HomeMy WebLinkAbout1999-011227 - 8x20 addition ' PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ;-.;;...,�,_,.,;x;:�,=;
C� stal Ba , Minnesota 55323 Permit Number: ___
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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: -. f:;�:�;i ; ,:_:,-;�. - �-,� . _.-;-� OWNER:
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APPLICANT-PERMITEE SIGNATURE �� ISSUED BY:SIU�i^ �
Total Fee: $� �C5 . g�! Date Received:
Entered By: !� Pernait#: //� �7
CITY OF ORONO - BUII.DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
------------------------------------------------------------------------ --- -�-_---------------------------
_�__...
THE A.PPLICAl\'T IS: (circle one) OWNER OR _ _ RACTOR �>
___.___._
JOB SITE ADDRESS: �3/ � ,��v', •.� l__;-,�•�� �r�cK�c� ZIP: s��S%
/� PHONE: (home)���- - b l �"l
NAME OF OWI�TER: ������ I��� � ��r�r�•� i�
(work)
MAILING ADDRESS: .�< ���`�� %r� �-�� CITY: �".Y'�'�G ZIP: '�?S �
CONTRACTOR: �� � C�S rn_�-n � ����, (•�� PHONE: �,� - Y?v- l�9-5
CONTACTPERSO`': ll �-r� �rr��l MOBILE/PAGER: ��`f9�E5o �,
MAII.I�i 1G ADDRESS: c�. �G x ���'� CITY: ���:�:_ ZIP: �< � ;i
STATE LICENSE: # 1 �o `�
ARCHIT'ECT/E�'GItii'EER: PHONE:
�ZAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition �/ Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �c��.��� ����������S 4 rcc T i ti��S
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�i IATED CONSTRUCTION VALUATION (excluding land): $ �j�,�%��=� �
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 pernut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE:��zc'---���e-=�� DATE: ��,�_3.��q
NOTE! 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.
Sec.13.04 RIGH'TS OF SUBJECTS OF D�TA
Subd. i. Type of data. The righ[s of individual on whom the data is storcd or to be stored shall be as set for[h in this secaon.
Subd.2. Information req�rired to be given individual. An individual asked ro supp(y privace or confideodal dara concerniag himself shall
be inform:d of: (a) the purpose and in[ended use of the requestcd dam wi[hin the collecang"statt ageacy, po(idcai subdivision,or stacewide systtm;
(b)wheet:er he may refuse or is legaliy required to suppiy�he requesced data;(c)any known consequeace arising from his supplying or refusing to supply
priva�e or conndenaal data;and(d)the idendry of other persoas or enodes auchorized by scate or federal law to receive[he data. This requiremeoc shall
not apply when an individual is ask�d to supply invescigadve dan, pursuanc to secaon 13.82, subdivision 5, co a law enforcement officer.
The commissioner of revenu- mav pla�� the nodce r-auired under this subdivision in the individual income tax or orooectv rax refund
instruccions inscead of on �hose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual sball be informed whether he is tho subjecc
of stored data on individuals,and wherher it is classifi:d u public, private or confidendal. Upon his furcher request,an individual who is the subject
of stored private or public dara on individuals shall be shown che dara wichouc any charge to hicn and,�if he desires, shall be informed of the contenc
and meaning of rhat data. After an individual has bezn shown che priva�e data and informed of its meaning,[he dara need not be disclosed to him for
siz monchs �hereafter unless a dispuce or acdon pursuanc eo chis secaon is ptnding or addidonal data on the individual has been collected or creaced.
The responsible auchoriry shall provid�copies of the private or public data upon requesc by che individual subject of[he dara. The responsible authoriry
may require che requesring person to pay the acnial cos�s of makinz, cerafying,and compiling the copies.
The responsible authoriry shall comply immediately, if possible, wi�h any reques�made pursuant to this subdivision,or wichin five days of
the dace of the requesc,ezcluding Sanirdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannoc comply with the requesc
wichin tha!ame,he shall so inform[he individual,and may have an addidooal five days wichin wluch to comply wich�he request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completaness of public or private
data conceming himself. To exercise chis right,an individual shall nodfy in wricing che responsible au�horiry describing the nature of the disagreement.
