HomeMy WebLinkAbout1998-010710 - deck PERMIT
CITY O� ORONO PERMIT TYPE: �- - Y=.
2750 Kelley Parkway- P.O. Box 66 !=��_-�-` L-='=�'"�
Crystal Bay, Minnesota 55323 Permit Number: �_:;�_:��'i;_
(612) 473-7357 Date Issued: t_;��:f i,�_.;�-i;:i
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — �:!=°�°� �i=��"►fi� �'
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APPLICANT�PERMITEE S GNATURE ISSUED BY:SIGNATURE
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Total �ee: , $ ��a?. �/3 � Date Received: ��,,���,y� � ;
Entered By: �'! � Permit#: �i� 7/o �
CITY OF ORONO - BI.TILDING PERMIT APPLICATION �
All information must be submitted in full before plan reYiew will be started.
(please print a11 information) . %
THE A.PPLIC��"i' IS: (circle one) OtiYNE R CON �TOR ` � � . � 1
�
_.________— . J
JOB SIT� ADDRESS: �vl�� � 10��f1C.. l�� � � n u e ZIP: ��5 3� �
l M � (� 1 �x�N+�2r�� �
� NAME OF Oti�NER: �;,�c,�;E N PHONE: (home) y�-i-q y �a
(work) 4�- /- �5�5�
NIAZLTNG ADDRESS: ��me �S A.� ��G CITY: 1,�A y�A�� ZTP: 5 �
�
CONT'RACTOR: PHONE: � ;
CONT'ACT PERSON: MOBILE/PAGER: � '
MAlI�Ytii TG ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECTlE�'GINEER: P�IONE:
I��IATI:Pi IG ADDRESS: CITY: ZIP:
I�1AME: REGISTRATION#
TYPE OF ti�ORb: New Addition Accessory Structure
Move � � Remodel/Alteration�_ Land Alteration
PROPOSED ti�ORT�(describe in detai�: ���� n��,-� t1,,,n �',������- �xis�iu� ���, , ,
�
A� `�T rl i `.� i U �`�C���t u.� V' !N ,ES�/C IJ 7 L:Ci5 5�i�� �v r t.� �- io� x /(n �
STORIES: j SQ.FEET OF EACH FLOOR: �}'��� -
NO. OF BEDROOMS: �Z GARAGE STALLS: ATT. 1 DET.
E.STI'iYIATED CONSTRUCTION VALUATION (excluding land): $
� //GO `1 p-f�a�i' �tr
. C,�Uar Q-�nC:p ��,�-��L:c�,� /i��f`'4��
I hereby apply for a buildinJ permit and I aclrnowledge 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 Buildin� 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.
� ��`�Q rr��. �'�� ��r�S�''�'1 �> �; .
APPLICA�'T'S SIGNATLTRE: DATE: ��a� , l r �t�
NOTE! �'arade Q Homes events require separate permit approval by Police Department and
� City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
�
Sec.13.0.RIGHTS OF SLlBJECTS OF DATa
Subd. i. Type of data. The righ[s of ir.dividua.l on whom rhe dara is srored or co be s�r`d shall be as sec forch ia this secdon. -
Su�d.2. Information reqirired to be�ven indicidual. r1n iadividual�sked to supply privac:or co�Fdeadal daca concera�g hims:lf shali
be icformed of: (a) c�e purpose acd inr_aded use of the requu�daa wir.hin the eollecdag Yta�e a,eacy,polidcal subdivision,or s3tewide rys�m;
(b)whecher he rnay r4�se or is le3ally requi-:d to supply[he r:quesud dat3;(c)any Imown eoasequence arisin3 fr�ca his suppIying or refusing to supply
priva:e or eon:�dendal dara;ar.d(d)[he ideedry of other pe;soas or enddes aachorized by sr�ca or fed:al law to r:ceive tfie daca. This requiremeatshall
r.o�appfy when an ir.dividual is asked to supply invesd�adve da�,purziianc to secdon 13.82,subdivision 5, co a law enforcemeac of�ccer. -
Tha comm.ission:r of revenue nav olace �he nodce r_auir-d under this subdivision in ehe individu�! ir:cone rax or orooam caz r_fued
ins:rucdar.s ins�_�d of on chase forms.
