HomeMy WebLinkAbout1996-008102 - deck ___ _. __
� PERMIT
° �CITY OF ORONO
��?50 Kelle Parkwa P.O. Box 66 PERMIT TYPE: �, ��.
y y Permit Number: �: - �--`�'��'��
C;rystal Bay, Minnesota 55323 t rR>;.�_:��.�
(612) 473-7357 Date Issued: _ . _
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: - �;�:,��?, i s�}�{. -
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APPL ANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE .t.�,
� Total Fee: � ,��./S DateReceived:
DateApproved:
Entered By: �d , Permit r�: ,�/C' �--
CITY OF ORONO - BUILDING PERNIIT APPLICATION
�I.L INFORMATION�ItiST BE SLBMTTT'ED IN FULL BEFORE PL��1 REVIEW WII.L
BE STARTED
-------------------------------------------------------- —�-------------------------------------------------
THE APPLIC:�NT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: � ��� C�iSCv P�• ,��, ZIP:
NA.�ti1E OF OW�1ER: ���J/ �- ,�'�s r /�9c����' PHONE: (home) �.7/-� Y/J
(work)
MAILING ADDRESS: �.��/ C�S�o ��,�c/ CITY: c,</y��s � ZIP:
CONTRACTOR !�� 1�- -S , C.:. jv. �i c`J PHONE:
v10BILE PH0�1E/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGI�YEER: PHO�TE:
MAILTi�1G ADDRESS: CITY: ZIP:
;����,�: REGISTR.ATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Larxi Alteration
PROPOSED�VORK(describeindetail): C��C K- `- � �� `1-� C�'x'i��S��, ,�� c�C�C�.
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET.
EST��TEDCONSTRUCTIONVAI,UATION(eYcludingland): $ yL'�� UL
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 Buildin' 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.
��
APPLIC�'�1T'S SIGNATLTRE: � - DATE: b���l ��
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.
.
,
Sec.13.04 RIGHT'S OF SLIBJECTS OF DATA
Subd. 1. Type of data. 'I�e rights of individual on whom[he data is scored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given indiridual. An individual asked to supply private or co�dendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wi�hin the collecting'state agency, political subdivision,or stacewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any imown consequence arising from his supplying or refusing to supply
private or confidendal data:and(d)the identiry of other persons or enaries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesogadve data, pursuant to secrion 13.82, subdivision 5, [o a law enforcement officer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individuai. Upon requesc to a responsibte 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 co�denual. Upon his further request, an individual who is the subject
of srored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shal]be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of irs meaning,the data need no[be disclosed to him for
six months thereafter unless a dispute or action pursuant to this secaon is pending or addidonal data on[he individual has been collected or created.
The responsible authority shall provide copies of the private or pubtic dara upon request by the individual subject of the data. The responsible auchoriry
may require the requesting person to pay the actual coscs of making, certifying, and compiling the copies.
The responsible authoriry 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 holidays,if immediate compliance is not possible. If he cannot comply with the requesc
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 private
data concerning himself. To exercise this right,an individual shall notify in writing the responsible au[horiry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt ro nodfy past recipients of
inaccurate or incomplete data, i�cluding recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disciosed only if the individual's statemen[of disagreement is included with the disc(osed data.
T'ne determination of the responsible authoriry may be appealed pursuant to the provisions of the administncive 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 reques[
for a pernut 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 permit 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.
��i cJl S �7�t��S c�/
First / Vliddle Last
Zr�U/ ��s�v ��• �c%
Address
(��i �Z S�y C/!!/.�✓
C�n, State Zip Phone
I under d my rights as stated above.
1 " �'"
�
Signa re
? . . ....
. CHECb: OFF LIST FOR ISSUAIvCE OF PERl��1TTS
FOR OFFICE USE QNLY
�.DDRESS OR LEGA.I-:
z`�� t C:�l � ,� L�.� .� �c" �!� �✓�
PID:
DESCRIP'TION OF WORK: �- :' . -! -
ZO�'G REVIEW BY: � . __ DATE APPROV�D: ! -L� � �
BUII.DING REVIEW BY: � - C C �-_._. DATE APPROVID: l Z� 4�
FEES TO BE CHAKGED: Misc. Fees Calculated By:
PER1vSIT Yes � �a
PL� ��w Yes r� �o SEWER CONNECTION
STATE SL`RCHARGE Yes `� No WAT�R COivNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units _ OTHER (specify)
---------
ZO�tING CHECK LIST Zoning Discricr. �o - �� Shoreland Disuict : �--� � —
Fire Department: /1/U C(+�?��ost O�ce:
�" School Diszricc:
I.,oc Area: Sq.ft. t�1,� S v_Acres � YS' �'id� � � � Depch
Survey Submitted: Yes � No Date of Survey: �[)�Ic -�`5
Proposed Setbacks:
�$t ��e�: (�U � '� Ri�ht Side: /� S
Rear (Stree�): /�
/A- Lefr Side: �`��'� r'�
Adjacent Structures: ������ Wetland: t^�I�
Buildi.n� Heighc: Def. Hgt. /J��" Peak H�t.
