HomeMy WebLinkAbout1996-008293 - finish basement PERMIT
` CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �-'t17 i=�':F',�`'
Crystal Bay, Minnesota 55323 '-'�-'�:�:_'�'���
(612) 473-7357 Date Issued: - '� -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — i��t�:=�:a 1 i c��-��. — °=:i . i T c:: OWNER:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY SIGNATURE
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Total Fee: $ � �'/ � J % Date Received: �- , ~-
Entered By: � -L Permit#: o� 9�-�'
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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_ .---___-----
THE APPLICANT IS: (circle one) WNER OR CONTRACTO ,
�__._..,----------�-_ _
JOB SITE ADDRESS: L-�' �>� C.L`L��i � r'� � ZIP: ��� ���
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---.---_
NAME OF OWNER: I d V� -Q� , , PHONE: (home) . `�� 'Z 5 !
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MAILING ADDRESS: I�a ���CITY: � ZIP:
,;
CONTRACTOR: �=,����ti�-�• �•___, �-� � ,, -�__ PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
. '� C. �..
PROPOSED WORK(desc 'be in detain: ��i�°���� �-7_=�1'l�� C'��
`? �,�,, , �
' ��._ ;� r � �
STORIES: SQ. FEET OF EACH FLOOR: I ��G'�J j� ��J�---��
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ Z---J 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 t a permit and work is not to start without a
permit; and that the work will be yrra ordance ' the approved plan.
�� - - �� .__.—._-
APPLICANT'S SIGNATURE: t� DAT`E: ��t�����Y�'�
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
� �
Sec.13.04 RIGHTS OF S[JBJECTS OF D�1TA
Subd. 1. Type of data. The riehts of individual on whom the data is stored or[o be stored shall be as sec forth io this secaon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data concerning himself shall
be informed of: (a)the purpose and in[ended use of the mquested data within the coliecting"state agency, poliacal subdivision, or statewide system;
(b)whe[her he may refuse oY is legally 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 idencity of o[her persons or endries authorized by state or federal taw to receive the data. This requirement shall
not apply when an individual is asked to supply investieaave data, pursuan[to secaon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place �he nodce reouired under this subdivision in the individual income tax or propertv tax refund
R,
instructions 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 whe[her it is classified as public, private or confidenaal. 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 hun and, if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown[he privace data and informed of its meaning, the data need no[be disclosed to him for
six months thereafter unless a dispute or acrion pursuan[to this section is pending or addidonal dara on the individual has been collected or created.
The responsible authoriry shall provide copies ot the private or public data upon request by the individual subject of[he data. The responsible authoriry
may require [he requesting person to pay the actual cosu 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 reques[,exduding Saturdays,Sundays and leeal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays,
Sundays and le¢al holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or privare
data concerning himself. To exercise this right,an individual shall notify in writing the responsible authori[y dzscribing the nature of the disagreement.
T'he responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipients of
inaccurate or incomp(ete 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 disetosed only if[he individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riahts 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 pernut 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.
��
�.' - �:� i�'�-� i �n
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First Middle st
1 �
Address
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C�ry � State ip Phone
I underst�nd rights as stated above. �
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Signa[ure
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � :��.�� � �����:t F,,i� -� � i:
��-`
PID: ���°i - � � � ' � i_� ���0 7
DESCRIPTION OF WORK: f�;-.;��� ,�a�r-��,.,,,;_..r-
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ZONING REVIEW BY: N(A DATE APPROVED:
BUILDING REVIEW BY: ,.,,(, � DATE APPROVED: g -z i-�c �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes � No SEWER CONNECTTON
STATE SUR��IARG� Yes c/ No WATER CONNECTION
INVESTIGAT'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
N.P
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland Dist:ict:
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):
26
. ,
BUILDING REVIEW CHECK LIST
UBC: �Z,-3 CONSTRUCTION TYPE: �( N
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 2S,c9oo �
Inspections Required: Work Requiring Separate Permits:
Site D( Plumbing Fire
Hardcover Removal � Mechanical Water Connection
Footing Septic Sewer Connection
�( Framing Fireplace Lawn Irrigation
K Insulation (Masonry) Other
k Wall Board (Mfg.) Well (State Permit)
.� Final Grading/Filling p� Electrical (State Permit)
Other
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By�
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REMARKS(TO BE NOTED ON PERMITj:
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DATE TIME
CITY OF ORONO �� z CALLED IN ��� , �
INSPECTION NOTICE �� '� ' �' SCHEDULED �a� -er
, ,
PERMIT NO. ��-"� COMPLETED
ADDRESS ��� � C-cJ
OWNER �� CONTR. ���--P�- -
TELEPHONE NO. Jo1-<c- L-J� O�
� DESCRIPTION r� cc�" \ I � N �
� 01 F Q 11 MECHANICAL RI 18IXCAV/GRADINO/FIWNO
� FRAMINO� 13 MECHANICAL FINAL 19 LAi�SHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z 05 FINAL 14 SEWEH HOOK-UO O6 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
.�
� 07 DEMa—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
�+ 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORAFY
0 BEFORECOVERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. r_ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in pection 2a hours in advance.473-7357
Owner►Contracto o ite
Inspector. �
White Copyllnspector's File Canary Copy/Site NoHce
DATE TIME
CITY OF ORONO CALLED IN
,
INSPECTION O 1 SCHEDULED '—
PERMIT NO. COMPLETED
,.,,y _
ADDRESS � � �� � r-- �
OWNER •� CONTR.
�
TELEPHONE NO.
� DESCRIPTION -�``f I� ��"'�� �� '`J
ty� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 12 WATER HOOK-UP 17 SITE INSPECTION
5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� -SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -; pHOTO TAKEN
INSPECTOR WtLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in ction 24 hours in advance.473-7357
Owner/Contr ctor on sit .
Inspector. '`
White Copyllnspector's File Canary Copy/Site Notice
�
DATE TIME
CITY OF ORONO CA�LED IN �/' /y� � '
INSPECTION NOTICE scHEou�Eo `/ — �L '/ � �'
PERMIT NO. � '`(�-� COMPLETED
ADDRESS .,�:G ; � ��C r t�7=�.�.._ ..,,, �1 zt C (_ �
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OWNER l ,� �����.�, r.-,�(�� �,-• C-l� �CONTR. �
TELEPHONE NO. 5 S f � G �.S �
; `
� DESCRIPTION �.�d.�-r i�r-�^�� -�i�u. � �
� 01 FOOTING 11 MECHANICALRI 18IXCAV/GRADING/FIWN(3
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETUINDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z pq Wq�.�BD. 12 WATER HOOK-UP 17 SITE INSPECTION
e Q$FINAL 14 SEWER HOOK-UO O6 PROGRESS
2
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOIlOW-UP
= 09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r pHOTOTAKEN
INSPECTOR WILL REfURN
O STOPORDEFi POSTED.CAIL INSPECTOR '=� CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
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D�TE , TIME�
CITY OF ORONO CALLED IN g/-�o�9E,
INSPECTION NOTICE SCHEDULED `-' '3 >�—
PERMIT NO. �S-Z) � COMPIETED �l 0'4,
ADDRESS L-��c �� �ifZ�����u�.�
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� DESCRIPTION �-� - � Z
� 01 FOOTING 11 MECHANICAL RI � 18IXCAV/GRADINO/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL � 19 tA1�SHOREIWETLANDS
Q 031NSULATION 24/25 WOOD BURNEH/FIREPLACE 34 TREE REMOVAL
� p4 WAl1.gp. 12 WATER HOOK-UP 17 SITE INSPECTION
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05 FI I�L�, 14 SEWER HOOK-UO O6 PROGRESS
J ITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAI
�+ 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOR WILL RETURN `
❑STOP ORDER POSTEO.CALL iNSPECTOR '.^, CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne i spection 24 hours in advance.473-7357
OwnerlContrac n si e
Inspector. i
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