HomeMy WebLinkAbout1999-012147 - garage addition PERMIT
CI�Y OF ORONO PERMIT TYPE: - : ,; - -
2750 Kelley Parkway - P.O. Box 66 � `' ' �'`�'
PermitNumber: ��r.�y''' " .�
�Crystal Bay, Minnesota 55323 - - _ -
(612) 249-4600 Date Issued: -. - . - -.
SITE ADDRESS:
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APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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I Total Fee: $ ; ,��`7� ��`�`� Date Received: %%����
Entered By: ,��� Permit#: i 2-i`-17
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
--------------------------------------------------------------------� ----- -------- -------------
THE APPLICANT IS: (circle one) OWNER CONTRA TO
JOB SITE ADDRESS: � �� C��� �f�y �,y-,r�S-� �s� ZIP:
NAN� OF OWNER: !'�{ n' � ��>�1��� _ PHONE: (home)
(work)
MAILING ADDRESS: ) �Z Cl-tv C��� �,CITY: C7ro�•'�� ZIP: I
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CONTRACTOR: SC�-�.�.(��'� &�'- I �_�">��� PHONE: �� ��... � ���' ��
CONTACT PERSON: v S , � •;'7N10BILE/PAGER:
MAILING ADDRESS: ��-� �c�,-,.�j b�., ��c. CITY: �V� ^�- Z�-. ZIP: S_��
STATE LICENSE: #
.3� �,� ( �����
ARCHITECT/ENGINEER: J A Z �r C�-.� ��`� PHONE: � �`� _ � �b �
MAILING ADDRESS: ����] 1�"1��,,'�"o�� ��c CITY:��-`��-�<.,:��, ZIP: �S 3°� )
NAME• A r-� . �P.. Z�.��0,1 a 2=�sG� REGISTRATION#
TYPE OF WORK: N�w Addition`� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: ���r� , � c, �� ����
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STORIES: SQ. FEET OF EACH FLOOR: '
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding 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 City 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 accord ce it approved plan.
APPLICANT'S SIGNATURE: � �j��.^���,��,� DATE: � �� � � �
NOTE! Parade of Homes events require separate perntit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
`_ 1
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 section.
Subd.2. Information required to be given individual. An i�ividual asked ro supply private or confidential data conceming himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide
system;(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 supply private or confidenrial data;and(d)the identity of other persons or enti6es authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, ro a law
enforcement off'icer.
The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or orouertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible 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 confidential. Upon his further request, an individual who
is the subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed
of the content and meaning of that data. After an individual has been shown the private data and infornted of its meaning,the data need not be
disc(osed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data.
The responsibfe authoriry may require the requesting person to pay the actual costs 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,exduding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the reques[within that time, he shall so infornt the individual, and may have an additional 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 contest the accuracy or completeness of public or
private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authoriry shall within 30 days either. (a)conect the data found to be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is induded with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrauve procedure act reladng
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
request for a permit or license from the �ity 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 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 pernut 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.
� � �� � 5c h-���c Z
First Middle Last
"3��1 �«,��,���� � Y� S,
Addre\ c\ � J`'� � 1 1 f 7 .C� / �p y
�, z� � � S �
�[�y State Zip Phone
I understand my rights as stated abo
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Signature �^,��., /
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. CHECK OFF LIST FOR ISSUANCE OF PERMITS
• FOR OFFICE USE ONLY
ADDRESS OR LEGAL: t ZZ C►-�EV 4 C r-t�s-e
PID:
DESCRIP'TION OF WORK: Gq.�6� �Q. �c,•-�
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ZONING REVIEW BY: DATE APPROVED: // -�s -g�
BUII.DI�G REVIEW BY: DAT'E APPROVED: C I- �S•�`i
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes v No SEWER CONNECTION
STATE SURCHARGE Yes �i' No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SI'TEINSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: IZ R -)�
Fire Department: w��� Post Office: �,v/�t�y4-Tv� School District: ��y-�
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Lot Area: Sq.ft. (a�$ O� Acres . y`'1 7 Width �p o Depth t q S
Survey Submitted: Yes � No Date of Survey: '7- I b•S{J Co nr F)c.�.)
Proposed Setbacks: � �
Front (Lake): 7 5 fi Right Side: 1 2 �'
� �. , �-
Reaz (Street): tiS — Left Side: G`'�
Adjacent Structures: �}7'TAc�+t:� Wetland: —'
Building Height: Def. Hgt. O � k-- Peal:Hgt. 0.�L
Lot Coverage: ��� ��
Grading: Staff Approval Date: "— By: Council Approval Date:
Septic: Staff Approval Date: �" By:
Zoning File: # '— Resolution: # Resolution Date:
Shoreland District: ��
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: �- 1 CONSTRUCTION TYPE: �/�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
.�
Estimated Construction Value: $ ZS�t9c�0
Inspections Required: Work Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removal Mechanical Water Connection
�c Footing Septic Sewer Connection
'� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI�:
8
CITY OF ORONO � 6124730510 10/14/98 14:13 � :02/02 N0:534
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8c�►�,c: , �" - 30' . ❑ APPf�VE�D V11lTH REVISICIt'�1�
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We heretiy �ertify t�et this is a true end Correct r!�`br
th� boundorles of t�E land apdv� described end of fp,��j�,oCat
if ony, t�1CrGQh, �n� vll visibte e�crOeChments, i , � an .
Det�d thfs 1___,6�Cay of Ju�.v , 18$ EG�N, FIEIp b NawAK �
� Surveyora .. . • .
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �
PERMIT NO. bI ZI�I� COMPLETED ? � '� '^��
ADDRESS 2-2 ��-v� ��� � ✓� •
OWNER CONTR. `-==C-�1'vJci.'�Z- �v� ,
TELEPHONE NO. ��� � ����
� DESCRIPTION l�G1r�t�
� 01 FOOTI�— NG'� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMM NTS:
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W ORKSATISFACTORY:PROCEED G PROJECTCOMPLETE
W ,�ORRECT WORK 8 PROCEED L ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. L- pHOTOTAKEN
INSPECTOR WILL RETt1RN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector.���` ""y�- ��tis
White Copyllnspector's File Canary CopylSite Notice
DA E TIME
CITY OF ORONO CALLED IN f� %
INSPECTION NOTICE SCHEDULED / 02� � %/`..��
PERMIT NO. ��Z� '`f� COMP ETED /�r "`29 -3�
ADDRESS f t r �
; �Z
OWNER CONTR.�S'
TELEPHONE NO. � �� � � 4� `f .3
� DESCRIPTION i
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 F� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBI 36 FOUNDATION/REMOVAL
� OWNERI ONTRACTORh'O MEET YOU: YES_NO
� COMMENTS:
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d ❑WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
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� �ORRECT WORK 8 PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,_-, pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDERPOSTED.CALLINSPECTOR �l: CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473�73�J7
Owner/Contractor on site:
Inspector��✓���'9'-5
White Copy/lnspector's File Canary Copy/Site Notice