HomeMy WebLinkAbout2000-P02484 - deck ° , PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po24s4
Crystal Bay, Minnesota 55323 PeC'1711t Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 6�sioo
SITE ADDRESS: 895 Forest Arms La
MOUND,MN 55364
f���: 07-117-23-12-0015
DESCRIPTION: UBC occupancy R3
Construction Type VN
Proposed Use:
Buildin Census Code 434
Permit Class g
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 304.03
APPLICANT: Jo�rr o'BRIEN OWNER: J P O'BRIEN&C O'BRIEN
895 FOREST ARMS LA 895 FOREST ARMS LA
MOLJND,MN 55364 MOUND MN 55364
THE UNDERSIGNED I�EREBY REQUESTS PERM[SSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICAN'C PERMITEE.IGNATURE ISSUED BY SIGNATiJRE�
Copies: City,Applicant, Assessor, Finance Page 1
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Total Fee: $ jp�� G � Date Received: S�� /pv
Entered By: �;� _ Permit#: /.� p,z �8�
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �y �� �� e� 't" �1�rns c�}n,� ZIP: S �S 3(p�/
, �
NAME OF OWNER: � � .c.u-�-�. PHONE: (home) '�7,,? -�l$�-�
(work) -3 � —`�''3�//
MAILING ADDRESS: ��� J�'►�� ,� ��v CITY: �/'Lrn-�.s—' ZIP: S`�S�3G y
CONTRACTOR: ,� ���,�.y ���� PHONE: Jl j � 3y(��6
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION�
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�:
STORIES: � SQ. FEET OF EACH FLOOR: �Z �U �-�
NO. OF BEDROOMS: � GARAGE STALLS: ATT. _� DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � �.(�E� �c�
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 i� not a permit and work is not to start without a
permit; and that the work will be in accord�' with the approved plan.
, ,
APPLIC�NT'S SIGNATURE�,�'� � ��'�c.� DATE: S / ��
,
NOTE! Parade of Homes efents require separate pernzit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righu 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 concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the coliecting state agency,political 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 confidenaal data;and(d)the idennry of other persons or enuries 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 mav place the notice required under this subdivision in the individual income tax or properri tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,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 individuai has been
collecred 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.
T'he responsible authority shal(comply immediately,if possible,with any request made pursuant[o 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 dme, 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�vhen 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 responsible authoriry 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 notify
past recipients of inaccurate or incomplete daha,including recipients named by the individual;or(b)notify the individual that he believes the da[a
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
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 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 permit 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(available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�d ��� a �:.
F� t Middie Last
�� � �GT�c:�'"� /'��/LY'ti'}-�
Addre,ss,r�
(.%�`�� ��� S S ��`/ �/�J����'�Sr
Ciry State Zip Phone
I understand my rights as s ab e.
�---�, � ' \
Signature
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: S`1 S ����=5� 1gM�n s t,�rv L
PID:
DESCRIPTION OF WORK: ��G.�� �- �o�t�-e�.
-------------------------------------- ------- - ----------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: S•3i� ��
BUILDING REVIEW BY: DATE APPROVED: s• 3r �v�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓� No
PLAN REVIEW Yes f No SEWER CONNECTION
STATE SURCHARGE Yes ✓l No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: C,,Q•/Q
Fire Department: ��n��p Post Office: yvLo�,v,/> School District: �,u2 s Ton►t�1
Lot Area: Sq.ft. N� C/�,.�Acres --- Width — Depth —
Survey Submitted: Yes p< No Date of Survey: g'l3'9 Z �0� t����
Proposed Setbacks: � �
F��(Lake): �qU � Right Side: 7S
Rear (Street): �5� �- Left Side: CI� �
Adjacent Structures: pn,�a�H-�.T►'� Wetland: n/ //�
Building Height: Def. Hgt. N/�" Peak Hgt. —
Lot Coverage: C���C.
Grading: Staff Approval Date: — By: — Council Approval Date: —
Septic: Staff Approval Date: — By: —
Zoning File: # -- Resolution: # — Resolution Date: —
Shoreland District:
Avg. Setback. N//'-I Bluff Setback: — Lot Coverage: —
Existing Proposed
Hardcover: 0-75'
75-250'
250-500' (�•(L
500-1000'
Hardcover Variance Required: Yes No DL Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: ►Z-� CONSTRUCT'ION TYPE: �1 N
Sq Footage S Per Sq Ftg
Basement z =
lst Floor t =
2nd Floor s =
Garage � _
e =
TOTAL
0
Estimated Construction �"alue: � I l�,C�00`Z
Inspections Required: �`�ork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal l�iechanical Water Connection
Dc Footing Septic Sewer Connection
d Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�Final Grading/Filling Electrical (State Permit)
Other
RENIARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing 1�'ew
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT�:
8
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L DATE TIME
CITY OF ORONO P��L'� � CALLED IN �_�r ' � �
INSPECTION TICE z SCHEDULED �%��0 6.`a a
PERMIT NO. � COMPLETED � O(� '
ADDRESS � �S �O'�2.a� ��✓�rn ��oH-.:��
OWNER � ,�-J1�►'� CONTR. D � g M�►'l.
TELEPHONE NO. "T�� � O 7s C,x.e.C'�
� DESCRIPTION '� 3��-- y3 ��
lu 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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3 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 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 PIUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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Q i 7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
C] STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
Cl INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlCor�t r on ' -
Inspector� G��'''�-
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC. scHEou�Eo
PERMIT NO. �� �� COMPLETED ��t''
A D D R ESS �cJ 7 c�V �'S� �`✓rY15 l�..et.y'L2,
OWNER �`��i�,r'1 CONTR.
TELEPHONE NO. �� ���
� DESCRIPTION G�iY�—
l� O1 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING � 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 D. 12 WATER HOOK-UP 17 SITE INSPECTION
OS FIN 14 SEWER HOOK-UP 06 PROGRESS
� 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
Ll STOP ORDER POSTED.CALI INSPECTOR ' CITATION ISSUED
❑ INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector. ��Q,� �Gil/1�
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White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION f�QTICE SCHEDULED � '•3�
PERMIT NO. "t'�a`-1 8�I COMPLETED S �J %; 3�
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ADDRESS g�s �a��+`���g L4-�-
OWNER CONTR. ��'�
TELEPHONE NO.
� DESCRIPTION Q.e.��
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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
4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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O t l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
C] CORRECTUNSAFECONDITIONWITHIN HOURS. — pHOTOTAKEN
INSPECTOR WILL RETURN
�7 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
il, INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cal�for the next inspection 2a hours in advance. 249-4600
OwnerlCont a tor on site:
Inspecto0� v ��-t��,� 5
White Copyllnspector's File Canary CopylSite Notice
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