Subd. 3. Access to data by iadi�idual. Upon requesc to a responsibie au�horiry,an individual shall be inforaed whether he u the subject �
of scord dati on individuals,and whecher it is elassificd as public,privaco or confidenrial. Upon his furcher request,aa i.^.dividual who is the subje:c
of stored privace or public data on individuals shall be shown che dati wi�hout any charge to him and;if he d�sires, shi!I be infocm:d of the eonten[
ar.d meaning of chat dara. Ah.r an individual has been shown tha privac:data aad inforsed of iu meaaing,tha daca need not be disclased to him for
six monchs �t:ereai�cer unless a dispucc or acdon pursuan�to �his secdon is ptnding or addidoaal da�on ttie individuai tas beea collecLd or ereaced.
The rsponsible au�horiry shall Qrovide copies of the private or public data upon requesc by the individual subjecc oF[he da�. Tne responsibte aachoriry
may rcquir_che cequesdng peaon to pay th:accual coscs of making,eerdfying,and compiling che copies.
The r_sponsibiz au�hor,ry shall eo�ply immediatety,if possible, wich aay requ:st madz pursuant to chis subdivision,or wichin Five days oF
th�da[e of che requesc,excludir,g Sacurdays,Sundays and legal holidays,if immediate compliance is notpossible. If he canaot eomply with the r.quesc
wichin�hat time,he shall so inform[he individual,and may have an addiaonal five days witfiin which to comply wi�h the requ:st,escltdiag Sacurdays,
Sundays and legal holidays.
Subd.4. Procedure�shen data is not accurate or eomplete. An individual may contest d:e accuracy or completeness of public orpri�ate
dara cor.ceming hir.:self. To exe;cise this ri¢ht,an individual shaii noa"ry in wridng che respansible auchoricy describing the nantre of the disagreement.
The cesponsible auchoriry shall within 30 days either: (a)eorr.cc che data found to be in3ccuaca or incomplete and attempt to noofy pasc tecipienu of
inaccurace or incompiece dara, including re:ipienes rtamed by the u:divideal; or @)r.obfy the individaal that he betieves the data to be coaecc Data
in dispuce shall be disclos:d only if che individual's s��emenc of disagrecrr.enc is includtd wich che disctosed da�.
The decerminadon of the rzsponsibl� au�horiry rr�y he appzaled pursuanc to 4'�e provisions of che adminisaariva procedure act reladng to
eontesced eases.
DATA PRIVACY ADVISORY
In accordance with h1.S. 13.04, Subd.Z, "Rights of subjects of data", we would like to inPorm you that your reques[
for a perm;t or license from the Ciry of Orono or any of its depar�ments may require you to fumish certain private or
confidential information. J
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 licease.
3. The infocmation may be shared with ocher local, scate or federal agencies to the extent necessary to process
' the permit or license.
4. If your reques[ed permit or license requcres Council actlon to approve, some information maq become
public.
5. You have certain riQhts under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this applicatioa or perm.ic.
��eXCZi"1C��G� /� ��k�'� C�. `JuJP/7�5e �
Firsc �fiddle Last
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Addreu
) fGZ �Iinr� �J�3`��/ `���/- 4-�l/
Ciry Sa� Zip Phaae
I understand my ri�hcs as stated above.
��t'�� C�;��]l1 `�����'�.., �, ��'1S.r���
s�g�a:«
, CHECK Ok'F LIST �'OR ISSUANCE OF PER.�tiIITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAY,: _ � q,S ��;ti� A v� �
PID:
DES CRIPTTON OF WORK: _ �Luc �
ZOY .�G REVIE��BY: � � � ~ DATEAPPROVED: �r L--�� �
BUII_.DTNG REVLE�'V BY:. . DATE APPROVED: � :2 -�'�
�EES TO BE CHARGED: � � � Misc. Pees Calculated By:
PERNIIT Yes ✓' No '
PL� ��� Yes ✓ No SEWF.,R CONNECITON
STATE SUR`H1��G� Yes � No ti�AT'II�CO�tNECTTON
INVESTIGA'I`ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECITON
Number of SAC Units OT'HER (specify)
------------ ------ ----
ZONING CHECK LIST zoning Districc: �/z -�c � �
Fire Department: �,�p�,,nN.1 Post Office: �Vt,u�✓vvJ School District: �,..eSrp.Ni�1-
Lot Area: Sq.ft._ 1 U, �7 � Acres ,Z � �Vidth 5� Depch �� ��f 3
Survey Submitted: Yes�_ No Date of Survey:
Proposed Setbac�s:
Front (La.'ce): . 5� Right Side: �N ` � .
Rear(Street): )�d-�� . Left Side: Z I'
Adjacent Structures: _/4��r�c� �Vetland: �//�
Building Heiaht: Def. Hgt. Peak Hgt.
