❑ Direct or power vented Y
Atmospherically vented N A�nospherically vented N
«ater hearing—nonsolid fi.tel ' Sealed combustion Y Space heating—solid fuel ❑ Atmosphencally vented Y*
❑ Direct or po�ver vented Y Water heatine—solid fuel ❑ Atmospherically vented Y
Atrnospherically�•ented N Hearth—solid fuel ❑ Atmospherically vented Y
* If atmospherically vented solid fuel or direct or power vented nonsolid fuel space heating is installed, then make-up air to match
flow is required for each individual e:chaust device which exceeds 300 cubic feet per minute.
P art C 1. VENTILATION
VENTILATION QUAI��T'ITY
(Mechanical ventilation must be provided per the lar�er quantity calcuiated below)
'Z�j�;��; ; cubic feef x 0.00583/minute = i y I cfm ( � g 15 cfm/bedroom)+15 cfm= � cfm
volume of habitable rooms number of bedrooms
�'E�ITILATION FAN SCHEDULE
! Check method(s)proposed -� ;_�Exhaust only ❑ Balanced (heat recovery ventilator, air exchanger, etc.)
Fan descriprion or location � � (���..., ' ` r�_� �"�- " `-��- -Z-- TOTALS
VENTILATION Inta�e cfm cfm cfm cfm cfm
AS DESIGNED Exhaust � (1 cfm � cfrn ("} cfin (� cfm 7��c'? cfrn
Statement of Compliance: The proposed building design represented in these documents is consistent with the buildin� plans,
specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the
requirements of the Minnesota Energy Code.
`
�� �r v� ; � � ��t� �Z � o I �S"z- ��fi-Sz� Z�
:�pplicant(pnnt name) SiQnacure Date Telephone number
�art C2. VENTILATION (Submit Part C2 upon completion of system verificationj�)
�.
�� ----------------------------------------------------------------------
Job Site Address: Permit\Tumber
Fan description or location TOTALS
ti1EASL'RED Intake cfin cfm cfm cfm cfrn
PERFOR.�tilANCE-� Exhaust cfrn cfm cfm cfrn cfrn
j Ventilarion rate must be measured and verified when the performance oprion is used in lieu of the prescriprive oprion for the seaIino
of joints in the buiiding conditioned envelope(from Part A).
Compliance Statement: Installed��entilarion system is in compliance with�fN Energy Code and is sized to provide the design air flow.
Applicant(print name) Si�nature Date Telephone number
12
� t +�_`..`,�,�
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O,�Q�O City of Orono Sob Site Address: t • "S � �
P.O.Box 66 . f"" , y
��:� �rys`a'Ba`-,�55323 ENERGY CODE WORKSHE�T 'FOR ;
'�j�_� �, (952)239-4600 �
�' �'������� `�� ONE & TWO FAlVIILY D�VELLINGS
�
E8A08
INSTRUCTIONS: Complete Parts I, II and III. Clearly mar�C plans «�ith: insulation R-values; windo«�and sl.-��li�ht U-values; size and
ri�pe of equipment; equipment controls; and location of interior air barrier, vapor retarder and «�ind���ash barriers. More detailed
information can be found in the Minnesota Ener�•Code Summarv Sheets available from the Minnesota Department of Public Service.
