HomeMy WebLinkAbout1996-008278 - replace deck � ' PERMIT
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CITY OF ORONO PERMIT TYPE:
�750 Kelley Parkway- P.O. Box 66 �;f i i;_f:i 1;��Jt;
� �rystal Bay, Minnesota 55323 Permit Number: �_}�_�;_:�-;,y�
�12) 473-7357 Date Issued: :`�;^;_;� �:,i��
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FEE SUMMARY:
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CONTRACTOR: OWNER: _ ���,r,� ��;�;;t. —
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��,
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Total Fee: S /�_����/ DateReceived:
Date Approved:
Entered By: ,(�; Permit#: �'� 7��
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORNIATION 1�1tiST BE SLBv1ITTED IN FULL BEFORE PL��1 REVIEW WILL
BE STARTED
------------------------------------------------------------- ----------------------------------------------------
THE �PPLIC��iT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: �,o� �`.� �rt���a.� �2i�I �� Z�� �� J�1 �
NA1v1E OF O WNER� Q� �`; , r ��1 PHOiV"E: (home) �{'t j- �S��1
�(work) y 7:�- �(o�O
vIAII,Il�,'G ADDRESS: ��I`-i �v��S+a.� Octr.r IC� CITY: CJY�y�p ZIP: SS 3 4 �
f ��� -IYl-IGW J
CONTRACTOR: �Y' �� I Ct,� I CX� PH0�1E: ���- (0(7� �
MOBILE PHOVE/PAGER:
�TAII.INGADDRESS: (D�'�S R[.1tit�,b�t�v �v1 CITY: ,�,1dt.i.y�_ ZIP: ,��'��c�,
STATE LICENSE: #
ARCHITECT/ENGI�YEER: PHO�TE:
MAILING ADDRESS: CITY: ZIP:
�;�,,y�; REGISTRATION #
TYPE OF WORK: New Addition Accessory S�ucture
Move Remodel/Alteration �C Land Alteration
PROPOSEDWORK(describeindetail):z�����r� �. C�,�Gk.�'� ��'ii.l �Z
d � ��ps
, !� �-�x��► ��w
w�.�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STAI.LS: ATT. DET.
EST�IATED CONSTRUCTION VALUATION(escludingland): $ 'a���
I hereby apply for a building permit and I acknowled�e 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 w will be in accordance with the approved plan.
� ;
:�PPLIC��1T'S SIGNAT'LTRE: DATE: �
NOTE! Parade of Homes events require separate permit approval by Police Depariment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
�
Sec.13.04 RIGHTS OF SLlB.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 sec forth in this secaon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a) the purpose and incended use of the requested data within the collecring'state agency, polidcal subdivision,or sta[ewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidenaal data;and(d)[he idenary of other persons or endaes authorized by stace or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesagaave data, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propem tax refund
instrucrions 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 co�dential. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to hirn 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 secrion is pending or addidonal data on the individual has been coflected 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 accual costs of making, certifying, and compiling the copies.
The responsible authority shall compty immedia[ely, 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 noc possible. If he cannot comply with the requesc
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Sacurdays,
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 concerning himsetf. To exercise this right,an individual shall notify in wri[ing the responsible authority 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 nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individuat; or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if[he individual's statement of disagreement is included with the disclosed data.
The determina[ion of the responsible authoriry may be appealed pursuant to the provisions of the administntive procedure act relacing 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 pernut 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 determuie your qualification for the permit or license requested.
2. You may refuse to suppiy data, but refusal may require that the City deny the pernut or license.
3. The information may be shared with other local, state or federal agencies to the e�tent 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.
(. Your full name is required to process this application or permit.
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C.t.�r�c� C� � � ��u-��r�S�'�
First n �tiddle� Last
��1'J l ,riu 5� t�.� � \`-�.
A ress
����; � �111� ��� I �� 1 -� 531
C�ry State Zip Phone
I nde stand my rights as stated above.
