HomeMy WebLinkAbout1995-007454 - replace patio dr/window �___
P�RMIT
CITY OF ORONO t � PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: `.; �i';;�"`-
Crystal Bay, Minnesota 55323 � -'� �'- �
(612) 473-7357 Date issued: _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - ==;.r-�r=1 i�.: :-.:-� _: .-. OWNER:
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APPUCANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: S r � DateRecei��ed:
DateApproved:
Entered Bv: � _ py`�lt 1' , y��
CITY OF ORO�O - BUILDING PERtiIIT APPLICATION
:�LL I��'OR�IATIO�r IILST BE SL�BIIITTED I�1 F�1�I.L BEFORE PLr��1 KEV�tiV tiVII�L
BE ST:�RTED
THE �PPLIC:�.��1'T IS: � (c�rcle one) O��`�ER O CONTRACTOR
JOE SIfiE :�D
DRESS: ���� C.� �/�, / � ZIP:
'— � ) PH0�1E: (home) �7/ "��/3�
�1��1E OF O`VNER: ( o v� �'�/ � I c�t �
(w�orh)
11AIL��G�DDREss: /yiv ' o��,.
� CITY:�r vs��� ZIP:
�--�J ,/ L Pxo��: ��- 599�
CONTR�,CTOR: / .0 L{ PIS��^ �r�s7
�, I�IOBILE PHO�tE/P�v���
�IAII.�tG:�DDRESS: ���/ �6•// C.% CITY: �� ZIP: $'S�2�
STATE LICE�i SE: n .353�
:�RCHTI'ECT/ENGLti`EER: PHO��E:
CITY: Z�:
�IAILL\G�DDRESS: REGISTI2�TIOr r
N�ti�IE:
TYPE OF WORI�: New �ddition Accessory Structure
�Iove �e:ncdeJ.'Lte:�tion � Land=�lt�ranon
PROP SED`VOR�i( escribein etail): .C� /" 1`�c� � � Sl,� Siz
� _� L
G,�i C��-✓ P � .� a � �.
STORIES: = f� SQ• �ET OF EACH FLOOR:
�,TO. OF BEDROOI�iS: �__ G��GE ST:�LLS: ATT. DET.
ESTLl�1�TED CO�tSTRL�CTIO�V�,I,L`:�TIO�'(escludin�land): �� �G't-�
%
I hereby apply for a buildin� perm.it ar.d I ac?cnowledae that the information above is complete
and accurate; that the work wi11 be in conrormance with che ordinances and codes of the C:��
and with the State BuildinQ Code; that I understand this is not a permit and work is not to start
without a permit; and that the work will be i.n accordance with the approved plan.
�P
PLIC?�'vT'S SIG�IATURE: ��� D�"�: /o r7 >�
NOTE! Parade of_Homes events require separate�nput�i eaents a'llbn�beCal�wed. ent and
City Counctl 60 days prior to the event. Non pe
Sec.13.04 RIGHTS OF SL'B.TECTS OF D�T�;
Subd. 1. Type of data. �he riehts oi individual on whom[he data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be�ven indi�idual. :�n individual asked[o supply private or confidenaal dara concerning himself shall
be informed of: (a)the purpose and in�ended use o[the requested da[a wi[hin the collecang'siate agency, polidcal subdivision, or statewide system;
(b)whecher he may refuse or is legally required to supply che requesced data;(c)any known consequence arisine from his supplying or refusing to supply
private or contidennal data;and(d)the idendty of other persons or endnes au[horized by state or federal law to receive the data. This requirement shall
no[apply when an individual is asked to supply invesdgaave data, pursuan�to secnon 13.82, subdivision�, to a law enforczment officer.
The commissioner of re�erue r�a� olac 7 rodc r auir�d unde- this subdivision in the individual income �z or oropem tax refund
instructions instead of on chose forms.
Subd. 3. ?.ecess to data by individual. lioon requesc to a responsible authoriry,an individual shall be informed whecher he is the subjec[
of stored data on individuals, and whe[her i[is classitied�s puolic, pnva[e or conridennal. Upon his funher request,an individual who is[he subject
of stored private or public data on individuals shall be shown [he daca wichouc any charge to him and, if ne desires, shall be informed of the co�[ent
and meaning of thac data. �Rer an individual has been shown[he private data and informed of its meaning, the data need not be disclosed to hun for
six mon�hs thzreatier uriless a dispute or acaon pur5uanc co this secnon is pending or addinonal data on the individual has been collected or created.
The responsible au[honry shall provide copies of the pri�ate or public daca upon request by the individual subject of the data. The responsible au[hority
may require the requesting person to pay the actual costs of making, ceitifying, and compiling the copies.
The responsible authority shall comply immediately, if possibfe, with any request made pursuant to this subdivision, or within five days of
the date of the request,excluding Sa[urdays,Sundays and legal holidays, if immediate compliance is no[poss�ble. If he canno�comply with the request
within thac time,he shall so inform[he individual,and may have an addidonal five days wi[hin which to comply wirh the request, excluding Saturdays,
Sundays and legal holidays.
