HomeMy WebLinkAbout1999-011282 - addition over garage PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Ke�ey Parkway- P.O. Box 66 _ � ''`
Permit Number: ` ` ```"E'
Grystal Bay, Minnesota 55323 Date Issued: � �� �'"�" ��"
(612)473-7357 . _ . ...._ . _ ._
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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APPLICANTPERMITEE SI � ATURE � ISSUED BY!SIGNATURE
Pf��s� �Z,
Total Fee: $ / i ��-�l � Date Received: <.�-%d' ��
Entered By: Permit#: 1 �� �.�z.
CITY OF ORONO - BLTII�DING PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICA�'T IS: (circle one) OWNER OR CONTRACTOR
JOB SIT'E ADDRESS: ,�Z3 i 5 ��U�N L ��-T;�-� C;�„Jc� ZIP: SS 35�
I�'A1�iE OF Otii�"ER: -�JJv u��,�� �o�7 r-r a�ti PI30NE: (home) �{7.6' �l £f/
(work)
NIAILPi 1G ADDF�ESS: �3 i� .t�z�,N L�� CITY: [L�N�� G.��t ZIP: SS3 S�
COVTRACTOR: �`•�, G'S r►2�r( E ;�v�v' PHONE: `���� /���3
CONTACT PERSON: �I�r��l� ��r1 I�IOBILE/PAGER: ,�i �- �So �.
MAII�I\'G ADDRESS: �U.6v X �s� CITY: �.rl�z s r�,z ZIP: SS 33/_
STATE LICENSE: # /�10�
ARCHITECT/E\TGTi�TEER: PHOi�tE:
�IAILING ADDRESS: CITY: ZIP:
rJ�,�; REGISTRATION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration `/ Land Alteration
PROPOSED WORK(describe in detain: �(�� � .���5 s��� o�R �--t����'�;1.—
�/1�'�l�i E �H�f l�E�Q�c
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
EST�IAT'ED CONSTRUCTION VALUATION (excluding land): $ I�S�� �
I hereby apply for a buildino 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 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 in accordance with the approved plan.
� DATE: 3 � y y
A.PPLICANT'S SIGNAT'URE:��cr�-�-�- ( ti�-�
NOTE! Parade o 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.
Sec.13.04 RIGHTS OF SLJBJECTS OF DaTA '
Subd. 1. Type of data. The righcs of individual on whom che data is stomd or to be stored shall be as sct forch ia this secaon.
Subd.2. Information reqirircd to be given individual. An individual asked to supply private or confidendal dara coacerniag himself shall
be iaformed of: (a)the purpose and inttnded use of the requuted dam within the collecdng state agency,poliacal subdivision,or sracewide rystem;
(b)wheck:ec he may rsfuse or is.legally requir.d to supply che requesud data;(c)any Irnown coascqucnce arising from his supplying or refusing to supp[y
privam or conndenrial data;and(d)the idenary of ocher Qersons or enodes authorized by state or federal law to receive[he dara. 'Ihis requirement shall
noc apply when an individual is asked to supply invesdgadve dara,Qursuanc�o secdon 13.82,subdivisian 5, to a(aw enforcemenc o�cec.
'Ihe ce^imissioner of revenu- mav pla-- che nooc- r�uird under[his subdivision in the individua! income tax or oropem ax refund
instrucdons inscead of on chose forms.
Subd.3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whecher he is the subject
of stored data on individuals,and whecher it is classified as public, private or confidenriai. Upon his furcher tequest,an iadividual who is the subjec�
of stored private or public data on individuals shall be shown che dara wirhout any charge to him and;if he dtsires, shall be infotmed of the contzn�
and meaning of[hat data. Aher an individual h�s been shown[he privare dan and informed of i�s meaning, che data need not be disclosed to him for
siz mon[hs thereafter uriless a dispute or acaon pursuan�to [his secdon is pending or addiriooal data on the individual has been collecced or creared.
The responsiblt au[horiry shall provide copies of[he private or public data upon request by the individual subject of the dara. The responsible authoriry
may require the requesring person to pay the actua!cosu o[making,cerdfying,and compiling the copics.
The responsible auchoriry shall comply immediately, if possible, wich any cequest made punuant to this subdivision,or within five days of
the dace of the requesc,excluding Sanrrdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request
wi[hin that dme,he shall so inform the individual,and may have an addidonal five days wi[hin wtuch to comply with[he request,ezcluding Satucdays,
Sundays and legal holidays.