. C, ` � �
Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 33i 5 C12�s7-W L ��qy (?�pq,p
PID:
DESCRIPTION OF WORK: �CLK
--------------------------------------- -------------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: i� -�L 4 <:
BUILDING REVIEW BY: DATE APPROVED: �? �� -4 t�,
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �r' No
PLAN REVIEW Yes �' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No �' PARK FEE
SAC Yes No ,�� SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: C.2-�C..
Fire Department: 1'�lp�,r�l� Post Offce: w�'Lt-� School District: �/L�N-O
Lot Area: Sq.ft. (y,53J Acres • 3 3 Width !,�� Depth �3 � '�
Survey Submitted: Yes DC No Date of Survey: 6 ZZ-�1�
Proposed Setbacks: � ,
Freat (Lake): `{� -j Right Side: �i3 .�
Rear (Street): (� � '� Left Side: y 5 � +
Adjacent Structures: /-l�rr*�,G�tC� Wetland: N(/�--
Building Height: Def. Hgt. /�1�n1 Peak Hgt. /v��
Lot Coverage: - t5l'7N b•) yt,u�p�ed1 1 K•(�
Grading: Staff Approval Date: �(f� By: Council Approval Date:
Septic: Staff Approval Date: /J ��4 By:
Zoning File: # 2i�q"1 Resolution: # Resolution Date: Z -I 2-�lo
Shoreland District: y�S
Avg. Setback: v�4-(C.�v�.ntc.< Bluff Setback: /V/�9-
Existing Proposed
Hardcover: 0-75� 3 y� 3 z.z
75-250' 2(o•Z$ ZZ•Z
250-500'
500-1000'
Hardcover Variance Required: Yes _ C No Date of Council Approval: 3-�Z'°�b
REMARKS (in house):
10
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BUII.DING REVIEW CHECK LIST
UBC: � '3 CONSTRUCTION T'YPE: �((J
Sq Footage � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gara�e x =
x =
TOTAL
Estimated Construction Value: $ �.c-=,?��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_ ( Footing Septic Sewer Coanection
_� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Weil (State Pemut)
_ �L Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
RENIARKS(TO BE NOTED ON PER.�'VIIT):
27
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� � �`�` r,!OT Ai'�'s�OV�D — CO�ZRE+G�` & RESUBMIT .
�:�a,r:.� c��+►t�sn2, .r; for your tnit�rmc�R�n.A{I�ortc xtu�tl�e�cs�s .
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DATE TIME
CITY OF ORONO CALLED IN /G'/S' yS�
INSPECTION NOTICE r-, -t �� scHEou�E� i4 -�S = Y� � G��
��� � T
PERMIT N0. cOMPLETED �.:,`7�
ADDRESS ���5� j � �G��
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OWNER �Ld"���,� zrr� c�P.�ONTR. �'rt' , Cc lt.�'
TELEPHONE NO. �7�" -%�' �O � �`'�V
� DESCRIPTION IC•'-��'-�
�0 OOTIN� 11 MECHANICALRI 78IXCAV/GRADINO/FIWNO
�Q 02 FRAMINd 13 MECHANICAL FINAL 19 LAI�SHORElWETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 VyAu gp. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAI 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARO COVER REMOVAL
� 10 PIUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES�NO
� COMMENTS:
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d ORK SATISFACTORY:PROCEED ^ PROJECT COMPLETE
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WC CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pM0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP OR�ER POSTED.CALL INSPECTOR C7 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
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DATE TIME
CITY OF ORONO CALLED IN /2 ' �'f"�%
INSPECTION NOTJ,/C�E SCHEDULED i Z -/c� �
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� Ot FOOTINO 11 MECHANICAL RI 18 EXCAV/(3RADINQ/FIWNO
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAi�SHORElWETLANDS
� 03 INSUTATION 24/25 WOOD BURNER/FlREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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� �p5 FINAL 14 SEWER HOOK-UO O6 PROGRESS
J 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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❑STOPORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor�si�eR
Inspector. v
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