HomeMy WebLinkAbout1997-008689 - garage add/remodel -� � PERMIT
' CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 _i_;_;�;_r,.;:;=;
Crystal Bay, Minnesota 55323 Permit Number: �
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(612) 473-7357 Date Issued: - _ _ - ,_�-
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR:
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APPLICANT-PERMITEE SIGNATURE � ISSUED BY:SIGNATURE � ,
Total Fee: $ � ��'` �� Date Received:
Entered By: ;r;.�` Permit#: �(�,�(;�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all in ormation)��
_ __
----------------------------------------------------- -----------------------------==��-----------------------
THE APPLICANT IS: (circle one OWNER OR CONTRACTOR � �a ?-y
JOB SITE ADDRESS: ��y rE,E�J,��c� f,r1 llr`: ZIP� .5 S-3�i
Gv f4 �/Z-.4 i�'f,
NAME OF OWNER: �/��./� /��t�)E� /�� PHONE: (home) Lj 7� - S�!��
� (work)
MAILING ADDRESS: 3�! /=C 2.✓1�i9c.c. .C'D i�t/ CITY: �.v,4 y�;rl�ZIP: /�►N
� f
CONTRACTOR: L,f��L�2 /�,�c_,S PHONE: y��- - 3� �, _
CONTACT PERSON:�'y��,q�,p �3u.-E.� MOBILE/PAGER: 7 y•J - �s�� =;,�_ ,
MAILING ADDRESS: �9Q ,��,E.v�N��. �f/�� CITY: �„� y 7�;-� ZIP: �-S,�9�
STATE LICENSE: #;;Zv�Z�G,�
ARCHITECT/ENGINEER: �',�..�c_c:c �c..,i-n��o r PHONE: y•;?� -- � � � .z
MAILING ADDRESS: CITY: � ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure t�'
Move Remodel/Alteration ,/ Land Alteration
PROPOSED WORK (describe in detai�: ��.,0 / � �-� � ��!'� -'-
�r - n�L.;�� i
STORIES: ,;�---- SQ. FEET OF EACH FLOOR: 1� � ��G r /�-o�-G
NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. e2 DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �y �-�-� . ���
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 a �oved plan.
� � � � ..
APPLICANT'S SIGNATURE: ,' `� Y� DATE: /� ��' �
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.
9
Sec.13.04 RIGHTS OF SUBJECTS 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 individual asked to supply private or confidential data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'sta[e agency, politica( subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of o[her persons or entities 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 may place the ❑otice required under this subdivision in the individual income tax or propertv tax refund
instructions 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 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 its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section 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 authoriry
may require the requesting person to pay the actual costs 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 concerning himself. To exercise this right,an individual shall notify in writing the responsib(e authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the daca found to be inaccurate or incomplete and attempt to notify past recipients 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 shali be disclosed only if the individual's statement of disagreement is included with the diselosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRNACY 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 license requested.
2. You may refuse to supply 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 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 (availabie upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
C��y State Zip Phone
I understand my rights as stated above.
Signature
�C� . �.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �C;�i Fc���tv�.>;3 l..i:. j�o,�c� ��v
PID:
DESCRIPTION OF WORK: _ ���� ; n�tii C i 2-�.iti�v c�:-.t.._
------------------------------------------------------------------------------------------------------------------------
ZONING REVIEW BY: �-� ;, �, � �'
DATE APPROVED: i ` :S `��7
BUILDING REVIEW BY: � .z;,,_��-� DATE APPROVED: t - � ��'7
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t-�'" No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SUR:�ARGL Yes v'' No WATERCONNECTION
INVESTIGAI'ION FEE Yes No PARK FEE
SAC Y�s No SITEINSPECTION
Number of SAC Units OTHER (specify)
-------------------=----------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: (��j?-t t�
Fire Department: v�„r�.�-v}-r� Post Office: t,�,�,�,-t,q-� School Districr. �� r�7Zq--t�
L.ot Area: Sq.ft. ti� c i����� Acres -- Width — Depth "
Survey Submitted: Yes ,�t No Date of Survey: ,'Z - Z� -`�f.E;.
Proposed Setbacks:
Front (Lake): Z ''S� � Right Side: ��> � * �-
Rear (Street): �1c� � + Left Side: 3� � �
Adjacent Structures: r�i'��cs' Wetland: lv�(�}-
Building Height: Def. Hgt. C'• C�- Peak Hgt. �< (�
�Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Y Y� .
