HomeMy WebLinkAbout1999-011270 - basement finish . PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: `��''= =``�''"�`
Crystal Bay, Minnesota 55323 __:� i:w'i.�
(612)473-7357 Date Issued: _ _ `
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: _ r,;�:�,; ; ,_::,,-.�_ — :�;- . _.�� OWNER:
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APPLICANT PE MITEE IGNATURE ISSUED BY:SIGNATURE
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�� Total Fee: $ /� �. >.�z:, Date Received:
! Entered By: r! . Permit#: //.,z'I 'J
CITY OF ORONO - BUILDING PERMIT APPLICATION ,,�,��",
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All information must be submitted in full before plan review will be sta
(please print all information) ' � � � t���
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THE APPLICANT IS: (circle one) OWNER O CONTRACTOR �-�
JOB SITE ADDRESS: ��C� 'I[� ,�,��, ,�.��� � ,,:�'_� ��� �i� � � ,_ ZIP:
NAME OF OWNER: ��%� Q-= Lf,`�,��� __ PHONE: (home) _��;�.,�. -%��/-�:;=`��
(work) �:: ��-�=
MAILING ADDRESS: .'l-��c� ��;,�,,��,�v;,�� , r�� �� CITY: �,�< ZIP:
CONTRACTOR: � ;,. �s C�c/v�sT�'�c�'Ti :�i..�iL� PHONE: ��5'/`�J �/- f/(s��/r�
CONTACT PERSON:�)�,;.?r..; ��,E .r+� OB E; AGER�;`i� �4=�� :-„i�a<7
MAILING ADDRESS: ����s� �=-�,����c�,�.�C.G�f��v CITY: �� ����/�,;;�y ZIP: �, si� 5—
STATE LICENSE: # �;'��
ARCHITECT/ENGINEER: ��%�z��. ,��=� c�� ;/� i= /, PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move emod�lteration Land Alteration
_-- �
PROPOSED WORK(describe in detai�: }";,,;�<,f{ ' _ �z t.v " -
�>���. �fl-�fir� �. i C- �( ��7 . �;�� .�� .1n�— � � l ��/� �'f��L�i i/:. /i / ��fY1�.� ��
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION excludin land): $ �' ^
( g `�G'C��;� � c�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.
,--f
APPLICANT'S SIGNATURE�-` � � DATE: ���-//- ��_
NOTE! Parade of Homes events require separate pernzit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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Sec.13.04 RIGHTS OF SLJBJECTS 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 uidividual asked to supply private or confidential data concerning himself
shail be informed of: (a)the purpose and in[ended use of the requested data within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legaUy required to supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or confidendal data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav alace the notice required under this subdivision in the individual income tax or orovem 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,private 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 iu meaning, the data need not be
disdosed to him for six months thereafrer unless a dispu[e or action pursuant to this secrion 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 authority may require the 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 request,excluding Saturdays,Sundays and legal 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 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 authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify
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 included with the disclosed data.
The determinaaon 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 �iry 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 shazed 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.
'a��t �� � !�-r� `-
First Middle Last
� '� =� �(, � V c�i`il�F"�L., /-'�"��/
Address -
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l_L'�..���i � 1/�f�i � / , _r — �_, ,
Ciry State Zip Phone
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I understand my righ4�.�s stated above�-�-� � � ,
%' � �, � � ��
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Signature
6
` CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2.b�0 Lo u,�-�.�,s��.2 �2
PID:
DESCRIPTION OF WORK: �F�iv i5 c�(i�o� f N �3�5t�
------------------------------------------------------------------------------------------------------------------------
ZONING REVIEW BY: �Q.�,�-_ DATE APPROVED: 3-J7- S�
BUILDING REVIEW BY: DATE APPROVED: � •�� -S�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLAN REVIEW Yes ✓� No SEWER CONNECTION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: /UO Cff�nlG�
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 ide:
Rear (Street): Left S de:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff etback: I.ot Coverage:
Exist' Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: �� 3 CONSTRUCTION TYPE: �(I'V
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �,�O0 "—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
p(Framing Fireplace Lawn Irrigation
( Insulation (Masonry) Other
�Wall Board (Mfg.) V�'ell (State Permit)
_�Final Grading/Filling v Electrical (State Permit)
Other
REMARKS(IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT):
8
DATE TIME
CITY OF ORONO CALLED W � -- �?�� 5 '.��•j�. /�'1
INSPECTION NOTICE SCHEDULED L_ -.� 3 �� ����-�
PERMIT NO. /� �D COMPLETED �� �
ADDRESS c� �"D � C�[..-L'�c- � C
OWNER��-u-���� NTR. � • C��i'u�u'�Cd�.
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TELEPHONE NO. � �/`S��n u �
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
�� 02 FRAMI_ NG , 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 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-UP 06 PROGRESS
� 07 DEMO-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 OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
Z
� COMMENTS:
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d ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQU�RED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCont�r o 'te:
Inspector. `�
White Copylinspector's File Canary CopylSite Notice
D� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 36
PERMIT N0. (�I 1 �Z-1 L� COMPLETED �a�L�� T _3�l
ADDRESS L_ (o7O (,���rz, <;r-�F ��'�• I,J,
OWNER��'�jcr� 1--�c V-c�(-t% CONTR.
TELEPHONE NO. �-tU�-_ Z�7 ���
� DESCRIPTION �tr1o� � �
� . .��,�rv+� � ���..�.�.�-
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-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
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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Q � �2 /'�'S� � c�� �'C'6�rQai�=
�
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� �w��
W
�
�
d ❑WORKSATISFACTORY:PROCEED OJECTCOMPLETE
W
� �ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN �. PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector. L/'� ��'c laa- � J
White Copyllnspector's File Canary Copy/Site Notice
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2�2- 12,E �� __. _ _. 2� ` r' T 7 t 7 n Requirements includit?g items r,�t she i;'scaily.roted n This review.
at4c 1 % 4' _ �1 11 3 K f 1/ 1 (`'lad.. ° KEEP THIS P1 AN SET ON SITE ATA TIMES
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