Avg. Setback: lJ�� �`� Bluff Setback: ✓� 1 � Lot Coverage: N �¢
Ezisting Proposed
Hardcover: 0-75' —
75-250' ry�,Q l=�l..0
250-500' —
500-1Od0' —
� Date of Council Approval:
Hardcover Variance Reouired: Yes i o o�
Grading: Staff Approval Da[e:
,�f ��%. gy; Council Approval Dace:
Septic: Staff Approval Date: /" {� By�
Zoni.ng File: n /� `� Resolution: # Resolution Date:
� -
�: .,
RF.,.'ViARKS (in house):
,
- � .J �
BULLDPi tG REVIER' CHECK LIST
tJgC: 2_j CONSTRUCT'ION TYPE: ��/`t
Sq Foota�e S Per Sq Ftg
Basement x —
lst Floor x — -
2nd Floor z —
Garage x —
x =
TOT�L
u�
Estimated Construction Value: � y�°
Inspections Required: Worl� Requiring Separate Permits:
Sice Plumbing Fire
Hardcover Removal �iechanical Wacer Conneccion
Footing Sep[ic Sewer Connection
Fram.in� Fireplace Lawn Irrigation
Insulacion (Masonry) Other
Wall Board (Mfg.) Well (State Perm.it)
vLFinal Gradin�/Filling Electrical (State Permit)
Other
g:��MARI�S (IN HOUSE):
-----------------
REVIEW BY OTHERS: DATE:
Access: Ezistin; �eW
Access Approval: Date BY�
REI�IARKS (TO BE NOTED ON PERl'�-1IT):
�.
Y -
� _ - - ---__._... .
��
�
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI SCHEDULED
PERMIT NO. COMPLETED � 1 ��
AODRESS__�� � ��-�C G 1��: � �
�
OWNER CONTR.
TELEPHONE N0.
� DESCRIPTION ��(��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAOING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 0 LL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
05 FIN 14 SEWER HOOK-UP O6 PROGRESS
� 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
D C M ENTS:
� Q
a
�
o � �,.
�
0
�
W
�
Q
�
z
W
�
W
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d �WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W
� ❑ CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �.' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector.����G"� ���L��
White Copyllnspector's File Canary CopylSite Notice
, j
��
DATE TIME
CITY OF ORONO CALLED IN � -Z�' ��'
INSPECTION N�TICE SCHEDULED � -'��/l� _`�� 'I �sv
PERMIT N0. %G `L� COMPLETED
ADDRESS a��U / L�� �--� '
OWNER ��, ��� CONTR.
TELEPHONE NO. '��7 i J��/ 7
� DESCRIPTION �.Lz�
� 01 FOOTINd 11 MECHANICALRI iBIXCAV/GRADIN(i/FIWNO
y 02 FRAMING 13 MECHANICAL FINAL 79 LAI�SHORE/WETLANDS
Q 03 INSULATION 24l25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� FINqL ' 14 SEWER HOOK-UO O6 PROGRESS
�
J 07 M�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEM�FINAL �5 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAI
v 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
a �S Q 1��
o a� � o s' s ;�r
�.
�
0
�
W
�
Q
�
a
W
�
W
�
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d ❑WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
W
� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O �CORRECT WORK,CALL FOfl REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
OwnerlContractor si
Inspector.
White Copyll�spector's File Canary CopylSite Notice
�s - � , f r '_ ``a �
. _ . . � 6-:�� � .'� �6�' -�"� �'..�� .>, ���
CERTIFICATE OF SURVEY ��,� • � n � n� ��
for Paul J. Hauser �� ' _.. -_ �`i� , (� 1�
� in Lots 125 and 126 , Spring Park � "`��"� ``�r�"'�r a�
_ Hennepin County, Minnesota
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I hereby certify that this is a true and correct representation of a survey of the boundaries of that part of Lats
125 and 126 ; and that part of Lake Shore Avenue, vacated; and that part of the tracts of land across from Lots �
125 and 126 on the opposite side of Lake Shore Avenue as designated and defined in the instrument of dedication
of the plat of Spring Park described as commencing at the Northeast corner of Lot 126 ; thence Westerly along ' � " „""""'""'""�
the Northerly line thereof 20 feet ; thence Southerly para11e1 to the Easterly line of Lot 126 a distance of
38 feet to the point of beginning; thence Northerly parallel to the �asterly line of Lot 126 to the Northerly c�� a� oRa�o
line of Lot 126 ; thence [�lesterly alon, the Northerly line of Lot 126 and its extension to the shore of Lake
Minnetonka ; thence Southerly along the shore of Lake Minnetonka to its intersection with a line running paralle+ � n SI�'E �'�.AN T__ GRADING PLAN
to and 70 feet Southerly of the Northerly line of Lot 126 and its extension, as measured at right angles to the � �',�P���7V�C �.�-CI�
Northerly line of Lot 126 and its extension; thence Easterly along sa�d parallel line to a point which is 170. 4 ' i._) ��-'�'��Vv� y11;1;a f��'���IONS
feet Westerly from the point of beginning ; thence Easterly to the point of beginning, all in Spring Park, accord:�ng ' r-; ��r��r,�,�;-}����;
to the recorded plat thereof, and the location of all existing buildings and visible hardcover thereon. It doe:c ; �y �
not purport to show any other improvements or encroachments . ����� � —
COFFIN & GRONBERG, INC. Scale : 1" = 30 '
�.,...,_...._...,......_,.______..:._____ _...__._.�_.._ - -�
D a t e : 10-6-8 8,i�..,6-8P o.�.��b,�.�o�,�
�i2�� .:�•c�---T o : Iron Mark��r
Mar S . Gron erg Mn. Lic. No. 1�
Engineers , Land Surveyors , Planners
Long Lake, Minnesota .
,.
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