HomeMy WebLinkAbout1996-008068 - decorative wall � , PERMIT
, CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:i_!T[,_r:a T��[;
Crystal Bay, Minnesota 55323 Permit Number: _ _ _ . __.
Date Issued: `_""''"'`''i�"" `
(612) 473-7357 �;�=.:'�F.;'`�%`
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ p:��,�,� �F�;S"i t. _ :_;i . �_��: OWNER:
��=�r::E G��ss_�iw��r�Y E;t:I LC=�t�'�� s 47��.i i�.�1 �.=�;w,r�� _:�'.'���t��I�it.��f=±t� I��
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APPLI NT%PERMITE SIGN URE ISSUED BY:SIGNATURE n-�.
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• Total Fee: S -%��' � � � � DateReceived: l�� - 1v� 'r,_
� DateApproved:
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Entered By: ' � =� Permit#:,�;�.�: i�� _
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CITY OF ORONO - BUILDING PERII�IIT APPLICATION
AI.L Ti�TF'ORNIATION�IUST BE SLB�IITTED IN FULL BEFORE PLt��r REVIEW WII..L
BE STARTED
----------------------------------------------------------------------- -_ - ----------=--4_----------------------
THE �iPPLIC��1T IS: (circle one) OWNER OR�ONTRACTOR '
�-- ---
JOB SITE �1DDRESS: � � ��'� G'�� ��'12 L�� _ ZIP: 5����s-s�
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NA.�y1E OF OWNER � � � ',��.��,�, �r�r,�, __ PHONE: (home)
;� (work)
NIAILIl�'GADDRESS: :� '-c.�-, �c,�.� ��; CITY: �. , {��, �, ZIP: Ss".�s(,
CONTRACTOR �.� �'r� (��,,,.�i r�_-i �"�L�YL� PHONE: L/ 7�- �%�- / _
�IOBILE PHONE/PAGER: ��%�',� Y J�
MAILINGADDRESS: ; ��o �r�� S� CITY: �-- � c'�C.s��;���' ZIP: ����1
STATE LICENSE: # ��;�-�(�_
ARCHITECT/ENGliYEER: f r� k'� �'�,� ,��tz � PHO�IE: �/ ��/ - 7/,�- �
iVIAILPitGADDRESS: '33�7 L`��-.!� �,.'i_ CITY: 1` �'c��'�5;�.,r ZIP: Ss =�-��
NA.IVIE: <, , ;j �_ c-" ,_; , w- . REGIST'R.ATION #
TYPE OF WORK: New Addition k C�-R�� Accessory Structure
Move Remodel/Alteration Land Alteradon
PROPOSED WORK(describe indetail): ��, ��'� � �r�-�-�. ���i,`t�� ,-<> ;�=� t� . c l�
iZ �� c� *� '� E� �1� ��}�� �� �
STORIES: - SQ. FEET OF EACH FLOOR !V
NO. OF BEDROO�IS: GARAGE STALLS: ATT. DET. ��
EST��,TED CONSTRUCTION VAI.UATION(escluding land): $ � �' s �� �''
I hereby appl_y for a buildin� 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 Buildin� Code; that I underst nd t�}s is not a permit and �vork is not to start
without a ermit; and that the work will be iq��ccbrdance with the'approved plan.
P
PLIC��'T'S SIGNATURE:,--�`��� � � DATE: ;�� �'� ��
f1P , ,
NOTE! Parade of Homes events require separate p��t_,approval by Police Department and
City Council 60 days prior to the event. 1Von permitted events wiZ1 not be allowed.
�
Sec.13.04 RIGHTS OF SUB.TECTS OF D�TA
Subd. 1. Type of data. The righLs of individual on whom the data is stored or to be stored shall be as set fonh in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply privace or co�dendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or co�denaa!data;and(d)che identiry of other persons or enaties auchorized by state or federal law to�eceive the data. This requirement shall
not apply when an individual is asked to supply investigadve dara, pursuant ro secrion 13.82, subdivision 5, to a taw enforcement officer.