Subd.�l. Procedure when data is not accurate or complete. An individual may con[est the accuracy or completeness of public or private
data conceming himseif. To exercise this rieht,an individual shall notify in wnring the responsible au[horiry describing the nature of the disagreement.
The responsible au�horiry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to notify past zecipien[s of
inaccurate or incomplete data, includine recipienu named by the individual; or(b) nocify the individual tnat he believes [he data to be correct. Data
in dispute shall be disclosed only if the individual's sta[emen[of disagreement is included with the disclosed data.
The decermination of the responsibfe authonry may be aopealed pursuanc to che provisions oP the administranve procedure act rela[ing to
contested cases.
DAT.� PRIV aCY :�DVISORY
In accordance with M.S. 13.04, Subd. �, "Rights of subjects of data", we would like to inrorm 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.
":ou are :o�ified thar.
1, The information you furnish�•��ill be used to detemune your qualification for the permit or license requested.
2. You may refuse to supply data, but refusai may require that the City deny the permit or Iicense.
3. The information may be shared wich o[ner local, state or federal aQencies 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.
j. You have cenain riQhts under �1.5. 13.04 (available upon request) to review private data on yourself.
6, Your full name is required to process this application or permit.
�� � /�✓l�l S t� ��
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First lliddle Lasc
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A es �� � � � �
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City Stace Zip Phone
I understand my rights as stated above.
� �-,�—
Signamre
CHECK OFF LIST �OR i�SUANCE OF PERv1ITS
FOR OFFICE USE ONLY
:�DDRESS ORLEG:�I.: /Y��' cf���2y ��'�" PID:
DESCRIPTIO\ OF �`'ORI�: w�►v°ac.� G �''T
---------------------------------------------
-----------------
------- ----------- ----__---_�
ZO``I�tiG RE`��V BY: N(�- DATE APPROVED.
BL�.DL\G REVIEW BZ': DAT'E APPROVED: �a •��- � �
------------------
-------- ---f-
FEES TO BE C�L�RGED: �iisc. Fees Calculated By: _
PERVIIT Yes No
PLAN REVIE`� Yes �� No `�- SEWER COlV�ECTION
STATE SliRCH�RGE Yes �/ No WATER COIv'Vi ECTION
INVESTIG�TION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
tiumber of Sr�.0 Units OTHER (specify)
--------------- -
ZON�G CHECK LIST Zoning District: Shoreland Discrict :
Fire Department:
Pos[Office: School Dis�rict:
LotArea: Sq.ft. Acres Width Dep
Survev Submitted: Yes No /i Da�e f Survey:
, / !
Proposed Secbacks:
Front lLake) Righ�Side: �
� Rear (Stree : Lef� Side: /
r !
i
Adjacen� �'iructu � s: ; Wetland:
;
� Peak H t � %/
Building Height: �Def. Hg . � g 'i� —�—
� � i ,� � _
Avg. Setback: 7 Bluff S�tback: i' Lot C�verage:
i '
}; Existi�ig Pro�s�—�--
Hardcover: �I 0-75' �� � � —�---
_�— �
�� 75-250' � 1 �
� 250-�00' I �
�, �00-1000'
Hardcover Variance Required: Yes No Da[e Council Approval:
Gradins: Staff Approval Date: By: Council Approvai Dat :
Sep�ic: Staff ?.pproval Date: BY�
Zonin? File: n Resolution: # Resolution Date:
��iA�tKS (in house):
26
BtiII.DL\G RE«�`' CHEC� LIST
LBC: �Z —3 CONSTRliCTION TYPE: 1��
Sq Foocase 5 Per Sq Fto
Basement Y —
lst Floor �
2nd Floor X
GaraQe x —
y C —
TOTAL
cL
Estimated Construction Value: � Z 5��
Inspections Required: �Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Foo[ins Sep�ic Sewer Connection
o� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mf�,) Well (State Permit)
_�( Final Gradin�/Filling Electrical (State Permit)
Other
—
----------------------------------------- -
REi�iARKS (L�i HOUSE): I
- ----------------------
REVIEW gy OT'HERS: DATE:
Access: Existin� �eW
Access Approval: Date BY�
- --------------
RE�IARKS(TO BE NOTED ON PERiVIIT):
27
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DATE TIME v /
CITY OF ORONO CALLED IN /G -,/,���5 ��` ��
INSPECTION NOTICE �j SCHEDULED /a �i�3�;�� /�' ��Q�
PERMIT NO. �`�`✓ � COMPLETED � �
ADDRESS ��� �'�'�'
OWNER /.t����J 1 � CONTR. � 2�G�G•-��� ��
TELEPHONE NO. ���� � � � �%" �S
� DESCRIPTION �C� ����C��-�' ��C�=����-�-r���r /S s-�-��
�
lU 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMIN ' 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z 04 WAL 12 WATER HOOK-UP 17 SITE INSPECTION
05 AL �� 14 SEWER HOOK-UP O6 PROGRESS
� MO-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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr o si :
Inspector.
White Copyllnspector's File Canary CopylSite Notice