Shoreland Disl_ict:
Avg. Setback: Bluff Setback: Lot Coverage:
� Existing Proposed
� Hardcover: 0-75'
1 75-250°
� zso-soo�
; 5�-��0�
�
Hardcover Variance Required: Yes No Date of Council Approval:
�
REMARKS (in house):
26
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BUILDING REVIEW CHECK LIST
UBC: � - 5 CONSTRUCTION TYPE: �/��
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
�, .
Estimated Construction Value: $ 3�=,u c.� `'`
Inspections Required: Work Requiring Separate Permits:
Site � :��<"� Plumbing Fire
Hardcover Removal � Mechanical Water Connection
�_ Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
� Insulation (Masonry) Other
� Wall Board (Mfg.) Well (State Permit)
,� Final Grading/Filling �r Electrical (State Permit)
Other
-----------------------------------------------------------------------------------------------------------------------------------------------
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ON PERMIT):
27
DATE, TIME
CITY OF ORONO CAILED IN 3���/� �
INSPECTION NOTIC� �, scHE�u�Eo " ii �� � ' ��Z
PERMIT NO. - `� � COMPLETED
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ADDRESS � ' C�, i - i� > �. _�.�.[� , �-�t � �,
OWNER �--�1�.:�._,�i CONTR. ���c�.�
TELEPHONENO. "� J � � C-- 3C' �
� DESCRIPTION � �< <�' ��zf���
� Ot FOOTING 11 MECHANICAL RI 18IXCAV/GRADINO/FIWNQ
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHOREJWETIANDS
Q 03 INSU_LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Q Qt'WALL BDl j 12 WATER NOOK-UP 17 SITE INSPECTION
= 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEM�SITE 27 SEPTiC MAINT. 21 COMPIAINT
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�Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WI�L REfURN
❑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
OwnerlContract 't :
Inspector. ��
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DATE TIME
CITY OF ORONO CALLED IN t=���7
INSPECTION NOTICE /�, SCHEDULED .l - /9 �/:3 �'
PERMIT NO. ,�[L��� COMPLETED u _��
ADDRESS �G' � �-��'�%�7 �Q�� ��� ��
OWNER ;��t.����'✓ CONTR. —
TELEPHONE NO. �1 7 3 ' �v S .�%
� DESCRIPTION /����-t�
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y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
p 03 TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 70 PLUMBINO FINAL 36 FOUNDATION HEMOVAL
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0 BEFORECOVERING PERMANENT
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INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR
=:CITATION ISSUEO
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
OwnedContra or o s' e
Inspector.
White Copylinspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN .:< /�� / . �`
INSPECTION NQTICE SCHEDULED -�/i.-Z/`i � �-c �-
PERMIT NO. � ���y COMPLETED
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ADDRESS _'�C:i ��.--->�4-% , l <�� /� -
OWNER.� _. .- CONTR.�%...-�-<-__-
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� DESCRIPTION r.�-�_��� �� (�P.��q`e.0
� 01 FOOTINO l 11 MECHANICAL RI 18 D(CAV/aRADINO/FIWNQ
y 02 FRAMING 13 MECHANICAL FINAL 19 LAi�SHOREJWETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIflEPLACE 34 TREE REMOVAL
Z pq yyqLL gp, 12 WATEfl HOOK-UP 17 SITE INSPECTION
� OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
2
F` 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
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INSPECTOR WILL RETURN `
❑STOP ORDER POSTED.CALL INSPECTOR
❑GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contract
Inspector. —
Whlte Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN _�� `, 7
INSPECTION NQ310E SCHEDULEO �-'>/=�/% '/ -�-��y�—">�—
PERMIT N0. � COMPLETED 3�S ��7 � U� �U
ADDRESS --'-%C- '. -�r = - � l
<. � .1 �-f �/
OWNER -"F:< CONTR.` ��-�;{�
TELEPHONE NO. '� % s "�t-
� DESCRIPTION - z �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ORADINQ/FIWNO
y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
Q ;�03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Q �'pq yyqLL gp. 12 WATER HOOK-UP 17 SITE INSPECTION
= 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL 72 FOLLOW-UP
= 09 PIUMBINCi RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBIN(i FINAL 36 FOUNDATION REMOVAL
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0 BEFORECOVERING PERMANENT
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INSPECTOR WILL REfURN r CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
0 INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.47�73�J7
OwnerlContract n si .,
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White Copyllnspector's File Canary CopylSite Notice