HomeMy WebLinkAbout1998-010451 - deck addition , PERMIT
• " CITY OF ORONO PERMIT TYPE: -
2750 Kelley Parkway- P.O. Box 66 �"°�-'��'-.`i#`"`='
Crystal Bay, Minnesota 55323 Permit Number: :_3;r;;�=�
(612) 473-7357 Date Issued: ;;::;�;;��=,���;;_;
SITE ADDRESS: -
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: — �����°� 3�=��i�� —
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� '
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� Total Fee: $ � ���� � ' Date Received:
Entered By: ��. Pernut#: j�'
CITY OF ORONO - BI.TII..DING PERNIIT A3PPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------- - - ----------------------
THE APPLICANT IS: (circle one) OWNE OR CONTRACTOR
JOB SITE ADARESS: �� �o �C��� ��� � 'L7�U�ZIP: �5� S�
NAME OF O`�NER: V�� t- �A� l ,�o,� PHONE: (home) �7�-����
(work) '��{—/.S�g
MAILP�tG ADDRESS: S�-rn� CITY: L,, L�u ZIP: �'`3.5�
C0�ITRACTOR: � j -F PHO�TE:
CONTACT PERSON: � MOBILElPAGER:
MAILI�i 1G ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHIT'ECT/ENGINEER: PHO��tE:
MA.ILI�i 1G ADDRESS: CITY: ZIP:
rJ�,ME; REGISTRA.TION#
TYPE OF `VOR�i: New Addition_� Accessory Structure
Move � Remodel/Alteration Land Alteration
PROPOSED`VORK(describe in detain: ���� �-�,:� h G�-� C�.�
STORIES: SQ. FEET OF EACH FLOOR: -
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�i IA.TED CONSTRUCTION VALUATION (excluding land): $ a,��C�
I hereby apply for a buildin�permit and I acknowledje that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with
the State BuildinJ Code; that I understand this is not a permit and work is not to start without a
pernut; and that the work will be in accordance with the approved plan.
4
APPLICAI�T'S SIGNAT'URE: Je DAT'E: � ��( - J`r�
NOTE! Parade o Flomes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
�
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Sec.13.0�RIGHTS OF SUBJECTS OF D.aTA
Subd. 1. Type oF data. "Ih�righ�s of individual on whom che data is stored or to be scored shali be as set forth in this secaoo.
Subd.2. Informatien reqtrired to be givea indiridual. An icdividual asked to supply private or confideaaal dara concerniag himself shall
be informed of: (a) the purpose and in�:nded use of the requesced dara wichin[he colleccing§tare a�eacy,polidcal subdivision,or sratewide rysum;
(b)whether he may refitse or is legaliy requir.d to supply the tequested data;(c)any�own consequouce arising from his supplying or refusiag to supply
privace oreonfidenaal data;ar.d(d)the idenary of ocher persoas or endd:s au�horized by sta�e or federal law ro receive the data. This requiremen�shall
no�apply when an individual is asked to supply invcsdeadve data, pursuan�to secdon 13.83,subdivision 5, to a law enforcement ofricer. -
'Ihe commission�r of revenu� mav pla-e ch^ noric- rauired und�r this subdivision in the individual u:come nx or orooern taz refund
inscrucrians ins�ead of on those foRns.
Subd. 3. Access to data by indi�-idual. lipon request to a responsible au�horiry,an individual shall be informed whe�her he is the subjecc
of scored da[a on individuals,and whech�r ic is classified as public,private or confedenrial. Upon his furtber reques�,an individual who is the subjecc
of stored private or public dara on individuals shall be shown che dati wi�houc any charge to him and;if he desires, shall be informed of the coacenc
and meaning of�hat dara. After an individu�l has been shown che priva�e data and informed of irs meaning,che dara nzed noc be disclosed to him for
siz monchs chereafter uriless a dispuce or acdon pursuan�to [his secaon is pznding or addidonal data on the individual has beea colleckd or creaced.
Thz responsibl�auchoriry shall provide copies of the privace or public data upon requesc by the individual subjecc of[he data. The responsible auchoriry
may require che requesring person to pay the accual cosu of making, cerafying,and compiling the copies.
