HomeMy WebLinkAbout1996-008261 - deck PERMIT �
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 i=;��:i;.,::„�����s�
Crystal Bay, Minnesota 55323 PermitNumber: ;;;;;y; _�_,�
(612)473-7357 Date Issued: �- -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY: .
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CONTRACTOR: OWNER: — �1�<<�i i.��;3�_. —
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� �Total Fee: $ r'�� �'� � DateReceived: '�- 3� 9(0
Date Approved:
Entered By: �Ut Permit#: ��� /
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BESTARTED
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: y�(�5 �=1�i �P��u.')9 �-.�v- ZIP: S 5 3 5 G(
NAME OF OWNER: � t ►� C�Rrv�c.�-� PHONE: (home) y�f r-t-U�7 v
(work) � i �
MAILINGADDRESS: LI3i�5 Ch�P��c,Ux► L•v- CITY: U,rZ�, ZIP: ss3��
CONTRACTOR: �� /�? PHONE:
-� MOBILE PHONE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHTTECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration _ '� L.and Alteration
PROPOSED WORK(describe indetail): ��:��,%� n� Tz��q T�d> ���`c.lc ,_ ,��
7�c�-� �,;�
�-
STORIES: � SQ. FEET OF EACH FLOOR: ���O
NO. OF BEDROOMS: ¢ GARAGE STALLS: ATT. � DET.
�n
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 1��
I hereby appl_v 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.
J r�
APPLICANT'S SIGNAT � DATE: / -3 ��lp
NOTE! Parade of Homes events require separate pernzit approval by Police Department and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
9 ���� �''�� ��, �l�
Sec.13.04 RIGHTS OF SLJB,TECTS 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 individual asked to supply private or confidential data concerning 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(egally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive[he data. This requirement shall
not apply when an individuai is asked to supply investigative data, pursuant to section 13.82, subdivision 5, ro a law enforcement officer.
The commissioner of revenue maV place the notice required under this subdivision in the individual income tax or propertv 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, privare 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 informed of its meaning,the data need not be disclosed 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 responsible authoriry
may require the requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authoriry shall comp(y 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 possibie. If he cannot comply with the request
within that time,he shall so inform 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 conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipien[s 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 administrative procedure act relating 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 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 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 permit 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.
.J,�,,v,r s l_ GO��� c,t�
First Middle Last
y 3 cS �(I����. �,ra l ,�-yti r
Address
���c�=c� �'n�,^ 5 �3 5`l �t �l 4�C+��(�
C��y State Zip Phone
I understand my rights as stated above.
��
�gnature
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: f� t%� [������-v��..>�i �--z-�-�--
PID: ��� ' // -�13 u � o�i/
DESCRIPTION OF WORK: ,��
---------------------------------------------------------------------------------------------------:---�--�a-------
ZONING REVIEW BY: � CQ� DATE APPROVED• 'l °c b
BUILDING REVIEW BY: DATE APPROVED: 8 -�3- 5 �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes v' No SEWER CONNECTION
STATE SUR��-IARG� Yes r� No WATERCONNECTION
INVESTIGAT'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: �(Z� l IA
Fire Departmeiit: Y{nApc,�c` PLA,nI Post O�ce: (V�n�i�e Pt,q-�N School District: p/2.c��,c�
Lot Area: Sq.ft. �-1`'j,�3 Z Acres �•OZ� Width IY�I• � Depth �o�.C�Z
Survey Submitted: Yes_� No Date of Survey: 9��5'- g�3
Proposed Setbacks:
f '
Front (�ej: ?S :- Right Side: � SZ
Rear (S�feet): 1 U�� } Left Side: N l�
Adjacent Structures: L S� s►(-ecQ Wetland: �tJ �/�.
Building Height: Def. Hgt. p� Peak Hgt. .
Lot Coverage: �,�L
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
A, Shoreland Dist:ict: .
N� Avg. Setback: Bluff Setback: L,otCoverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house): /-�F rClz 7�`+�= r'�4�T /�c 2 m � T ' N� pp� C.c;
Fc C; N-o v►-•�ow n�e�-,
26
BUILDING REVIEW CHECK LIST
UBC: �' 3 CONSTRUCTION TYPE: '��
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
Qe.e� Y43o x ��.�� _
TOTAL
ov
Estimated Construction Value: $ �,�O 0
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
D� Footing Septic Sewer Connection
_� Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Pernut)
Other
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
------------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ON PERMITj:
27
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Certificate of Survey for
Jim Cornick and Investors Title
of Lot 3, Dlock 1 , CHIPPEWA �1 cr� �
Hennepin County, tdinnesota ������ �'��� �7'
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�z1�•� Exisfin9 `_ � � ;�d t'::' 1 ., c v.>
�'shed �� -
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� Chrppewa Lane N
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i LEGAL DESCRIPTION OF PREh1[SES:
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Lot :i, 31ock 1 , CHIPPESJA.
� This sur�ey intends to shown t'�e boundaries of the abov� described
property, and the location of an �xisting house and shed thereon.
It does not purport to show any other improvements or encroachments.
i
. o Iron marker
Bearings shown are based upon an assumEd datum.
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1 hereby certif}'that this surve}'was prcpand by me or under my direct wper• onre 9-/5-9j
/ �1 I � '� ��� vision,and that I am a duly registered Civil Engineerand Land Surveyor under
��� the laws o(Ihe State of�linncsot..
"� SCnLF. /��=¢O�
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htark 5.Gronberg D1innesoW License Numbrr 12755 ������� 93-'Q O6
%�-9G6
DATE TIME
CITY OF ORONO CALLED IN �!���'�'1� �?��� .�/17
INSPECTION NOTIC '' SCHEDULED f 2_�:,� �. jf:o`'r''.o,
PERMIT N0. � � � COMP ETED �1 �_
ADDRESS �:��CJ�S ���,�,��l�� �-l�`--
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OWNER ���✓r��—� CONTR.
TELEPHONE NO. / 7�` � � ���
� DESCRIPTION ��-F' C'�
� Ot FOOTINQ 11 MECHANICAL RI 18IXCAV/(3RADINC3lFIWNd
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z ��D. 12 WATER HOOK-UP 17 S(TE INSPECTION
� 14 SEWER HOOK-UO O6 PROGRESS
�
J 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
�Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINCi RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBINa FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTFiACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d VORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
� ❑CORRECT WORK 8 PROCEED "- ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
r CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContract e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice