HomeMy WebLinkAbout1994-006072 - revise roof �
� ` PERI�IIT �
CITY OF ORONO �
i PERMIT TYPE: _. _ _ ._
2750 Kelley Parkway • P.O. Box 815 � PermitNumber: - - -`-�"--""'
Orono, Minnesota 55356-0815 `•"-"_"-'��
(612) 473-7357 Date Issued: ;�V i ;,_,4t
SITE ADDRESS:
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DESCRIPTION:
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APPLICANTPERMITEE SIGNATURE ISSUED BY:SIGNATURE �,C.�,
i
.
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ �1 j �r�C _ Date Received:
Date Approved:
Entered By: � C-lv
Permit�: ��� i.`.
AT•T• INFORMATION MIIST B$ SDBMITTBD IN FQI�L BEFORE PLAN REVIEW WILL B$ STAR�ED
(See Check-cff List Enclosed?
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
. ,
Jos sz� AnDxBss: /3 /�) ���� � �-c Z1P: 5.5- 3G�
(work) 5 1� -g G � 7
N� OF OWNERs .�� .. �X��- PHONE: (home) �-{7 a.-/ `I a I
MAILZNG ADDRESS: �� /D �'1�m.�,,�.s/ G]t,,,�-[ CITY: ZIP: .S�S3 �c y'
CONTR�CTOR: �}-��„� �� PHONS: � 1 � � V �
MAILING ADDRSSS: ,.�,,,, r CI'I'Y: ZIP:
STATS LICENSE: �
ARCHITECT/ENGIN�: PHONE:
MATLING ADDRSSS: Cl2R: ZIP:
gp,�: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Struczure Move
Demo Remodel./Alteration_� Renovate Land Alteration
PROPOSED WORK (describe in detail) : �,,.a� �y,� /Lo� �
STORISS:�_ SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: GARAGE STALI,S: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ � G o o .
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.
APPLIC.ANT'S SIGNATDRE:� � �/,� DATE: � /�
� • ,
�,.�.�.t�.. i
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minnetonka
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 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 permit or Iicense reguested.
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 iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�ate
data on yourself.
6. Yaur full name is required to process this application or
permit.
� � 5 � 1
G'6� doK /��l� S _
First Middle Last
Address
l 3 Ia �-
City /�j1�.� State sy��,,._ Z ip S s �� ��
Phone
I understand my rights as stated above.
��1�-=-�---- �.�-��'�- -
Signature
BUILDING&ZONIIVG—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING -
, �.. i
�.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of data- The rights af individusls on whom the data is
stored or to be stored shall be as set forth in this section.
g�d, Z, Information required t° be g��� �►���1" An.individual asked to
� supply private or confidentiel data concernina tamWi hin the collecti g state agency,
purpose and intended use of the requested
political subdivision, or statewide system; (b) whether he may refuse or is legally
required to supply the requested date; (c) any known consequence arising from his
supplying or refusing to supply private or confidentiel data; end (d) the identity of
.• state or federal law to receive the data. This.
other persons or enti�ies authorized by investi ative data,
requirement shall not apply when an indioiaig Qn orcementuofficer. g
pursuant to section 13.82, subdivision 5,
The commissioner of revenue mg rolert tax re�und instructionsui steadhos
subdivision in the individuel income tax •r
on those orrns. . - — -
Subd. 3.
Access to �ata by in�ivi�al- t7pon request to a responsible �
authority, an individusl shall be informed whether h��gteeor confidenti alte UPon �
individusls, and whether it is classified as public, p ublic data on
further request, an individusl who is the subject of e to himrlande if he desires, shall
individuals shall be shown the data witho ofan�y ��g, After an individual hes been
�e informed of the content snd meaning t h e data need not be disclosed to
shown the private data and informed of its meaning,
him for six months thereafter unless a dispute�� b en collected or �treatedt1�The
pending or additional data on the individuel ublic data uQon request by
� responsible authority shall provide copies of the private or p require the
the individual subject ofthe actual.co ts of mak ng,l cert fyingy and compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comply S of the date of the request,
made pursuant to this subdivision, or within five day
excluding Saturdays, Sundays and legal holideys, if immediate compliance is not
possible. If he cannot comply with the request within that time, he shall so in�orth the
individual, and may have sr► additional five days within which to comply
request, excluding Saturdays, SundaYs end legal holidays.
Subd. 4. Proc�ed�se when d�.ta is not accurate or complete. An individual may
contest the accuracy or completeness of public or private data coneerning himself. To
exercise this right, an individuel shall notify in writing the responsible authority
describing the nature of the disagreementbeTnaccurpa e or in omplete and att pt to
days either: (a) correct the data found to
notify past recipients of inaccurate or ia�P�t he believesdthe datalto be correct
the individual; or (b) notify the indivi
Data in dispute shall be disclosed only if the individuel's statement of disagreement is
• included with the �isclosed data. e�e� �u�nt to the
' The determination of the responsible authority may be app P
provisions of the administrative procedure act relating to contested cases.
' CHECR OFF LIST FOR ISSIIANCE OF PERMITS
. FOR OFFICE USE ONLY :
- , . ��� ;. ___ ' _ _
. , _.. �.