The commissioner of revenue mav place [he norice required under this subdivision in the individual income tax or propem tax refund
instrucdons inscead 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 individuais, and whe[her it is classified as public, priva[e or co�denrial. Upon his fur[her request, an individual who is the subjec[
of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires, shall be informed of the co�tent
and meaning of that data. Afrer an individual has been shown the private data and informed of irs meaning,the data need not be disclosed[o him for
six months thereafter uriless a dispute or action pursuant to this secdon is pending or addirio�al data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requescing 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 no[possible. If he cannot comply with the requesc
within that titne,he shall so inform the individual,and may have an addidonal 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 conceming himself. To exercise this right,an individual shall notify in wriung 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 incomptete and atcempt to nodfy past recipients of
inaccurate or incomplete data, including recipiencs named by the individual; or(b) notify the individual that he believes che data to be correct. Data
in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data.
Tne determinacion of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relacing to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riehts of subjects of data", we would like to inform you that your request
� for a pernut 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 a�encies to the extent necessary to process
the pernut or license.
4. If your requested pernut 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.
• —_ _� _ � ,
`-�.�= j -<' (r � � ' L ( �� � --�!j t �,�c� ,�
First Middlz Last
,� .�� �� ��
Address 1 )
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Ciry l i State Zip Phone
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I understand m�y�ghts as state�above. ,-
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Si ture
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- CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ' + � � � -! ; -
PID:
DESCRIPTION OF WORK: ' � ;: �;,� �� ; t- � -.- ��
------------------------------------------------------------------------------------------------------------------------
ZONING REVIEV6V BY: -x�'. � �, DATE APPROVED: �'-�'�—`lC�
BUILDING REVIEW BY: � '• -(,,; ? ;��.y� DATE APPROVED: G i Y `t�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: (Z�'•-)��
Fire Department: Post Off ce: School District:
�G
�nr�..- t Area: Sq.ft. Acres Width Depth
�.t
Survey Submitted: Yes_� No Date of Survey: p�.! 1=��-�
Proposed Setbacks:
Front (Lake): Z�S Right Side: �-(Z �
Rear (Street): /����' Left Side: �r�
Adjacent Structures: ��-�4c,�+-c_-� Wetland: N 1/f'
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By�
Zoning File: #� Resolution: # Resolution Date:
Shoreland District:
•' �C Avg. Setback: Bluff Setback:
��� Existing Proposed
Hardcover: 0-75
75-250'
250-500'
SOO-IOOO'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
BUII.DING REVIEW CHECK LIST
uBc: /'�,- � coNSTxuc�ox �-YrE: �//�
Sq Foota�e S Per Sq Ft�
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �,r5 �u
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
Wali Board (Mfg.) Well (State Pemut)
�7�- Final Grading/Filling Electrical (State Permit)
Other
REMARKS (ni 1 HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
RENIARKS(TO BE NOTED ON PERi'�1IT):
27
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BUILDERS ,„�
CUNNINGT4N
RESIDENCE
2300 FOX STREET
ORONO, MN
BRICK WING WALL EXTENSIC�N
P LANS AN D
CQNSTRUCT
ION BY
LAKE COUNTRY BUILDERS
339 SECOND STREET
EXCELSIOR, MN
474-7121 h���� � � . � �� �- =��� N.�
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339 Second Street • Excelsior, Minnesota 55331 • (612) 474-7121 • FAX 474-7957
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certtty th�t tf�ie plon, eurvey ar �pF� /
pr�p�red by me or under my dlydct
and th�t I a�a • duly Reqistered^«y w _ i_ `_ r cr�n p
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DATE TIME '
CITY OF ORONO CALLED IN
INSPECTION NOTICE scHEou�Eo G L� 4� f��°a
PERMIT N0. fC- �=" � connP�ErEo �-Z� "�I(9 l ( ?�
ADDRESS �3�U i—�x
OWNER L.��vi,�.+c.,1vN CONTR. CJ.��ct. C_-���,Tv�.,
TELEPHONE NO.
� DESCRIPTION
� �FOOTIN� 11 MECHANICAL RI 19IXCAV/GRADINQ/FIWNO
y 02 FRAMING 13 MECHANICAL FINAL 19 LAi�SHORE/WETtANDS
Q 03 INSULATION 24/25 WOpD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER FIOOK-UO 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPlA1NT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBIN(3 RI 23 SEPTIC FINAL 35 HAFtD COVER REMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED = PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCont or o
s
Inspector.
White Copylinspector's File Canary CopylSite Notice