HomeMy WebLinkAbout1998-010256 - storm damage repair PERMIT
.CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:=!�=�;T��t�
Crystal Bay, Minnesota 55323 Permit Number: �:;,i.;���F_�
(612) 473-7357 Date Issued: tt`„y�,J',�;�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — �a���1 ; �.�;;�.. — �W;?' . �_�f� . OWNER:
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• ' CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE iJSE ONLY
ADDRESS OR LEGAL: �`j P �% �' fl 5�=� r c�,��„ ; t'��:�
PID:
DESCRIPTION OF WORK: 5��;;`,,v�� �n�,,,,:�, �� �Z�,-�'.�t�('�
ZOivING REV�W BY: � �'� DATE APPROVED:
BUII..DING REVIEW BY: -_ � ��,,,,�.,,` DATE APPROVED: �-z� S��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes No .�- SEVY�CONNECTION
STATE SUR�F3ARGL Yes .� No WATERCONNECITON
INVESTIGAZ'ION FEE Yes No � PARK FEE
SAC Y::s No ' SITEINSPECTION
Number of SAC Units OTHER (specify)
�ZO�TING CHECK LIST zoning District:
!V:: C:.�/���:�.:,
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): _ Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
Buildin' Height: Def. Hgt. Peak Hgt.
L.ot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File; # Resolution: # Resolution Date:
Shoreland DisL-ict:
Avg. Setback: Bluff Setback: Lot Covera�e:
� Eziscing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
• 26
BUII,DING REV�W CHECK LIST '
�C: ��• � CONSTRUCTION T'YPE: V N
' Sq Footage $ Per Sq Ftg
Basement x =
lst Floor R _
2nd Floor x =
Garage x = .
R -
TOTAL
Estimated Construction Value: $ '1, S 7 `� v-'
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing . Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
rx. Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Nlfg.) Well (State Permit)
�' F�� Grading/Filling Electrical (State Permit)
Other
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RE�7ARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existin� New
Access Approval: Date gy; '
REMA.RKS(TO BE NOTED ON PERMIT�: � � �w
27
�
, CITY OF ORONO - BUILDING PER�iIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit�:
ALL INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
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THE APPLIGANT IS: (circle one) OWNER or CONTRAC�
Jos SITE AnDxBss: �29 i � C.�S�� P��tnl�T �lt. zIP: S��`f3 7
(work)
N� oF owrrEx: 7���� Fr4� F �5't�f pgorrE: (h ome) �{7�- v3 3/
MAILING ADDRESS: � �► R C/�SC� PO�i�T R� CITY: �y�t��/G� ZIP: �S�J
CONTRACTOR: Nf� U,G-�i�-��L CJrv`S7'r yL/✓C• PHONE: �7B �f��L
MAILING ADDRESS: j 7 `zl 7 l�.�v y 7 CITY: /"l� ZIP: j S�''f..�
STATE LICENSE: # :�2c� �{
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRSSS: CITY: ZIP:
NAME: R.EGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : � �P/}t 2 S Tt�R � � -4r�t�4C}-E �U
ROO �n1 LLS �b �l..a-l� ��"\�(�•��. ���i�C,_� � CC��fI?�
��.u.�E C� �e�'��� \ ���-�tz �'� ��E T� -
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF B$DROOMS: GAR�IGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $ �, ���..��
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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; t.hat 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 SIGNATIIRE: � `� " ��- " �"� DATE: � ��U r�
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Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
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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
Iicense 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 wiZl be used to determine your
qualification for the permit or license reques�ed.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or license.
3. The information may be snared with other 3ocay , s`ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii act�or.
to approve, some information may become pub3ic.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required �o process this application or
permit.
J ���. � CO��.�
First Middle Last
��,� �� �� • � '
1 V�dl Y1� N,�'� � ' G� �,� �����
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City State Zip
��1 � -- tlD2
Phone ' �.� �� ��� ,��
���/ _ �- ��i S �i'�,� z � � �.