The responsible auchoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempc to noafy past recipieau of
inaccurdte or incomplece data, including recipien[s named by che individual; or(b)nodfy the individual tha�he believes che data to be correcc. Data
in dispute shali bz disclosed only if the individual's statemznc of disagreement is included wi[h the disclosed data.
The de�erminaaon of the responsiblz aurhoriry may be appealed pursuanc to the provisions of the adminisaarive procedure act reladng 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 Ciry 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 perm.it 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 agencies to the ettent necessary to process
the permit or license.
4. If your requested pecmit or license requires Council action to approve, some information may become
public.
j. You have certain ri�hts 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.
�C c=: �`�3 �
Firsc �tiddla Last
Address
Ciry Srdte Zip Phone
I understand my ri�hts as stated above.
�
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Signacure
CHECK OFF LZST FOR XSSUANCE OF PER�I�.ITS
� FOR OFFICE USE ONLY
A1�DAESS OR LEGAL: Z�ti S Q�v„v (,4,w.e �
PID:
DFSCRIPT'iON OF VVORK: A c�����.oti �'f � �
ZO�TiYG REVIEti�BY: � � DATE ApPROVED: 2• 2 3 `�J�
BULLD .�i IG REVIEti� BY: � . DATE APPROVED: 2 - z 3- .�i�
FEES TO BE C�TARGED: Misc. Fees Calculated By: ~�
PERMIT -Yes � No '
PLAN REVIEW Yes �' No SEWER CONNECTiON
STATE SUR`H�,RG� Yes v No ��ATER COYNECITON
IIYYESTIGA'ITON-FEE Yes No PARK FEE
SAC Yes No SITEINSPECITON
Number of SAC Units �`OTHER (specify)
-------------- ----- -__
ZONI�TG CHECb LIST zoni.ng District: (�2- 1.(� �
Fire Departrnenr. �.p�� (,��� Post Oftice: (,c�,� c,�; School District: 6�� '
Lot Area: Sq.ft._ g�f 15� Acres 2 tiVidth 3`�v Depth Z Z5
Sucvey Submitted: Yes Oc No Date of Survey: o� ��(� Y-z2 75
Proposed Setbacks:
Froat (La.�Ce): . g Z�,-� _ _ _- Right Side: 1?7 � �— � __ -_-.
Rear (Street): ►�S�'� Left Side: 2.0 '{ � �
Adjacent Stnictures: _�4�-r�c.(>f�Y� �Vetland: /ll (/�-
BuiIdina Height: Def. Hgt. _ 6 .�� Peak Hat. — -
Lot Coverage: c`>� �C-
Gradin�: Stafi Approval Date: _ yt///-� By: Council Approval Date:
Septic: Staff Approval Date: _ �l/ (/�' gy; • � .
Zoain� File: � � Resolution: � Resolution Date:� •
Sl�orel2nd Dis[.-ict: /l/(� �
Avg. Setback: Bluff Setback: LotCoveraoe: �
� ' E���� Proposed
Hardcover: 0-75'
7�-250' . - •
250-500' . .
500-1000'
Hardcover Vaziance Required: Yes No Date oE Council Approval:
. Y
REl�L4RKS ('in house): �
z � _ . - .
,,� _ . 26
, ' �t� . .
BUII.,D7NG REV]Eti� CHECK LIST � : . � '
UBC: � •j CONSTRUCTTON TYPE: �/� �
� Sq Foota;e $ Per Sq Ftg
Basemeat x . - . - _
.. . . lsc Floor . � . . X . . — � . .
2ad Floor . .. . -. • .x .. . .. ' . , . .'
Gara�e " , — � • � . �
x . .
x
� TOTAL
Estimated Construction Value: S�,(�00°� �
- — ?nspections Required: • tiyork Requirina Separate Permits;
Site Plumbing �
Hardcover Removal Fire . . _
_�Mechanical tiVater Connection
_� Footin� Se tic • '
_�i , Frami�j P Sewer Coanection ' .
Fireplace �� �Q
_�o Insulation _. ,ation
�Wall Board �asonry') Ocher . . .