__ _ GZ�'j?�v'c�.` _: �.. PID. _ __�;:..._..:._ ._. ...._ ,:_.-: �_- -
ADDR$SS OR LEG�I,: - �`� -�•�� �, �_ - - y,
. :- _ : . , _ n � � l�-C9 � - _
, � - _ . . . ._ - � ,: ,
DESCRIPTION OF WORK: ►(�V
------- -------------------- ---------------- --- -- ----
--------------- - -
- - - - ,_
. .: _.._. _. � .__--• DATE APPROVED: - -..�!`'"'a�f"G`f _._
ZONING REVIEW BY: � '��'
BIIII�DING REVIEW BY: _ _ _ DATS APPROVED: ,s`/�-`T `( _ = . _ y:
FEBS TO BE CHARGED: � Misc. Fees Ca�culated By•
PERMIT Yes �No � SEWER CONNECTION
PLAN REVIEW Yes No
STATE SURCHARGE Yes C� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: t Of ' ce Sc�4oJ. District:
�
Lot Area: Wi th: Depth:
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake) : Right Side: � L� �s���� �,
Rear {Street) : Left Side:
Adjacent Structures: Wetland:
Buil.ding Height: Def. Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75 ' ,
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No Date of Council Approval :
Grading: Staff Approval Date: By: Council Approval Date:
Septi c: Staf f Approva7. Date: BY�
Zoning File• # Resolution #: Resolution Date:
REM�,RRS (in house) :
��.._.,�L:r.u.. i
BOII,DING REVIEW GHECK LIST �
, , ,
� _.,. - _;_�- v
IIBC: �-'-� , - _ ' CONSTRIICTION .TYPE. ,.u/� ' . ::; �.
;_ � �-�-
' . , --- , _ .�_. � -� .-. ��-� -�
,...,_ ___. .,.�. ..._ .,s.._ _ .
� := _ Sq Footage - $ Per Sq Ftg�-< - _ -
Basement _ x ;, - - - - �:...
... ._.�_ ._._._...__.___ _ .._�_. .. _....<_ _ _ _ .____ . :_ _ : Y.
_ _ _ ; � �' y
_-1st...F].00r� x -- _ _ - �
. - -
2nd :Floor - X � .. . ,., -- -_s= . - " _ . -
T-�--
_.� . .:' .:' :``.�'.- ��
Garage X = =; �
, x . _ - - = s �.� _
TOTAL . .
Sstimated Construction Value: $ �,� °� a �
Inspections ._Rem�ired: Work Reqniring Separate Permi.ts: =
Site _ Pl.umbing Grading/Fi�J.ing
Footing Mechanica� Fire
�p Framing Septic Water Connection
Insulation Firep�ace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
�Final. (Mfg.) Other
Other Well (State Permit)
Electrical (State Permit)
----------------------------------------------------------------
�F.MARRS (IN HOIISE) :
------------------------------------------------------------
REVIEW BY OTffi:E2S: DATE:
Access: Existing New
Access Approval: Date BY=
--------
REMARRS (TO BE NOTED ON PERMIT) :
_ _ - __ • , _ .. .. - - -
. � - •: z
_._ _._._ ____ ._ _ ...------ _--_ .- - -�_
_.
. - - -
. . .,.,. .._
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_�_...._ = . �-- -._,�. _.v . - - - �� - -;.�. _. _------ _.-.'v"' -. . . _
TITLE Book No.
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From Page No.—
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� ' F;�'FROVtD F�S SU6"•hIT?'�D
{ .,� � ,�;t'��`1�.D ���dl�";� C��.�„�t;�Tit�NS AS NOT�D
� I ---�`�1�� ' �, NO i RPRRUVED — CG-�iECT & RESUBMIT
` �--'--` .:;e commerts are for y�ur inf��m�!t;on. Ali work shail ba dana
" _ ;�mpf!ance with ali �{rrucz�hia bd�iding & zoning oede �e
� ..,i;n. �i•T,,; rt,t ���:�`i�tl!y •,ntCd 'n !M5 re'tt�k
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�� `� �ATE — I� PERMiT NO.
� f � R�Fi2UVtD AS SUBfJ11T i ED
� � ��, � AFPROVED 1�^'ITH �,GR2LCTi�hS AS NOTED
��\ �` NO"t� Ar�RUVED — CO��ic�T & RESllBMIT
•',a�� cOmmen'.s are ft>r yeur i�„crmaYi�n. A!i vraK shal� be 4:!rx'
� :r: tul: compliahce with al! epp�iC�bie bz►tldi:tg & z�enisog :�:e �i�
�---�-�"� � f e+f ica l t n�t ed �n r,,�- ��+:•��•<�
�:���rements incl�:i�n; � eTT15 ,lUt 9Q=' Y _ �' . `"- `
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Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
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J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
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J 10 PLUMBING FINAL 23 SEPTIC FINAL
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� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRiESS
J 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
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V 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'nspection 24 hours in advance.473-7357
OwnerlContr r on i :
Inspector. —
White Copyllnspector's Fil Canary Copy/Site Notice