HomeMy WebLinkAbout1996-008319 -replace deck - PERMIT
' CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 %.t i 1;i ;::7 Ev=_;
Crystal Bay, Minnesota 55323 Permit Number: ;_yt:}:-=:T;, ,�
(612) 473-7357 Date Issued: 4�:�;�;Y,{} t,��
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — �`,��c�1 �c:�t;t. —
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APPLICANUPERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: ���f o�� DateReceived:
Date Approved:
Entered Bv: C Permit#: � �3i9
CITY OF ORONO - BUII,DING PERIVIIT APPLICATION
AI,L INFORMATION��LTST BE SLBI�iITT'ED IN FULL BEFORE PLA:�1 REVIEW`VII�L
BE STARTED � '`
-----------------------------------------------------,�---- -----------------------�����---------------------
THE APPLIC��1T IS: (circle onej OWNER R CONTRACTOR
JOB SITE ADDRESS: Zg'� S ���
NA�ti1E OF OW�1ER: �jiG���1� ���2,1j�PHONE: (home)_ �2
' (work) ^
MAILIN'UADllRT�:SS: �'J�' �� 1 1 . �- CITY: 1N ZIP:_ i��/
CONTRACTOR: _�' �il/}� PHONE: G}7I��SZ
v10BILE PH0�1E/PAGER:T=-
MAILINGADDRESS: ���-� CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: /�/��y�� PH0�1E: �—
vIAILINGADDRESS: �--- CITY: ZIP: -----
N���: �,,._._._. REGISTR.ATION # �—
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ✓ Lar�Alteration
PROPOS D�VORK(describeindetail): J�-�Y' ` �'L
�� ��
STORIES: � SQ. FEET OF EACH FLOOR: �G(g � Gi '`
NO. OF BEDROOI�IS: d GARAGE STALLS: ATT. _j`� DET. d
EST��TED CONSTRUCTION VAI.UATION(eYcludingland): $ ��� . �
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 Buildinj Code; that I understand this is not a permit and work is not to start
without a permit; and that the work w' b in c rdance with the approved plan.
APPLICANT'S SIGNATURE: DATE: �o''��,�_
NOTE! Parade of Homes events require separate permit approval by Police Depariment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
� �
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is scored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal data concerning himself shall
be informed of: (a)the purpose and incended use of the rEquesced data within the collecting'state agency, poliacal subdivision, or stacewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidenrial data;and(d)the idenary of other persons or enades authorized by state or federal law[o receive the data. This requirement shall
not appty whe�an individual is asked to supply investigaave data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propercv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject
of stored data on individuals,and whether it is classified as public, private or co�den[ial. 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 its meaning,tbe data need not be disclosed to him for
six months thereafter unless a dispure or action pursuant to this secdon is pending or additional data on the individual has been collected or created.
The responsible authority shali provide copies of the private or pubiic data upon requesc by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making, cemfying, and compiling the copies.
The responsibie au[horiry 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 legal hofidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so infornt the individual,and may have an addidonal 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 contesc the accuracy or completeness of public or pmate
data concerning himself. To exercise this right,an individual shall notify in writing ttie responsible authoriry describing the nature of the disagreemen[.
The responsible authoriry shall within 30 days either. (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipiencs of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individuai that he believes the data to be correct. Data
in dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determina[ion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to
concested 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 fumish 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 pernut>or license.
3. The information may be shared with other local, state or federal a?encies 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.
�'�r-Gl,�.��� ���'/� �1�
First , �fiddle Lasc
Address /, � 7 /
���
Ciry State Zip Phone
I understand my rights as stated a ve
� �
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ?��o`� �:.r���'<_ r� ,,,�.- ��-c:.�
PID:
DESCRIPTION OF WORK: �:���i�
------------------------------------------------------------------------------------------------------------------------
ZONING REVIEW BY: -� !� � 1 �'���--- DATE APPROVED: �', �.'�, 'c�
BUILDING REVIEW BY: , r: _, ..,� ti•� DATE APPROVED: � �.k, �t�
�������������������������������������������������1' �������������������������������������������������������������������
FEES TO BE CHARGED: �� Misc. Fees Calculated By:
PERMIT Yes f No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SUR`HARG� Yes �/ No WATER CONNECTION
INVESTIGAT'ION-FEE �Yes t� No � PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: �i-d C_
Fire Department: IMp�N� Post Office: L�,�'��z v�rv� School District: �,,����C,�y�c/�-
Lot Area: Sq.ft. ti� Acres — Width -- Depth —'
Survey Submitted: Yes �'C No Date of Survey: ��s ,_��= �( � Z 3 �(1,
Proposed Setbacks: t
Front (Lake): 1 i 5 � Right Side: �'Z � -�
Rear (Street): Left Side: Z S � �
Adjacent Structures: ►4��--�_-'►'� Wetland: /'�-' � �
Building Height: Def. Hgt. �'�'i`4 Peak Hgt. � (r�
Lot Coverage: �' � <<-
Grading: Staff Approval Date: r.,' � •'� By: "� Council Approval Date:
Septic: Staff Approval Date: 1'U ( �'1 By: "
��'? 3C::
Zoning File: # :� +2 Resolution: # •—' Resolution Date: d �'c` � `I �
Shoreland Dist:ict: �� . �
Avg. Setback: ���� � _ Bluff Setback: N��� Lot Coverage: /1�f l�
Existing Proposed
Hardcover: 0-75
75-250' rl`1 �
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
�
REMARKS (in house): � c...�=:.;��c u��,v� �.� .�-, �� -��" ,1.:�,_,.� � —
26
BUILDING REVIEW CHECK LIST
UBC: f� - '� CONSTRUCTION TYPE: \r(L
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
�._
Estimated Construction Value: $ j���
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
—�Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ON PERMIT):
27
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DATE TIME
CITY OF ORONO CALLED IN �'a G'- c�(`
INSPECTION NOTICE SCHEDULED 9 � � i��`
PERMIT N0. r '/ 7 COMPLETED �_ �_
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ADDRESS��G� ��-�-t� � �` `�
OWNER f C���'�-�c-�y-� CONTR. �
TELEPHONE NO. �l I/ - ��-� ��
� DESCRIPTION ���-t `�
� Ot FOOTING 11 MECHANICAL RI 18 IXCAV/GRADINO/FIWNd
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNEH/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� OS FIN/� 14 SEWER HOOK-UO O6 PROGRESS
J -07 DENtC�§ITE 27 SEPTIC MAINT. 21 COMPLAINT
�Q 07 DEM4—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d T�WORKSATISFACTORY:PROCEED PROJECTCOMP�ETE
W �
W ;/L CORRECT WORK&PROCEED L ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex�in�pection 24 hours in advance.47S-7S57
OwnerlContr c�si e:
Inspector. ��� � /1J�
White Copylinspector's File I Canary CopylSite Notice