HomeMy WebLinkAbout1996-007802 - bath remodel � —� ,�:.. _ .
PERMIT
' CITY OF ORONO PERMIT TYPE: _.
2750 Kelley Parkway- P.O. Box 66 ���� 3 !_�_��:f`�:�
Crystal Bay, Minnesota 55323 PermitNumber: ;;;";�,=;r_±;:
(612)473-7357 Date Issued: ,_�:_;�-�F ; ^��,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — ������� i��:.����i_. — OWNER:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: � `�a2(u � =�� DateReceived: � J .'� '�
DateApproved:�_� �: � - � 4�
Entered B�: �,�� _ Permit#: '7.�C�;,Z
✓
CITY OF ORONO - BUII..DiNG PERNIIT APPLICATION
ALL INFORMATION I�IUST BE SLBI�IITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
---- ---------------
THE APPLIC��1T IS: (circle one) OWNER O�CONTRACTOR �
JOB SITE �DDRESS: �.�� C-�-�=�---�-;`r C'�'`�`�' ZIP:
NAiI�� OF OWNER ��'� ���� � 1--��� PHONE: (home)
(work)
VIAILI�i TG ADDRESS:/2� C^�"�-`T c�>'-l-�-5'�"' CITY:C��c�,c<�', ZIP:
/ ���,��- �T c��
CONTRACTOR: ��'JS l �f��C--�- PHONE: � �'
vipBILE PHO�tE/PAGER: �
MAILINGADDRESS: �ySZ /1`'�-clS�A�� ��C'� CITY: �t'.c�/��� ZIP: ,`�z 2
STATE LICENSE: # a�''-��
ARCHITECT/ENGINEER: PHONE:
MAILINGADDRESS: CITY: Z��
N��1E: REGISTRATION #
TYPE OF WORK: New Addition Access.�y Structure
Move Remodel/Alteration �- � Land Alteranon
PROPOSED�VORK(describe indetail): ����•� ��-�-�t�'��-��==L- � �L�`��' �� '�-'
C%>k�, r' �-t_ �T7t_�.�
STORIES: Z- SQ. FEET OF EACH FLOOR:
NO. OF BEDROOl�1S: � GARAGE STALLS: ATT. � DET.
�ST�I�TED CONSTRUCTION VALUATION(escluding land): ��� ��-'��
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 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 work will be in�ccordance with the approved plan.
� r � , % .��-���'_ DATE: � ,�`�`� c .:.
APPLIC��T S SIG�IATURE: '� ���' _
NOTE! Parade of Homes even re�ire 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 SLJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd.2_ Information reqirired to be g�ioen individual. An individual asked w supplY private or confidendal data conceming hiauelf sha11
be informed of: (a)t�c purpose and in�ended use of the requested dara wichin the collecring'state agency,polidcal subdivision,or statewide sysum:
(b)whether he may refuse or is legally required to supply the reQuested data;(c)any known consequence arising from his supplying or refusing to snpply
private or confidenaal dara:and(d)che idenary of o[her persons or enrives authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply in�esvgaave dan, pursuant to secrion 13.82, subdivision 5, to a law enforcement ofFcer.
The commissioner of re�enue mav lace the noace re uired under this subdivision in the individual income tax or ro errv tax refund
insaucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,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 confidendal. Upon his fur[her cequest, an individual who is the subject
of stored private or public dara on individuals shall be shown[he data wi[hout any charge to him and, if he Id�ee��e d not be a��o ea�io him[for
and meaning of[hat data. After an individual has been shown the priva[e data and informed of i[s meaning,
six months thereaf[er unless a dispu[e or acnon pursuant to this secdon is pending or addidonal data on the individual has been collected or creared.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting penon to pay che actual costs of making, cerdfying, and compiling the copies.
The responsibte authoriry shall comply immedia[ely, 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 reques[
within[hat time,he shall so inform the individual,and may have an addidonal Five days wi[hin which to comply wi[h the request,excluding 3aturdays,
Sundays and legal holidays.
Subd.4. Procedure wheu data is not accurate or complete. An individual may contest the accuracy or compieteness of public or private
data conceming himself. To exercise this right,an individual shail no[ify in wri[ing the responsible authority describing the nature of tha dilec rients o[f
The responsible au[horiry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to no[ify p P
inaccura[e or incomplece data, including recipients named by the individual; or(b)notify the individual that he believes the data to be corcect. Data
in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the adminisaadve procedure act relaang co
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 tha[your request
for a pernut or license from the Ciry 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 deternune your qualification for the permit 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.
j, 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.