F�� rn'if�•) Well (State Permic)
Gradin�/Filling _� Electrical (State Perm.it)
Other
. REtI�IAR�iS (!N HOUSE): � ------- � - -
------------------ �
--------
REVIE'�'�BY OTHERS: DATE: `-- - ---___��----
Access: Exiscin� Ne�v "
-------
• Access �Approval: Date -
-------------------------------- $Y�
REiI�IA.Rb'S (TO BE NOTED ON PERitiIXT): `_r� - -
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED -'�� .. . C�
PERMIT NO. OII Z • o?�a' COMPLETED 3 cJ
ADDRESS I����I I Yl �-d�J �.sC
OWNER CONTR. �S�`'�'�
TELEPHONE NO. �7G;���'3
� DESCRIPTION
� 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
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
� 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTO TO MEET YOU:_Y NO
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W G WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� �JCORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� � BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CAlLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.4T3-7357
wnerl ontractor on site:
Inspector. ��.� l�'1�.S
White Copyllnspector's File Canary CopylSite Notice
DATE TIM
CITY OF ORONO CALLED IN ' � '�C � �� a�
INSPECTION NOTICE SCHEDULED ��-�H- �-i 9 � � Or_ YI
PERMIT N0. I �� ��I COMPLETED K �_
ADDRESS J�� �U� r'1 �.
OWNER ✓� �� CONTR.� • ����'I">'c=(1-�
TELEPHONE NO. �� U — f (L�i �
��Bf�CRtf�T�ON
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
r09 PLUMBING R� 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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� COMMENTS:
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� WORKSATISFACTORY:PROCEED G PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �i CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins�ection 24 hours in advance.473-7357
OwnerlContract o sit
Inspector.
White Copyllnspector's File Canary CopylSite Notice
___ CITY OF ORONO
� • � E3UILDING IT PLAN REViEW
" � �I �j
O/�,J / L O T C INSPECTOR
' � - �I -- - - -- - _ ,� 742 DATE ��-��...7 PERMIT NO.
• X /ao.� 93 5 - —- -
� � [�'AFPROVED AS 5UBM17TED
, � o _ �/89�994/E ❑ APPROVED WITH CORRECTIONS AS NOTE
��� 39D-o0 ❑ NOT APPROVED --- CORRECT & RESUBMI
_ These eomments are for your(nformation. AI!work shatl be ne
_ __ . X —in-futt compiiance with 811 Bpplicabie building & zoning code e-
x y93 �3 o quiremenis including items not specificalry noted in this re w.
� I � , KEEP THIS PLAN SEi" ON SlTE AT ALL TIMES.
� � O� M �� � �
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. A Benc.hmork
,�� 9� �95 5 � E�-9� y x 88 0 '
, � O��NO ���� � P��7'��GT �3�A��F1�L[f � IA
�91� �9j� °o ' D E S��I�A T E D �R�1 1 N F t�D S I T E S S H A L L B E S T A-
- - - �c 94.3 � ' KED OFF P�lOR TO �4��1��'RUC�ION OR EX RVA-
�I � - - - — �2�� - - -""4- a,�- i 29�a� - - o /36 p 88. � �o o x 8'.Z � ' �'I�:� lN THC AREA. �I�E [14�AINFIELD AREA HALL
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- — - 3 9a.00 .. ._ _
.5 8 9'44 9/��1�� a Denotes Kon monument Proposed lowest floor elev._
D pe.�otes affset stake Proposed top of foundatio�elev._ �1/.5
x 000-o De�wtes a's��^9 e�� BENCH MARK: �
(000.0 1 oenoces Proposee elev. � °/� �� h`�fJ L
Denoaes awfsoe dra�nage 2c ' no r�L' o��/ 3� 1/✓es T
� ProPosed�rage fbo�elev.= c f ��c c� �- o.; P i o Po s e�
�� ;�ou�e_ . .-9SSv�ne�/ c/= 9/ 5
� I hereby certify that th�s is a true and correct representatio� of a w�vey of File No_ .
'�O the bounJar�es ot the above described land and of the locanon of a�� bu��d�ngs,
DEMARS-GABRIEL �f any, thereon, and ali visiWe encroachments, �1 any, from o� o� sa�d �and `J,) �
R � - 3�� PREPARED FOR:
LANt)SL,ntVEYORS, INC. /; )�,y�! ° /�;',�� o�c� a:'°k Pa�
As wrveved by h�s— z r da�V o(----� . __ , 1..
3030 H�rpor Lane No. __ �-� � ���5� ��/T Z G UL � / C l�SO N
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Plymouth MN 55�1 �. ; �.• �,�✓_< <�.� - ------- - _ Sc�!r
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