HomeMy WebLinkAbout1996-007805 - renovate remodel � 'ERMIT
� +R�NO PERMIT TYPE:
�I50 Keiley Parkway- P.O. Box 66 �,:_:�(_(�3 [�.;f=
Crystal Bay, Minnesota 55323 Permit Number: i:ii`s�;=;t i�
(612) 473-7357 Date Issued: �`���i_�j j,��,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -- F;����1 i r;���;t. - :=:T _ t �:;_: OWNER:
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� LICANT PERMITEE StGNATURE ISSUED BY:SIGNATURE
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� Totai Fee: S ��� �'� DateReceived: �.:'- � � � Gi �'
DateApproved: �:` ��;� - �; (�-
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Entered By: �� Permit n: ��(?`�
CITY OF ORONO - BUII.DING PERl�IIT APPLICATION
�LL l�i tFORI�IATION I�IliST BE SLBIIIT'ITED IPt FULL BEFORE PL�v REVIE�V�VII�L
BE STARTED
- ---------------------------------------------------
--------- -- ---------------------------------------------- -
THE �,PPLIC:�vT IS: (circle one) O�V�1ER 0 CONTRACTOR
JOB sITE �DDREss: iy 20 �������s ��,��� ,� zIP:
�1�tiLE OF O`V�,�R: �?'�ii"f� l�✓u,une.r PH0�1E: (home)
(work)
�IAILING�iDDRESS: /y� l�d�ns ��hf r�� CITY: Ovo�,,v Z�:
j�L� i��j� ��rt��{ �,,-�nLrS PH��' : 'T 7�' ��y.s
co�;Tx�.cTo�: �'�� � Jo���-� �����t-
�10 ILE PHO�`E/PAGER: ____���-i 7 '�"7
l�1AIL�TG ADDRESS: ..,2DY� rr✓�.-�F�:/l�C k/ /�%�CITY: i'�?o�wrw/� ZIP: � -3ra
STATE LICENSE: r� �.Zc���-- (�(o�l,7
ARCHITECT/ENGLYEER: ,S�'Jcr•, �� ��(,�i��L .'�'il��i�PHONE: � `'S���� �3��
��I AILING ADDRESS: jQ"7�y G�Jci��.a�- t��urG CITY: lnr:�,�e fe�.��.- ZIP: f�'>�,
Nr��IE: �c� �� �';�/,�.a`�` %-�O° _ REGISTR��TION �`
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration 7C Land Alteration
PROPOSED�VORK(describeindetail): a�lcw� �t���r�s��'. ��l r��.� b n��� � cz.r'-��
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''r�7«Gc. �v0�,� a✓ i�� � �� /`iC.:.,. .�-�8v�' c :'s�sc�l�f,t9n--.
STORIES: SQ. F'EET OF E�CH FLOOR:
NO. OF BEDROOyIS: GAR�GE ST�LLS: ATT. DET.
ESTLI-IATEDCONSTRLCTIONV�I.ti�TION(eYcludingland): � �� ��.?v
I hereby apply for a building permit and I acl:nowledge 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 Buildin� Code; that I understand this is not a permit and �vork is not to start
without a permit; and that the work will be in accordance with the approved plan.
APPLIC��1T'S SIG�IATURE: �� '� ����y�- DATE: ��-6• �i'. 19��dk�
,,
1VOTE.' Parade of 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.
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C�TY of �
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�� i E'y Post Office Boz 66
�,� ,`.'1•��� :� G'�' Crr�stal Bay,�iinnesota 55323-0066
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DAT� PRIVACY ADV�LSORY
In accordance «�ith `1.5. 13.Os, Subd. ?. "Rivhts of subjec.s or data", we �vould ii�e to
inform you that your req_uest for a p�rmit or license irom the Ciry or O:ono or any of its
departments may require �Jou co fu.-nish c�rcain private or confidential iniormaiion.
You are notified that:
l. The info�-ination `�ou furnish «�ill be used to determine ��our qualificacion for the
permit or license requested.
2. You may refuse to suppl�� da�a, but refusal may require *�hat the Ciry der.y tr,e
perrnit or �icense.
;. The L�formation may be snared «�ith other local, scate or i�deral aQencies to t�:e
extent necessary to process t:�i� pe:rl�t or license.
4. If ��our :equested pe:mit or license requires Council action to approve. some
intormation mav becom� oublic.
�. You ha��e ce:�ain ri�?:ts under ��I.S. 13.0? (see fo�lo���in� p�a=) to revie�v private
data on ��ourself.
6. Your fu11 name is reauired to process this application or permit.
I'LE.-�SE PRL�T
��; � G�� o �' -� � ' ��
First
�r1� d;e Last
�, � �` ��,r. �. �/ � l ,
.�ddress
�"���?� ��c� S53 C�� y7�� f���
Ciry
State Zip Phone
I understand my riQhts as s�ced above.
S i�natu�f
�Pxo�-a-r�-��� • eAx-a�-osio
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513.04 RIGHTS OF SIIBJECTS �F DATA
Subdivision 1. Type of data- The rights of individuels on whom the data is
stored or to be stored shall be ss set forth in this section.