-- __
�1/"IG�-��-� 1.�,� -���"r l�-- �/�='t ��JS f-�'-1«�_.
tiiiddle Last
First �, '
�lj� /_t�=c=c�S/ �-�-�4 �U �
Address .tl�l ��`>��_ >�:, ��' -'�.�-- �� ���i�
�-����—� Phone
Stace ZiP
City
I understand my rights as stated above. �) ,
ii�%1�-1 � �-�c���
Signawre `
�
l,_�
� CHECK OFF LIST FOR ISSUAitiCE OF PERMITS
FOR OFFICE USE ONLY
�DDRESS OR LEGAI.: i ZZ GN C V GN –
PID:
DFSCRIPTION OF WORK: T1� =w�o�.L
ZONING REVIEW BY: N�1} DATE APPROVED:
BUII�DING REVIE`� BY• y . d � n� DATE APPROVED: � -zo �U
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes z/" No
PLAN REVIE� Yes c� No SEWER CONNECTION
STATE SURCHARGE Yes �'"No wATF� CONNECTTON
INVESTIGATTON FEE Yes No - — PARK FEE
SAC Yes No �� SITE 1NSPECITON
Number of SAC Units _ OTHER (specify) �___ _
------------
-----------------
ZO�'vG CHECK LIST Zoning District: Shoreland District :
Fire Department:
Post O ice: School is 'ct:
Lot Area: Sq.ft. Acres Width r� Depth
Survey Submitted Yes o Date of Surve�:
�
1
Proposed Setbac
i t Side:
Front ( e): �
Rear (St eet): ft Side:
Adjacen Structure • Wet d:
Pe Hgt. '
Building Height: Def. Hgt. —
Avg. Setback:
�� Bluff S tback: �Lot Coverage:
i
� � Proposed
1 Exist' �
i
Hardcover: 0-75' ,
75-250'
250-500' �,
500-1000'
Hardcover V ' ce Required: Ye No
D te of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff pproval Date: By�
Zoning File: Reso u �on: # Resolution Date:
p;��yiARKS (in house):
BUII.DING REVIE�' CHECK LIST
UBC: R-3 CONSTRUCTION TYPE: V�
' Sq Foota�e S Per Sq Ftg
Basement x —
lst Floor R —
2nd Floor x —
Garage x —
x =
TOTAL
QV
Estimated Construction Value: � 2'2���o "
Inspections Required: Work Requiring Separate Permits:
Site ,_�, Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_Z( Framing Fireplace Lawn Irrigation
_,� Insulation (Masonry) Other
/L Wali Board (Mfg.) Well (State Perm.it)
/� Final Grading/Filling _�C Electrical (S[ate Permit)
Other
REIVIARKS (IN HOUSE):
- ------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
REI�IARKS(TO BE NOTED ON PERNIIT):
27
ATE TIME`
CITY OF ORONO CALLED IN ' '' i� �C ' �J `�'7
INSPECTION NOTI E SCHEDULED ��- �� � � ,� ��>�'
PERMIT NO. � C� `� COMPLETED �"�- �� � �� � ��
ADDRESS �� `� �����'�i-r�.�Z ��
OWNER L�'�r�e— �-L�h�-L y
�-�- CONTR. u�� r'�r� c,e
TELEPHONE NO.�.�� " 33�(��
� DESCRIPTION �cL��}�-r� �,�.�,���`�
� 01 FOOTINQ� 11 MECHANICAL RI 18IXCAV/dRADINO/PIWNO
�Q 02 FRAMINO 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 W�OD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q �` 14 SEWER HOOK-UO 06 PROGRESS
�
J 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 HEMOVAL
J 10 PLUMBINO FINAL 36 FOUNDATION HEMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
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d B�qQRR8AT15FACTORY:PROCEED � PROJECT COMPLETE
W �
� �CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
O �'CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� "� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r on s'#e:
Inspector. �
White Copyllnspeclor's File Canary CopylSite Notice
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SEE ATT�,':��� ��-1EET
�OR Sr'�wK-�.
CODE F2EC�lJIREMENTS