HomeMy WebLinkAbout1996-008521 - pool/fence/landscape - �� � - . PERMI7�
� G'tiT�"OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ;=�;ix��;..;�;_�-�;_;
Crystal Bay, Minnesota 55323 Permit Number: i t;;�,L�::�
(612) 473-7357 Date Issued: " '� _. _
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SITE ADDRESS:
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DESCRIPTION:
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4_•'_'ll;k�:'= t_•t,�=�*'� _ t''� i''I$_�i�l���_i'�� �� i t',!_?�.: ! .
REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -- ��EG��:1 �,-. _... . — _ -.- . i.t..�: OWNER:
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APPLICAN ERMITEE SIGNATURE , ISSUED BY:SIGNATURE ��C C .
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Total Fee: $ e��-�t��-`I-`� '� ' > � Date Received:
Entered By: ,�%1..0 Permit#: �;2/
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 1�R CONTRACTOR
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JOB SITE ADDRESS: t ��;�_' /l�{�L'� ��'��- `�, ZIP: ����I i
' ��r ���
NAME OF OWNER: ��� - ��' ���%�--� I��l��.= PHONE: (home) � �
�� � ��� �ITY: (l,�rk) J� � (��,�� ��� )
MAII.ING AD)RESS: � �-,� �-1QJVV U� ���_ ' t ZIP: ��
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CONTRACTOR: ���=� � � ��t>C_� `� PHONE: `��( �"����
CONTACT PERSON: �--�Ldt,�, °��.�� � i,X c_1�.�_ MOBILE/PA�ER: �I;� - ��,` �! -
MAILING ADDRESS• l^�I �� � Ft�� ,`�— CITY: y�=='��r►�`-S'��-�',' ZIP: ?> > �'>'�'�
STATE LICENSE: # J�(��
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F �`'j��,� � � � .- ? �- -C>
N INEER: ��`�---- �_` -+� PHONE: `
ARCHITECT/E G �
MAILIl�i G ADDRESS: �:��Y��S � �G' T :f CITY. _����' ��,:��:' ZIP: 5� .� Y
' � , ` REGI5TRATION# �? ��, C�
N�: , ,, ,, � ,�-�r.��,�� 1 �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detai�: � I�i 'c:i��-�_ ='rt� �l l'}��� � - -acX��� s'
{�.�ti ,, �,r��� � '�� : � i �C�G i.' U ti c �' tl / � � �� _ ►�
{ , , \(' 7 J,
� ,_{� �' , �ti �z; _ z:�q _y-� �.� ���- -fil�r-�
STORIES: � � . FEET bF EACH FLOOR: ,�1; �'� � �
NO. OF BEDROOMS: '���� GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � ' � � �C%' ���
�
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 accordance with the approved plan.
� ,
� � I.,
APPLICANT'S SIGNATURE• � �� t�'°'�.�U�X� !< �(� DATE: ��`�,'.��'�?.�
NOTE! Parade o,�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.
6
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be scored shall be as set forth in this secdon.
Subd.2. Iaformation required to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and incended use of[he requested data within the collecring'sta[e agency, poliacal subdivision,or statewide system;
(b)whether he may refuse or is leealiy required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idenary of other persons or enacies authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve daca, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv tax refund
instrucdons instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals, and whether ic 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[he data wi[hout 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 informed of i[s meaning,the data need not be disclosed to him for
six months thereafter uriless a dispute or action pursuant to this secaon is pending or addiaonal data on che individual has been collected or created.
The responsible authoriry shall provide copies of the privace or public data upon request by the individual subject of the data. The responsible authoriry
may require the requescing person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply immediately,if possible, with any request made pursuant to this subdivision, or within five days of
the date of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidona(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 shalt notify in writing the responsible authority dzscribing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correcc ehe data found to be inaccurate or incomplete and attempt to nodfy past recipienu 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 inciuded with the disclosed data.
1"ne determination of the responsibfe authoriry may be appealed pursuant to the provisions of the administradve procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Riehts of subjects of data", we would like to inform you that your request
for a pernut or license 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 will be used to deternrine your qualification for the pemut or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pernut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
S. 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.
���l�tX��'�L� � �� ,�_�_(Th��� � I�. I� !;,_
First �iid le � Last
�q';�, � C�'�.�.�I(/,� � �- 'J'� � -
Addres —{. —
� �
'� ` .-1tL � ' ' �j_'�)`1 � `�'� �_s. c—;j �-;�
Ciry State Zip Phone
I understand my rights as stated above. 1
'�� _� \�.�,� �-��1 � �` ,�1�
,� _
��1
Signature
, � .