Subd.4. Ptocedure when data u not accurate or complete. An individual may con�est the accuracy or completeness of pubiic or privace
dara conceming himself. To exercise this right,an individual shall noriEy in wridng[he respo�sible auchoriry dascribing the nature of the disagreement.
Thc responsible authoriry shall within 30 days eitF.er: (a)correct tha data found to be inaccurate or incompiece and accempt to nodfy past recipiencs of
inaccurate or incomplece data, inctuding recipiencs named by �he individual; or(b)no[ify the individual thac he believes the dam to be correcG Data
in dispuce shall be disclosed only if[he individual's sta�emenc of disagreement is included wi[h the disclosed data.
The dtterminaaon of the responsible auchoriry may be appealed pursuant to the provisions of che administrarive procedure act relating to
contesmd cases. �
DAT� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 detemune 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 shared wich other local, state or federal a�encies to the eztent necessary to process
the permit or license.
4. If your reques[ed permit or license requires Council action to approve, some information may become
public.
5. You have certain ri�hts under M.S. 13.04 (availabie upon request) to review private data on yourself.
6. Your full name is required to process this application or perm.it.
Ic ff�IC.���/ �{ �,C5771or/
Firs � �fiddle Last
��. �-X�Y 7 5�,
Address
�X C��s��o�z �.J SS 33/ �%7D�-�C l 3 _
Ciry Sace Zip Phooe
I understand my ri;hts as stated above.
`��-�-_� � �� -
signzcu«
CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: .� ;� 1`_� ��F r '< �� l�r r c.L_
PID:
DESCRIPTION OF WORK: r�r.,�, ,-�,��;-, �,� � �;,arn.�� t �'-,��,:��.Ls��;���::
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ZOVLr'G REVIEW BY: �--' ''., � ;,,�;�._._ DATE APPROVED: 3 ?� � �+`t
BUILDIi�'G REVIEW BY: � _�',��;?, (��,r,,,,� DATE APPROVED: � z�t -`i�
----------------------------------------------� -------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER1v1IT Yes i/ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes ,/ No WATERCONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZO��1G CH�CK LIST Zoning District: �'.F�-i i>
Fire Department: (_,t>,.;� U!i� Post O�ce: �.k:����.��=c� School District: u f1�;-�=
Lot Area: Sq.ft. �7, 15-U Acres � Width 3't�: Depth Z-Z'�
Survey Submitted: Yes X No Date of Survey: �r� .=c� y-ZZ-�`?'
Proposed Setbacks:
Fron[(Lake): 1 H� � Right Side: Z Z� � �'
Rear (Street): I Z'(�,� "�= Left Side: i 3�i �-
Adjacent Structures: �'rT�C c(ti t� �Vetland: /ti �d�
Building Height: Def. Hgt. V .� Peak Hgt. —
Lot Coverage: N � r�
Grading: Staff Approval Date: -- By: �— Council Approval Date: —
Septic: Staff Approval Date: — By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: �%G
Avg. Setback: Bluff Setback: Lot Coverage:
Existing 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: 1Z � -3 CONSTRUCTION TYPE: '�(tLS
Sq Footage $Per Sq Ftg
Basement z =
lst Floor x —
2nd Floor x =
Garage z =
R =
TOTAL
Estimated Construction Value: $ i Z�,v�% t-
Inspections Required: Work Requiring Separate Permits:
Site 0� Plumbing Fire
Hardcover Removal ,�C Mechanical Water Connection
Footing ' Septic Sewer Connection
� Framing Fireplace Lawn Inigation
�Insulation (Masonry) Other
;� Wall Board (Mfg.) Well (State Permit)
�-- Final Grading/Filling � Electrical (State Permit)
Other
REMARKS(IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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RENIARKS (TO BE NOTED ON PERl�II'I�:
8
D E TIME
CITY OF ORONO CALLED IN � 5'
INSPECTION NOTICE�p SCHEDULED � -Z t�' %/ = O o
PERMIT N0. � O � COMPLETED I, �,
ADDRESS /
OWNER CONTR.