Subd. 2. Information required
to be given ind�v��' An.individual asked to
supply private or confidentiel data concernina gmWi hin the collecti g state gency,
purpose and intended use of the requested
(b) whether he may ref use or is legally
political subdivision, or statewide system; �own consequence arising from his
required to supply the requested dat8; (c) anY �d (d) the identity of
supplying or refusing to supply private or confidential data;
other persons or entities authorized by state or federal law to receive the data. This.
requirement shall not apply
when an individual is esked to supply investigative data,
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue m8v ple��v tax reound instr�uct�onsunsteadhos
subdivision in the individuel income tax or �r��
on those orms. --
Subd. 3. Access to �ata by individuel- Upon request to e responsible
authority, an individuel shall be informeda h blic,hp vate or confident al.e UPfln h�s
individuals, and whether it is classified p ublic data on
further request, an individuel who is the subject of Se to himrlsnde if he desires, shall
individuels shall be shawn the data witho o f an�y ��g. �ter an individual hes been
6e informed of the content end meaning the data need not be �isclosed to
shown the private data end informed of its ut�or�action pursuant to this section is
him for six months thereafter unless a �P
, � ending or additional data on the individ�e h� gteeor Pu�lic datarupangrequest by
P
responsible authority shall provide copl�The res onsible authority may require the
the individual subject of the data• p certif n and compiling the
requesting person to pay the actual costs of making, Yi g►
copies. ssible, with any request
The responsible authority shell comoly immediately, if po
macie pursuant to this subdivision, or with��8 e��f Simmediateatcompliance eisu not
excluding Saturdays, SundaYs and lega1 �
ossible. If he cannot comply with the reqf et �t�witi�ntwhich toh omplynw�h the
P have sn additional Y5
individual, and may �d le al holidays•
request, excluding Saturdays, SundaYs g
Subd. 4. Proce�se �►hen �ata is nat accu�'ate or comQlete. An individual may
himself. To
contest the accuracy or comQleteness of public orinri�t�t�he°r�Po�ible authority
exercise this right, an individuel shall notify �ible authority shall within 30
describing the nature of the disagreement. The respo
days either: (a) correct the data found tcom lete dataeincludingreec pients namedt by
notify past recipients of inaecurate or in P
the individusl; or (b) notify the indivTdual i�t�ldua�l,�s statemen tof disagreementci
Data in dispute shall be disclosed only if
• included with the �isclosed data• ealed pursuant to the
� The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases.
�
. �
� CHECK OFF LLST FOR ISSU��iCE OF PER'YIITS
FOR OF CE USE `���'��
�iDDRESS OR LEGAI,: � G �-yL'
PID: C��l�//�� � 3 33 aGe>3
DESCRIPTION OF WORK: �-
ZOiVING REVIE`� BY: n�(i� DATE APPROVED:
BUII,DING RE'VIE�V BY� (�,,.��.- DAT`E APPROVED: 3•�-56
- --------------------------
FEES TO BE CHARGED: �1isc. Fees Calculated By:
PERIViIT Yes ✓ No
PLAi�1 REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER COI�NECITON
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No �/ STI'E INSPECTION
Number of SAC Units OTHER (specify) `M _�_
-----------------------------
ZO�VG CHECK LIST Zoning District: Shorelan District :
�
Fire Department: Post Office: - School Distric :
� W� � � Depth
Lot Area: Sq.ft. Acres %� �
i
Survey,Submitted: Ye � Nt� ate of Survey: ``
,' � / �',
Proposed Setbacks: � �� �
Fron[ (Lake): ,� 12ight Side: �
r
Rear (Street): _�___�____ ` �fr Side: ' � �i
, a
Adjacent Structlires: � We�land:
/
.�- •
; �_--��------_ _ ___.
. Building Height: Def; Hgt• P� H�'
i
i
� � �luff Setback: �_ i I-ot Coverage:
Av�. Setback: � �—
� i
�Eeistin� � Proposed �'�
i I � l
Hardcover: d-75' ' � `
� r �'
i�75-250' ( � , 1
j 250-500' ,' i � ��1
� �00-1000' �` � � '
r �
Hardcover Uariance Requir :� Yes �o Date of Council Approval: �
� �� By: Council Approval Dat�:
Grading: taff Approval D t :
Sepdc: taff Approval Dat By'
Zoning File: # Resolution: � Resolution Date:
p���[�RI�,S (in house):
w , .
,
BUII.,DING REVIEW CHECK LIST
UBC: �,� CONSTRUCTTO�t TYPE: V�
Sq Foota�e S Per Sq Ftg
Basement � _
lst Floor x =
2nd Floor x =
Garage c —
� _
TOTAL
a�
Estimated Construction Value: � �� •��v� —'
Inspections Required: Work Requiring Separate Permits:
Site Ptumbing Fire
Hardcover Removal �lechanical Water Connection
Footin� Septic Sewer Connection
�_ Framin� Fireplace Lawn Irrigation
�( Insulation (Masonry) Other
,F'Wall Boazd (Mfg.) Well (State Permit)
_�C Final Grading/Filling _�_ Electrical (State Permit)
Other
R�MARKS (IN HOUSE):
- ---------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
- -----------
REI�IARKS (TO BE NOTED ON PER.i�IIT):
27
DATE
CITY OF ORONO j CALLED IN � 3 =�� /� �-�-'"'" �
INSPECTION NOTICE�j ,-1 SCHEDULED C� -g" � �i �-- f�-�
PERMIT NO. � r ��l� COMPLETED
ADDRESS �� `> ---�
OWNER � CONTR.
TELEPHONE NO.\ � � �� " � � 3 � �i� ���r
� DESCRIPTION a� ,
� 01 FOOTINO 11 MECHANICAL RI 18IXCAV/(3RA�INOlFIWNO
y 2FF�0�]IIRG� 13 MECHANICAL FINAL 19 LAi�SHORElWETLANDS
Q 03 TION 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-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
`Q 07 DEM�FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COM ENTS:
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d ❑WORKSATISFACTORY:PROCEED = PROJECTCOMPLETE
W
� CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE COND�TION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALLINSPECTOR
❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContr or ite.
Inspector.
White Copyllnspector's File Canary CopylSite Notice