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: /y 7_ c::H�V�j C tt��s� �►,�'�
PID:
DESCRIPTIOIV'OF WORK: �r���r
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ZONING REVIEV�J BY: � � ,,� DATE APPROVED: t o -Z?-ti:�
BUILDING REVIEW BY: - r � t DATE APPROVED: t c� � t7- �'�
-------------------------------------------------=t -------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t/� No
PLAN REVIEW Yes r/' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No c� PARK FEE
SAC Yes No �.--( SITEINSPECTION
Number of SAC Units OTHER (specify)
-------------------=---------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: �'�.-��
Fire Department: w T A�t-n Post Off ce: t,�;R-��--�-Y� School District: c.,�;,4-t,��,�-Ty�
Lot Area: Sq.ft. 2`���S�7 Acres � (�;� Width ��CJ Depth ��l�
Survey Submitted: Yes �. No Date of Survey: i G • 2 � -�i �
Proposed Setbacks:
Front (,ba�: t�Z r t Right Side: �� 1
Rear (St�ee�): C,�� {= Left Side: �l? �
Adjacent Structures: /� � Wetland: �t!/r�
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
�, Zoning File: # Resolution: # Resolution Date:
Y- Shoreland District:
Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
SJO-lOOO'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
�. .
. .
BUII.,DING REVIEW CHECK LIST
usc: N i/� co�rs�rxuc�o�v �rrnE: �t.�r/�
Sq Foota�e S Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gazage x =
x =
TOTAL
UcI
Estimated Construction Value: $ (v���}�'
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hazdcover Removal Mechanical Water Connection
,�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Pemut)
,�—F'inal Grading/Filling � Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
� Access Approval: Date By�
REI�IARKS(TO BE NOTED ON PERMIT):
27
DATE TIME
CITY OF ORONO CALLED IN �"�- �7
INSPECTION NOTICE SCHEDULED � �� %.3��
PERMIT NO. �S �/ COMPLETED � �
ADDRESS ��� C..j" �'��-c� �/'L c.z�., ,B�
OWNER �i. CONTR.-�� � �
TELEPHONE N0. �qS� r��C�
� DESCRIPTION ��
� Ot FOO 11 MECHANICAL RI 18 EXCAV/GflADING/FIWN(�i
y 02 ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 031NSULATION 24/25 WOOD BURNEH/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEMQ–SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
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O
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O
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W
�
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W
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W
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� WORK SATISFACTORY:PROCEED
W� PFOJECT COMPLETE
W f CORRECT WORK 8 PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
O i-1 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING pERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �- CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contra t :
Inspector. ��
White Copylinspector's F le Canary CopylSite Notice
y.i F NOTE. DOUBLE STTJDS UNDER CROIAMS
3i- z 9 0 �GTRDER 'TRUSSES DOUBLE JOIST BEAMS
,
Y-0 !-6 6-G 3•tJ 3-6
. 3 _ 6-6 -3
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SPECIAL NOTE
Scale Vq?, = t' '� 'F -Y
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Y �t ,fin .'i r, .. t• 1
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NOTS
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- 15-6
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ELEVATIONS
Scall %g -1 SCale %y"=/' *r pv.:.;SOS 11a1E
`
--VH 1 :; IC NS As NOTED.
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TAR -- �`,a � rT & RE;'SUBMIT
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3 t gats a« it>ar isY`^r.,
All work stai#e +f
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2 - 0 M rn r - -r.m s - r•- s t+yi! c rrt uu n items rc+ s+vow-�z fly ' *0 -
,� chest Paint win ►z I -Ht- N r � � � �iw
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. CUS ['QM CO [ TAGES LTDDATE
DE -S 1.GN _ P. 0. BOX'. 633 WAYZATA, MN,11 55301
RENARD ADDITION 7-24_, 4 f OF 2
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CUSTOM CCT•TAGES LTDRENARD
DATE
L1 ADDITION 7- 2:4-94 2 OF 2
DESIGN" P. 0. BOX .63.3 WA,YZATA, MN .'55,391