HomeMy WebLinkAbout1996-007814 - basement finish � P�RMIT
�� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �.:.:;.:,;:;.;w i:
Crystal Bay, Minnesota 55323 Permit Number: {.;�_;�;_:��
(612) 473-7357 Date Issued: - - - �-
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: — ��:����. a c��-��_. —
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APPLICANT%P ITEE SIGNA RE ISSUED BY:SIGNATURE �7 'C'�i �
Total Fee: � � "'�`�� �/�, DateReceived: �
Date Approved:
Entered By: ��;�: Permit#: -'��/�
CITY OF ORONO - BUII�DTivG PERMIT APPLICATION
ALL INFORMATION I�IUST BE SUBMIT"I`EU IN FULL BEFORE PLAi�1 REVIEW WILL
BESTARTED
__-- ---------------------
THE APPLIC�vT IS: (circle one) OWNE OR CONTRACTOR
� (�
JOZ SITE :�DDRESS: -�� o��"' �'�'2,(.�' �-`-� �" IP: ���� /
��
N�ti1E OF O`�tER: c�' PHONE: (home)�� I - ��1�-3
(wark) �'
vIAILINGADDRESS: j��lv �� � TY: ZIP: � -� �
CONTRACTOR: ����, PHOiVE:
�IOBILE PHO�IE/PAGER:
v�AIL�TG ADDRESS: CITY: Z�:
STATE LICENSE: #
I
�RCHIT'ECT/ENGli�tEER: �/��d� PHOiVE:
�VIAILING ADDRESS: CITY: Z��
V�V�: REGIST'RATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Lan�Alteradon
n ��..U.� -
PROPOSED`VORK(describe indetail): �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROO�IS: GARAGE STALLS: ATT. DET.
EST�I�TED CONSTRUCTION VAI.UATION(eYcludingland): $ /�1 1��0 �y
I hereby apply for a building permit and I acknowled�e that the information above is complete
and accurate; that the work will be in conformance with the ordinances and codes of the Ciry
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 wo will be in accordance with the approved plan.
�
APPLIC��T'S SIG�1A c DATE: �� ��- y�
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 RIGHTS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be sto�d shall be as set for[h in this sccdon.
Subd.2. Information req�red to be given individual. An individual asked to suppiy private or confidendal data conceming himself shall
be informed of: (a)the purpose and incended use of the requested data wirhin che collecdng§tate agency,polidcal subdivision,or staoewide sysoem;
(b)whether he may refuse or is legally required ro supply the cequested data;(c)any kno�+'n coasequence arising from his supplying or refusing to supply
privace or confidendal data;and(d)[he idenary of ocher persons or endaes authorized by state or federal law to receive the data. 'Ihis�equuement shall
not apply when an individual is asked to supply investigaave dara, pursuant to secrion 13.82,subdivision 5, to a faw enforcement officer.
The commissioner of revenue r�av place the nodce required under this subdivision in the individual_income raz or propem tax refund
instrucrions instead of on those forms.
Subd. 3. access to data by individual. Upon requesc to a responsible auchoriry,an individual shall be informed whecher he is the subjecc
of stored data on individuals, and whecher 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 wichout any charge to him and, if he desires, shall be informed of the content
and meaning of tha[dara. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for
six months thereafter unless a dispuce or action pursuant to this secrion is pending or addidonal data on[he individual has been collected or created_
The responsiblz au[horiry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesring person to pay the actual costs of making, certifying, and compiling the cupies.
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 request
within[hat time,he shall so inform[he 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. M individuai may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall no[ify in writing che responsible authority describing the namre of the disagreemen4
The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipiencs named by the individual; or(b)noufy che individual that he believes the data to be correc�. Dara
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 administradve procedure _ct relatine 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 thac •�ur:
for a pernut or license from the City of Orono or any of its departments may require you to fumish ce:- �n privacc
confidential information.
You are notified that: .
1. The information you fumish will be used to determine your qualifica[ion for the permit or license requested_
Z. 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 eetent necessary to process
the permit or license.
4. If your requested pernut or license requires Council action to approve, some i.nformation may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
�
� �i�'P Las[
FirstO�� �
Ad ss . ` ��% — �2-3
Ciry State ' Zip Phone
n rstand my rights as stated above.
