HomeMy WebLinkAbout1994-006013 - deck � � PERMIT
CITY OF ORONO PERMIT TYPE: ,
2750 Kelley Parkway • P.O. Box 815 ���_`��;�'��tz'�
Orono. Minnesota 55356-0815 Permit Number: - - _ .
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(612) 473-7357 Date Issued: ;::�: ; _ i' `
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SITE ADDRESS:
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APPLICANT/PE EE SIGNATURE ISSUED BY,SIGNATURE .zLf�
l/
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` CITY OF ORONO - BIIIZDING PERrLZT APPLICATION
Total Fee: $ ?`>� iZ�
Date Received: �" �� ��
Date Approved:
Entered B • ' 6��- _
y' Permit�: (�C� /3
AT•T• INFORMATION MIIST BS St7BMITT� IN FOLL BEFORE PLAN REVIEW WILI� BB STARTED
(See Check-off List Enclosed)
---------------------------------------�-,----------------------------------------
THE APPLICANT IS: (circle one)� OWNER_.-or CONTRACTOR
`- --- /
r' -� �; � ��E�'�i Z IP: :� _5 ��,5 cc
JOB SITE ADDRBSS: ��'�'r--t�� �C�X
(work) �-3< - �_5 l 11
�@ �ct
NAME OF OWNER- -� j"T"��'r'� � �}�` l'�V�-�`�'�y PHONE: (home) �7-�"'S /��
HA2I�ING ADDRESS: ��`��= '� �=� S1TLF��CITY: �-�-`-�•'Lj L•�-K�' ZIP: �S 3�(�
CONTRI�CTOR: �" � PHONE:
MAILING ADDR.ESS: CITY: ZIP:
STAT'S LICENSE: �
ARCHI Z'ECT/ENGINEEFt: PHONE:
IKAII.ING ADDRBSS: CITY: ZIP:
N�: RBGISTRATION A
TYPE OF WORR: New Addition�_ Accessory Structure Move
Demo Resnodel/Alteration Renovate Land Alteration
PROPoSF.D WORR (describe in detail) : ����� ��'�'�' � � d��� � ��
i��'� k c--� l� �� 5�
STORZES: SQ. FEBT OF EACH FLaOR:
NO_ OF B$DROOMS: GARAG$ STAI.LS: ATT. DET.
g,ST12�SATED CONSTRIICTION VALIIATION (eaclnding land) : $ �?�'� � • �'r
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 ' accordanc with the approvec3 plan. . •
�PPLIC�NT'S SIGNAZ'ORE: � Yl{J� � 'L'Y�t�-_/ DATE: '7� 1 �
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C ITY of ORON�
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� _ � � On. the North Shore of Lake Minneton.ka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike 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 wi13 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 iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or 3icense 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. Your full name is required to process this applicatioa o�
permit.
�)���{'��� � -�� L�f��1,'�o/�
First Midd3e Last
��'..�'r, �-
���-L� �C� c. � ��'1
Address
� �
'L��,�ci ���� � �'� ���> � �5 ,
City State Zip
4���-- S� �- �
Phone
I derstand my ights as stated above.
.I 42 •� '��
S ' n ture �
�
BUILDING&ZONING—473-7357 • ADMINISTRATION�FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSFSSING `
_ - -�-----'-- ------------- -- ! - .
513.04 RIGfl'I5 OF SIIBJECTS �F DATA �
'vision 1. TyPe of da�- The rights of individuals on whom the data is
Subdi
stored or to be stored shall be as set forth in this section. An.individual asked to
to be given individual.
g�d. Z. Information required �ms� Sh� be informed of: (a) the
� ' supply private or confidential data concerning
ur ose and intended use of the requested data within the collecting state agency,
p p tQ�; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �own consequence arising from his
1 the requested dat8; (c) any �d (d) the identity of
required to supp y rivate or confidential data;
supplying or refusing to supply P StBte or federal law to receive the data. This.