Part I. BUILDING ENVELOPE
CheCk option used: ❑ "Cookbook"Method(complete worksheet below) ❑ MnCheck method(attach report)
❑ Buildin�Component method(attach calculations) ❑ Systems Analysis method(attach analysis)
« » NIINIl�iUl4i REQUIRE�IENTS
Cookbook Wor�sheet for«�oo�boo�» o t;on,
❑ Heatin�svstem efficienc�: �finimum 90% AFUE
INSTRUCTIONS ❑ Entry Doors: 1'/<"solid«�ood or ma�imum U-value of 0.40
Step 1. Check item(s)that design meets on��linimum Requiremefits ❑ S �li�hts: None ermitted
list to the ri�ht. Must meet all items to use Cookbook option. ❑ CeilinQ Insulation: Minimum R-38
Step 2. Indicate proposed wall type on table below. ❑ Rim Joist Insulation: Minimum R-10
Step 3. Indicate Windo�v li-value and source. ❑ Floors over unconditioned spaces: �linimum R-30
Step 4. Verif� total���indo�v(including area of all foundation win- ❑ Foundation���indows: '/" insulated alass in wood or vinyl
dows)& door area is equal or less than allowable percentaQe frame or maximum U-value of 0.�1
•TABLE FOR DETERNTINING i��I�XIIIL)I�T WINDOW AND D�OR AREA
IVla�unum Allowable Total��'indow and Door
.=�rea as a Percentage of Exposed Wall �� 10% 12% 14°/a 16% 18% 20% 22% 24% 2b°/a 28%0
Wall T e (R-5 u to R-10 Foundation Insul.): Maximzun AveraJe �Vindow U-value exce t foundation�cindo���s p 5.6 sf):
� ?x=�, R-13 insulation. <R-� sheathin� 0.37 036 0.3Q 0.26 0?3 020 0.18 0.16 0.1� 0.14
❑ 2z�, R-13 insulation. L• R-� sheathinQ 0.37 037 0.37 0.37 0.3� 0.31 0.28 0.25 0.23 0.22
� 2x�4, R=13 insulation, �S R-7 sheathinQ 0.37 0.37 0.37 0.37 037 0.34 03I 0.28 0.26 0.24
❑ ?s6, R-1� insulation, <R-� sheathina 0.37 037 0.37 0.37 03� 031 0.28 0?� 023 031
❑ 2z6. R-19 insulation, � R-> sheathinQ Q.37 037 � 0.37 037 037 037 0.33 0.30 0.23 -0.26
❑ ?t6, R-21 insulation. <R-5 sheathin� 037 0.37 0.37 0.37 0.37 0.33 03Q 027 0.2� 0.23
❑ 2�6, R-21 insulation, � R-� sheathinQ 037 0.37 0.�7 0.37 037 0.37 035 4.31 0.29 0.27
�Uall T� e(tivith R-10 Foundation Insulation): I�Iaximum AveraQe «'indo�v U-value(exce t foundation windo�vs p 5.6 sfl:
'� ?�4, R-li insulation. <R-5 sheathin� 0.�7 0.�7 � 0.3� 0.28 0.�� 0.22 0?0 0.18 Q.17 0.15
❑ 2z4, R-13 insulation. L R-� sheathin� 0.37 0.37 0.37 0.37 037 033 0.30 027 0?� 0.23
0 ?z4, R-13 insulation, `- R-7 sheathin� 0.37 037 0.37 p.37 037 036 0.33 030 0.27 0.25
❑ ?x6, R-19 insulation. <R-� sheathins 0.37 0.37 Q.37 0.37 0.37 0.32 0.29 0.27 0.24 0.23
� ?s6, R-19 insulation. � R-� sheathin� 037' 037 � 0.37 0.37 037 037 03� 032 0.29 0.27
❑ �x6. R-21 insulation, <R-� sheathina 0.37 037 0.37 0.37 0.37 0.35 0.31 0.29 0.26 0.24
� '_s6. R-21 insulation, � R-� sheathina 037 0.37 � 037 037 0.37 037 0.36 � 0.33 0.30 0.28
�Vail T� e(«ith Rt1 l9 Foundation Insulation): Nlaa:imum Averase ���indow U-vatue(exc t foundation�;•indows p 5.6 sfl:
❑ 2x=�, R-I� insulation. <R-� sheathinQ 037 0.37 � 0.�4 0.29 0?6 023 0.?1 � 019 0.17 0.16
❑ 2z=1, R-13 insulation, � R-� sheathine 0.37 0.37 0.37 037 0.37 0.3� 0.31 0.28 0.26 0.24
❑ ?��1, R-13 insulation, b R-7 sheathinQ 0.37 0.�7 0.37 037 037 0.37 0.�� 031 0.28 0.24
❑ 2x6, R-19 insulation. <R-� sheathinQ 0.37 0.37 0.37 0.37 037 034 030 0.2S 0.25 0.23
❑ 2x6, R-19 insulation. � R-� sheathinQ 0.37 0.37 0.37 0.37 0.37 037 0.36 0.33 0.�0 0.28
❑ 2r6, R-21 insulation, <R-� sheathin� 037 0.37 0.�7 037 037 0.36 032 0.29 0?7 0.25
❑ 2t6, R-?1 i.sulation, b R-� sheathinQ 037 0.37 � 0.37 037 0.37 � 0.37 037 � 0.�4 0.31 0.29
VVindo«�U-value: ��� Source: D NFRC ❑ Code Default Table (see Part 7670.0700) i
100 X �i = � % < % � � -
,
'�"'`°° window&door area gross exposed wall area DESIGN ALLO�`ABLE (from table abave) '
13
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2 b I"1 C►qsC.o Po,�rr- 1��
PID:
DES CRIP'I'ION OF WORK: _ � �� �-5-,o N �/Z�,,•y�,�7 p�--L
_ ___�_w�_-- - --- -
� ----------------------------------------------------------------
ZOr"I1tG REVIEW BY: DATE APPROVED: /o -z 5 —o�
BUII.DI�i 1G REVIEW BY: DATE APPROVED; � o-z5 -ct�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes ✓ No