TELEPHONENO. "�'�IO ' /��.3
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FR�7?y���,� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� INSULATION 24/25 WOOD BURNEFi/FIREPLACE 34 TREE REMOVAL
Z12 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W��WORK SATISFACTORY:PROCEED C: PROJECT COMPLETE
W O CORRECT WORK&PROCEED C% ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '—' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract sit •
inspector.
White C yllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN 'I -a V �Z` V J
INSPECTION NOTICE SCHEDULED f-13 -co -� ��J
PERMIT N0.1�� ��- COMPLETED '�` '� d'` �'� �I� �`
ADDRESS 3 `� -�'� � �-
OWNER �'�.� CONTR.
TELEPHONE N0. `�` 7 �" --" l� ��
� DESCRIPTION �- "
l� 01 FOOTING 11 NIECHANICA�RI / 18 EXCAV/ ADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL `� 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WA .SD,_._ __ 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL � 14 SEWER HOOK-UP O6 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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� 1 ORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
C�CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
f 1 CORRECT UNSAFE CONDITiON WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
[1 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
[1 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on sit�:
Inspector. : 1?�Z` L ��L�t
White Copyllnspector's File Canary CopylSite Notice
-�
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTI E SCHEDULED '.30
PERMIT NO. OII • �' COMPLETED �� •, 3�'
A D D R ESS � a�I��P�I F'� L-d�� LSC
OWNER CONTR. �S'���
TELEPHONE NO. `�7G�CQ�J
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANiCAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
� OWNERICONTRACTO TO MEET YOU:_Y NO '
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a 2- � ?�t,'1� �c i C cz '� ��. G?5 ����
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� ❑WORK SATISFACTORY:PROCEED i- PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED i= ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473�73�J7
wner/ ontractor on site:
Inspector. ' ��.�c_ f��S
White Copy/lnspector's File Canary CopylSite Notice
— . CITY OF ORO1V0
• " ' � � �3UILDING IT PLAN REViEW
- � OUT"L O 7— C
' � INSPECTOR
P Q �/� (/
� � x ioou� _ � _ 43•5 - - - -- - -- d 742 DATE ��(ri - �_� PERMIT PIO.
ti .,_ �AP�PROVED AS SUBMITTED
' � ❑ APPROVED Wl7H CORRECTtONS AS NOTE
. ' . � ` �/89�49A/E
_ ��� �39�-DO --�- - _ ❑ NOT APRROV�D -- CORRECT & RESUBMi
. These eomments a�e far y0ur tnformation.All work shall be ne •
� Y .--trrfutt compliance with all 8pplicable building &zoning code e•
x 993 �3�0 � qulremenis Including items not specifically noted in this re w.
i � I � KEEP THIS PLAN SE7 ON SlTE AT ALL TIMES.
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S 8 9�44 9/t/V ° �TiO�°'O^mOn��^t Proposed lowest floor elev._
p Derotes offsrt stake Proposed top of foundatio�elev.= 9/5
7OO°-O D°^O��"�'�°�' BENCH MARK: �
(000.o) Da�otns Proposed etev. • oP o� h'/�
o�u��,rt�«ar���,.� , 2�' no r�h o•�d 3.� � wes�
�,` _ _, _r^_--_ ------- . - - � ProPosad�ngefboreiev.= cf �f6 co �- o� PioPoseq�
. <'�ouse_- . ASS4�ne�/ G-'/= 9/. 5
� I hereby certify that this is a true and correct reprezentat�o� of a wrvey ot Fik No,
the bounJaries of the abeve described Iand and of the locaoon of a1�bu�ld�nqs.
D��.GA$�j, it any, thereon, and-alt visiWe encroachments, �f any, from o� o� sa�d �and. �J,�� P R E PA R E D FQ R�
LAND SLTBVEYORS INC. ��' ? 7 � 8:�ok Pag�
,
As wrveyed by /4n�:_Z?" ' daSi or'�/J:.s� �u. 9 ��—��
30.'!0 Harpor Lane No. _1 � _ • i //�`�j T7 /// / //'�)//��� '
' Plymoutn MN�1 _lcv� � /l ��r' •f'�� .��.1•_ =� -------- �� 1 // L._ �V L L / �/��V' r
Fnone:(8t2)558��6C8 rr-���'' SC3�2
,9-.�1�, � '�
�I�nn. Reg No. — � ' ���
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