Signamre
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CHECK OFF LLST FOR ISSUAriCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAI.: �Zc� C/�5� Pb,,v r—
PID:
DESCRIP'TION OF WORK: d�4s�W���- N�
ZONING REVIEW BY: N � DATE APPROVID:
BLTII.DING REVIEW BY: DATE APPROVED: 3 -$�-y�
- ---------------------
FEES TO BE CHARGED: Misc. Fees Calculat�d By:
PERMIT Yes � No
PL� ��w Yes J No SEWER CONNECTION
STATE SURCHARGE Yes �/ No wAT� CON��ON
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No � STTE INSPECTION
Number of SAC Units OTHER (specify) _
-------------------
ZO�Ti�1G CI3ECK LIST Zoning District: ; Shoreland istrict :
Fire Department:
Post Office: School District:
Lot Area: Sq.ft. _Acres Width Depth
Survey Submitt : Yes No Date of Survey:
Proposed Setbac :
Front (Lake): Right Side:
Rear (Street): _� �fr Side:
i
Adjacen[ Structures: / Wetland:
Building Height: Def. Hgt. Peak Hgt.
Avg. Setback: Bluff Setback: Lot Coverage:
Existing �� P�osed
Hardcover: 0-75' � �
75-250' /
250-500' ________
500-1 /
/ Date of Council Approval: __
Hardcover Variance Req ired: Yes No �_
Grading: Staff Approv, Date: By: Council Approval Date:
Septic: Staff App
roval Date: BY'
�Zoni.n� File: # Resolution: # Resolution Date:
P:���l[ARI�.S (in house):
�
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BUILDntG REV�W CHECK LIST
uBc: � - 3 co�s�ucTTo;v �E: V�
' Sq Foota�e S Per Sq Ftg
Basement z —
lst Floor x —
2nd Floor R —
Garage X —
x =
TOTAL
v�
Estimated Construction Value: � � Zr O0°
Inspections Required: Work Requiring Separate Permits:
Site l� Plumbine Fire
Hardcover Removal �:vfechanical Water Connection
Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
Oc Insulation (Masonry) Other
� Wall Board (Mfg.) Well (State Permit)
p�Final Grading/Filling o<Electrical (State Permit)
Other
REM�,�L� (IN HOUSE):
----------
REV�W BY OTHERS: DAT`E:
Access: Ezisting New
Access Approval: Date BY�
RENIARKS (TO BE NOT`ED ON PERI�IIT):
27 .
� TIME
CITY OF ORONO CALLED IN `
INSPECTION NOTICE SCHEDULED tf r�� `J�
PERMIT N0. �1��or'--ri— COMPLETED �
ADDRESS � � - � r� � �
OWNER.��r� CONTR.' " .�. r� '
TELEPHONE N0. _.� �Q --_�l '7'� J
� DESCRIPTION t �������f'..r�' �:i"�•�/�L'l�
� Ot FOOTINO 11 MECHANICALHI /1�j 18IXCAV/dRADINCi/FIWNd
Q RAMING t� 13 MECHANICAL FINAL I ',�� 19 LAI�SHORE/WETLANDS
� f"�
� 03 ULATION�y 4�� 24/25 WOOD BURN R/FIREPLACE � 34 TREE REMOVAL
Z WALL BD. 12 WATEH HOOK-UP 17 SITE INSPECTION
Q
Z 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEMO—FINAL 15 SEPTiC INSTALL. 22 FOLLOWUP
= 09 PLUMBINO RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WIIL RETURN
❑STOP OROER POSTED.CALL INSPECTOR
❑ CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73rJ7
OwnerlContract n te:
Inspector. �
White CopyllnspecloPs Ffle Canary Copy/Site NWice
DATE TIME
CITY OF ORONO CALLED IN �� i��% �
INSPECTION NOTICE SCHEDULED i/i.;.�:1'' �- '/'�� r�
PERMIT NO. COMPLETED //� �_
(I % � �
ADDRESS �. O � C� ��_.�.� Q� �. �� :�cP�
OWNER.� �--f' CONTR. %�� �����_.-
TELEPHONE NO. ���.� �� '� �
� DESCRIPTION ���� _c>>.�� �-ci�c��-
lL 01 FOOTING 11 MECHANICA I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� c 03 INSULATIO-N�' 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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 OU:_YES_NO
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W
O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
0 TE TIME
CITY OF ORONO CALLED IN � S�y�
INSPECTION NOT�E- SCHEDULED � �.6 l/ =��
PERMIT N0. � COMPLETED �_ �-�. _
ADDRESS ���-���( :��-E^ � :��
OWNE���t' CONTR. ,_J�-,C�
TELEPHONE NO. ���I� - � � �
� DESCRIPTION /12�-�-�-��«� S �� W �D� 0)C
� 01 FOOTINQ 11 MECHANICALRI 18IXCAV/dRADINQJFIWNa
y 02 FRAMINO 13 MECHANICAL FINAL 19 IAI�SHORE/WETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAI
Z p4 yyqL�gp. 12 WATER HOOK-UP 17 SITE INSPECTION
� FINAL ' 14 SEWER HOOK-UO O6 PROGRESS
�
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBIN(i RI 23 SEPTIC FINAL 35 HARD COVER HEMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMM NTS:
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W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COYERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next in ction 24 hours in advance.473-7357
OwnerlContract o ite
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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