PLAl�t 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)
ZOYI��1G CH�CK LIST Zoning District: L/L - � L
Fire Department: Post O�ce: School District:
Lot Area: Sq.ft. /�,�-I(.-? Acres •y Width l�C�r6 u vt-6L Depth
Survey Submitted: Yes � No Date of Survey: �(- 1�7-01
Proposed Setbacks:
Fron[(Lake): !�5 � � Right Side: -�j,S�
Rear (Street): Z'7' �- Left Side: Z�' f
Adjacent Structures: — Wetland: "-'
Building Height: Def. Hgt. 2-z Peal:Hgt. z to
Lot Coverage: ( 6 -`�
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # 2�`�1 `1 Resolution: # `/6`{0 Resolution Date: �'S'��
Shoreland District: y�S
Avg. Setback: (�.)` Bluff Setback: �i1 (/� Lot Coverage: 16 -�
Existing Proposed
Hardcover: 0-75'
75-250' Z� �!
250-500'
500-1000'
Hardcover Variance Required: Yes_� No Date of Council Approval: `���7 '��
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: R •3 CONSTRUCTION TYPE: V�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor z _
2nd Floor x =
Garage z =
z =
TOTAL
Fstimated Construction Value: $ 35p,c�po �`�
Inspections Required: `Vork Requiring Separate Permits:
Site �_Plumbing Fire
Hardcover Removal v< Mechanical Water Connection
X Footing � Septic Sewer Connection
C Framing _�Fireplace Lawn Inigation
< Insulation (Masonry) Other
�Wall Board _�(Mfg,� Well (State Permit)
pc Final Grading/Filling �Electrical (State Permit)
Other
REMARKS (IV HOUSE):
-----------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy.
------------------------------------
RENIARKS (TO BE NOTED ON PER1tiII�:
8
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CITY OF ORONO ALLED IN
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Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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 FINA� 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Inspector. `
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� DATE TIME
CITY OF ORONO CA�IED IN
INSPECTIONJ�TI SCHEDULEo���' f 36
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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� DATE TIME
CITY OF ORONO CALLED IN
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Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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OwnerlContrac or on site:
Inspector. �L•�� ����
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✓ / DATE TIME
CITY OF ORONO LLED IN
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
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Call forthe next inspection 24 hours in advance. �95Z� Z49-46��
OwnedContracto on site:
Inspector. � �
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN '
INSPECTION NOTIC / 4 � SCHEDULED �,�I va
PERMIT N0. !T 3 � COMPLETED =-'31 r-- �
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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
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INSPECTOR WILL RETURN ❑CITATION ISSUED
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Call forthe next inspection 24 hours in advance. (952) 249-460�
OwnerlCon ctor on site:
Inspector yi�C��� ���1�
White Copyllnspector's File Canary CopylSite Notice
//
DATE TIME
CITY OF ORONO CALLED IN -�---��
INSPECTION NA�CE�3 � SCHEDULED _�pf� �r�.2�—�--
PERMIT N0. ;�� COMP�ETED � '7�Z` -� l O
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
F� 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
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Call for the next inspection 24 hours in adva ce. (952) 249-46��
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Inspector.//�,t�',l/,�� S
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPT FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCES
Cail for the next inspe�o h u s in advance. (952� 249-4600
OwnerlContractor on site:
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Inspector.
W 'e Copyllnspector's File anary CopylSite Notice