other persons or entities authorized by lnvesti ative data,
requirement shall not apply when an individu8l is asked to supply g
P
ursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue mg plfl=t tax reound instQu�te°s�i�nateadhos
subdivision in the individuel income tax or proDe
on those orms. � �-- -
t� �� by ����L Upon request to a responsible
Subd. 3. Access
horit an individusl shalt be informed Wh ublic h r vateeor confidential.e Upon his
a u t y� u b l i c d a t a o n
individuals, and w►het her i t i s c l a s s i f i e d e s p �
e to him and, if he desires, shall
further request, an individu e �L8 without any chargtored priva te o r
individuels shall be shown th of that data• After an individual h8s been
�e informed of the content and meaning the datg need not be �isclosed to
shown the priv�an��he�a�.fte°���°a l�sPute�action pursuant to this section is
him for six m n request by
endin or additional data on Lhe individual he.s been collected or created. e
- P g ublic data uP° require the
� responsible authority shall provide copies The hresponsibler authority may
the individuel subject of the data•
cartif n and compiling the
requesting person to pay the actual costs of maldng, Y� g'
copies. ssible, with any re9uest
The responsible authority shell comoly immediatelY: if po
�e ursuant to this subdivision, or withia five �f S1I°mediategtcompltance eisu n°t
ma P �d le al hol�days,
excluding Saturdays, SundgYs g Q with the
ssible. If he cannot comply wiLh the request within that time, he shall so inform t e
P° �Ve �r► additionel five days within which to com ly
individual, and may �d Ie aI holidays•
request, excluding Saturdays, Sundays g
dtu�e when data is not accurate or complete. An individusl may
Subd. 4. Proce himself. To
contest the accuracY or completeness of public or private dat�heo��Po�ible authority
exercise this right, an individusl shall notify in wrl�
des cribing
the nature of the disagreement. The responsible authocity shall within 30
� either. (a) correct the data f ound to be i ete datae including pee�Pi�� namedt bY ,
Y5
notify past recipients of inaccurate or incomp
the individusl; or (b) notify the individuel in�v dual'Ps statementof dissgreementcis
Data in dispute shall be disclosed only � �u�t to the
• included with the disclosed data. � apPe�ed p
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases•
- '� CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDR$SS OR LE�AL: Z.2�{O F'Ok gT�-� PID:
DBSCRIPTION OF WORR: �6G-!c
--------------------- ----------------
-------------_---�_----��-�-----------
ZONING REVIEW BY: � ,..—. DATS APPROVSD / 3
BIIILDING REVIEW BY:
DATS APPROVED: t �I
----------------------- ----------------------------------,3----------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT YeS f N� SEWER CONNECTION
PLAN REVIEW Yes No
STATE SURCHARGE Yes ✓� No WATER CONNECTION
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No v SITE INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST -----------------Zoning District �2-�Q-----------------
Fire Department: Pos f ' S ol District:
Lot Area: Widt - t -
Survey Submitted: Yes �C No Date of Survey:
O ns ti=�L.C
Proposed Setbacks : i � �
Front (L�e) : N �� Right Side: -j d
Rear (S�eet) : S�d �� Lef t Side: Zb0 � "'� W
� �
Adjacent Structures: �}TT74Ct�F�d Wetland: � ��U
Building Height: Def . Hg � P k Hgt.
Avg. Setback: ot Cov rage :
Exis i g Propo ed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Requir d: es N te of Counc 1 Approval:_______
Grading: Staff A roval D te: By: Council pprova�. Date:
Septic: Staff A proval Da e: Y=
Zoning File:� e olution ResoJ.ut on Date:
gE�RgS (in use) :
I.
BIIII,DING REVIEW CHECR LIST -
IIgC: rL -3 CONSTRIICTION TYPS: ��
Sq Footage $ Per Sq Ftg
Basement X -
lst Fl�oor X
2nd Floor X -
Garage X -
x =
TOTAL
Estimated Construction Value: $ 2-�8���`
Inspections Required: Work Requiring Separate Permi.ts:
Site � Plumbing Grading/FilJ�ing
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
- O�Final (Mfg.) Other
Other WeI.J. (State Permit)
Electrical (State Permit)
-------------------------------------------
REMARRS (IN HOIISE) :
-----------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
------------------------------------------
�Ff.I�ARKS (TO BE NOTED ON PERMIT) :
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DATE / TIME
CITY OF ORONO CALLED IN i� �`r
INSPECTION NOTICE l� SCHEDULED `� �`� r ' ��
PERMIT NO. �� ( / COMPLETED ��
ADDRESS � % % = '
OWNER �' _ --e CONTR. ��!�%;�
TELEPH�NE NO. T�I "� �l�
� DESCRIPTION �-�J
� 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINA� 18 EXCAVIGRADING/FILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
�
Z 04 L D. 12 WATER HOOK-UP 34 TREE REMOVAL
05 FINAL . 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� �ORKSATISFACTORY:PROCEED � PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� C� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
❑ INSPECTION FiEQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contrac o ite: _
Inspector. �-
White Copyllnspector's ile Canary CopylSite Notice
// DA/T!E � TIME
CITY OF ORONO CALLED IN `1 �7 �f
INSPECTION NOTICE SCHEDULED `� - � � `� � �'`�
PERMIT NO. �DO�3 COMPLETED � �_
ADDRESS � `� ��' ' J��
OWNER �Z-�^�� CONTR. —
TELEPHONE NO. �3� - � � ��
� DESCRIPTION �-�`�-�
�t FOOTIN�ij 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 IAKESHOREIWETLANDS
�
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET(fURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. CPHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
� INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-7357
OwnedContract r n s :
Inspector.
White Copyllnspector's File Canary CopylSite Notice