Lot Coverage:
Gradia�: Staff Approval Date: . By: Council Approval Date:
Septic: Staff Approval Date: gy; • .
��. Zonina File: # Resolution: # Resolution Date:� �
Shoreland Dis�-ict: � �
Avg. Setback: Bluff Setback: I.otCoverage: �
' Ezisting Proposed
Hardcover: 0-75'
75-250' . . � '
250-500' . .
SOQ-1000'
Hardcover Variance Required: Yes No Date of Councii Approval:
�
REI�ZA�R.KS ('in house): �
z � � � � �
: y�� � 26
. ��A. . .
_ BUILDIlVG REVIEW CHECK LIST . . : _
UBC: � � 3 CONSTRUCTTON TYPE: �l�
. . Sq Footage $ Per Sq Ft�
. Basemeat x . .
. . lst Floor . � � X =
2nd Floor . .. . - � . .x ,. . . ' .
Gara�e , X . _ . � � . .
x
TOTAL
Estimated Construction Value: � � � �p m= .
- - -- InspectiorLs Required: • Work Requiring Separate Pecmits: �
Site Piumbing �
Hazdcover Removal Fire . . . _
Mechanical Water Connection
_� Footin� Se tic • � .
—� FramiR� P Sewer Connection '
InsuIation __ F�e��o�) O�� �gation
Wall Board (11dfg.) � Well (State Permit)
�F�� Gradin�/Fillin� Electrical (State Perm.it)
Other
REMA.R�i S (!N HOUSE): . ------------�" -- -
---------------
--------- DATE
REVIE'�V BY OT --�-� --
HERS: . --- ----------
Access: Exisci.n� Nesv -
-----__
• Access Approval: Date .
-------------------------------- �y�
REMARKS (TO BE NOTED ON PERitiiiT); ` � . - '
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. . ' CERTIFICATE OF SURVEY
FOR: HUSSMAN INVESTMENT COMPANY
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LEGAL DESCRIPTION �
LOTS 3& 4 , BLOCK I , NAVARRO � �
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o Denotes iron monument Proposed lowest floor elev._
o Denotes offset scake Proposed top of foundation e�ev._
x 000.o Denotes existing elev. BENCH MARK:
(000.o) Denotes Proposed elev.
--r Denotes surface drainage
Proposed garage floor elev.=
�eviscd Z�17�83
I hereby certify that this is a true and correct representation of a survey of File No.
the bounJaries of e above described land and of the location of all buildings, 3475-A
DEMAKS -GABRIEL if any, thereon, d all visible encroach nts, if any, from or on said land.
LAND SUftVEYORS, INC. `I Book - Page
As surveye b e this ,�y of e��U�� , 1 g B-3
3030 Harbor Lane No. �i ��5 ��
Plymouth MN 55441 �'�,
� ' Scale
Phone: (612)559-0908 � =40
/ .,\ � 90�v10 �rl �
� Minn. Reg. N6.
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STA!RS
CC�D� 1��3�:.;���..(r:�i�9��� ! 8"MAX. �AIS�R 9" IvIIN ' .
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�; I I , I BUI DIN P�'H (T N R VIE'. �
' INS�EC70F ._ �
I DA _ �� Z;. g _FF^ tiT t�i ';
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Tha 2 ccrnm rts, .:f.,;y:��!r ir.io;rnati;n.PJI� rk shat be dong
! I in f; i cor�pl�>r:;�;-v;:�+: ��;t up�lic=.bla ui!:finy nd zonr.g cod � S \ f�� 2.`
' I ReQ irernent i,�c•:��ii�;;i;.�ms:ot speci:caily no�d in ihi review.
� ` EEP'f 'iS P'�N S:- O�J TC A AU..T MES
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i ° Sitill�tlJ
.I� ---- --�-------�---_�,_� . ---
{—
�����U ���
DATE TIME
OF ORONO CALLED IN /r-/y y� ' 3�
ECTION NO CE SCHEDULED �� �� �
MIT NO. �� U� COMPLETED � �
DRESS �� S�-5 � �-�t��� N`�--
VNER �.�t/� CONTR.
ELEPHONE NO. �{ ��— ���.�---
DESCRIPTION C��
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
! � . 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL� 14 SEWER HOOK-UP 06 PROGRESS
1�--oTDE1C�fD-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
� COMMENTS:
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d WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContrac s�:
Inspector.
White Copyll�spector's Fil Canary Copy/Site Notice