I understand m� rights as stated ab����� �
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Signatu
BUILDING&ZONING— 473-7357 • ADMINISTRATION& FINANCE— �73-7358 • PUBLIC WORKS —473-7359
ASSESSING
�
$].3.04 RIGHTS OF SIIB.7ECT5 OF DATA
Subdivision 1. Type of data- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be gi�en in���' An.individual asked to
� supply private or confidential data concer a a tamw hin the collect ng state gency,
purpose and intended use of the requeste
(b) whether he ma� refuse or is legally
political subdivision�he requestede da 8em; y
required to supply (c) an 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 s Vgdu��e8skedlto supplyinvest gat ve data,
requirement shall not apply when an indi
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace the notice reauired under this
subdivision in the individual income tax or ro ertv tax re und instructions instead o
on those orms. . -- - �
Subd. 3.
Access to d�ata by in�vi�ugl- Upon request to a responsible �
authority, an individusl shall be informed whether h�Vgteeor c�nfident alre Upon his
individuels, and whether it is classified as public, p ublic data on
further request, an individual who is the subject��gQ to�mrl�ae if he desires, shall
individuels shall be shown the data withou�fan�Y t �ta. After an individuel hes been
�e informed of the content and meaning the data need not be disclosed to
shown the private date and informed of its mesning, ��ugnt to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the indivif�h h� a eeor publi t datarupon8request by
responsible authority shall provide copies o F require the
the individu8l subject oft�e actual•co ts of mak ng,l cert fyingy and compiling the
requesting person to pay ,
copies. immedietely, if possible, with any request
The responsible authority shall comQly
macie pursuant to this subdivision, or with lide e,�f Simmediateatc mpliance e�su not
excluding Saturdays, Sunc3ays and legal Ys
possible. If he cannot comply with the re9five �thin�i��ntl�ch toh omplynfor h �hQ
individual, and may heve an additional YS
request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Procediu'e �►hen d�ata 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 individugl shall notTh r spons bletauthocty shall within 130
describing the nature of the disagreement.
days either: (a) correct the data found tcom lete dataeincludingreec pients nemedt by
notify past recipients of inaccurate or in P
the individuel; oc (b) notify the individ�h i div'idual'slstatemen tof disagreementci
Data in dispute shall be disclosed only if
• included with the di.sclosed date. be a ealed pursuant to the
' The determination of the responsible authority may PP
provisions of the administrative procedure act relating to contested cases.
DATE TIME
CITY OF ORONO CALLED IN � ��� /�:��'I�f�>
INSPECTION NOTICE SCHEDULED Co ' - � � 3C���j�
PERMIT NO. �v COMPLETEp) � �
ADDRESS CI�� �
OWNER �- � '�� CONTR. ' ��
TELEPH � /T "_�J �- -�
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADWG/FILLING
� 02 FR 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q
,� 03 INSULATIO�1 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 0�. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED � PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
' CITATION ISSUED
C]STOP ORDER POSTED.CALL INSPECTOR
C'., INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Calt for t ext�n pection 24 hours in advance.473-7357
OwnerlContract o sit : -�
Inspector. i
White Copylinspector's File Canary CopylSite Notice
DATE t7p TIM/E
CITY OF ORONO CALLED IN ��)'�+G�"/d ���/J tt/n
INSPECTION NOTICE SCHEDULED � -S �`j"J� �
PERMIT N0. /!):��6 COMPLETED
ADDRESS ,'��7I � L��(r�` �C-L1t�k� ffl
OWNER -�u�6�t'Sc�i CONTR. ��J��r� � Cd���
TELEPHONE NO. � �U " /�0:�
� DESCRIPTION k f��'Z th C.�Ct--,�
� 01 FOOTING 11 MECHANICAL� 18 EXCAV/GRADING/FILLING
2 FRAM� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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 FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �WORK SATISFACTORY:PROCEED l PROJECT COMPLETE
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� CORRECT WORK�PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
W
O �I CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR
1 CITATION ISSUED
�::; INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac r n te:
Inspector.
White Copyllnspector's le Canary CopylSite Notice