The responsible aurhoriry shall compiy immediacely,if possible, wirh any reques�made pursuant to[his subdivision,or wichin five days of
the da�e of�he request,excluding Saturdays,Sundays and legai holidays,if immediate compliance is not possible. If he cannot comply wich the requesc
wichin that time,he sha(1 so inform the individual,and may have an addirional Five days within which to comply wich che requesc,ezcluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accumcy or completeness of public or pri�•ate
data concerning himself. To exercise this ri¢hc,an individual shall noa"ry in wridng che responsib(e auchoriry describing the nature of the disagreemenc.
The responsible authoriry shall within 30 days eichcr: (a)corrcc[he data found to be inaccurate or incomplece and attempt to noafy past recipiencs of
inaccurate or incomplece data, including recipients named by che individual;or(b)noufy the individual tha[he believes che data to be correcc. Data
in dispute ahall be disclosed only if the ir:dividual's sc3temenc of disagreement is included wich[he disclosed data.
'Ihe decerminarion of the rzsponsibte authoriry may be appealed pursuanc to the provisions of the admirtisaarive procedure acc relaring to
contested cases.
DATA PRIVACY ADVISORY
In accordance wich M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would like to inform you that your request
for a permi[ or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential informacion.
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, bu� refusal may require that the City deny the permit or license.
3. The information may be shared wich ocher local, state or federal a�encies co the ex�ent necessary to process
� the permit or license.
4. If your requested permit or license requ'tres Council action to approve, some informa[ion 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 permic.
First �Siddiz Last
Address .
Ciry Srate Zip Phone
I understa.�d my ri;hts as stated above.
�
Signa�ure
� CHECK OFF LIST FOR ISSUANCE OF PERiI�IITS
FOR OFFICE USE ONLY
ADDRESS ORLEGAL: �S C����`.ti V,���,�, ,��� �
,
PID: �, �� - . .i �>
DESCRIl'TION OF WORK: ��_
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- ----------------------
ZONING REV�tiV BY: � .. DATE APPROVED: `]- � -4�G
BUILDING REVIEW BY: s �...c..:_ DATE APPROVED: �� - � - +�;��,
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FEES TO BE CHA.RGED: Misc. �ees Calculated By:
PERMIT Yes ��'' No '
PLAN REV�W Yes _� No SEW�Z CO�INECTION
STATE SUR`HARG� Yes ::� No WATER CO�NECTION
INVESTIGAT'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
-------------------------------------- -----
ZONING CHECK LIST Zoning District: !I(�-fC
���2. Fire Department: Post O�ce: School District:
��1
L Lot Area: Sq.ft. Acres `Vidth Depth
Survey Submitted: Yes_� No Date of Survey: �,� (���
Proposed Setbacks:
Front (L�ace): I ��i ± Right Side: -?i� ±
Rear E&��eet): 3��` � � Left Side: �(U ` _f
Adjacent Structures: /4-���:� �Vetland: �t,� (/}
Building Height: Def. Hgt. �t/{ Peak H�t.
0
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: gy;
Zoni.ng File: # Resolution: # Resolution Date:
�� Shoreland Dis�ict: �
� Avg. Setback: Bluff Setback: I.ot Covera�e:
� Ezisting Proposed �
Hardcover: 0-75'
75-250' .
250-500' .
500-1000'
� Hardcover Variance Required: Yes No Date of Council Approval:
,
RE11�ZA.RKS (in house):
x
, • � 26 .
,
.
BUII,DTNG REVIEW CflECK LIST .
vBc: � - 3 covs�xUc�ov�E: U,.�
� Sq Footage $ Per Sq Ft?
Basement x
lst Floor . x —
2nd Floor . x . _ .
Garage � -'
x
, TOTAL
Estimated Construction Value: $ 'Z,S�j��(� �
Inspections Required: • Work Requirina Separate Permits:
Site Plumbin� Fire
Hardcover Removai Mechanical
� Footing Se tic water Connection
. _� Framiug P Sewer Connection �
Fireplace Lawn Irri ation
Insulation (Masonry) o�' Other �v:;�
—� F��Board (ttilfg.) Well (State Permit)
Other GradinJ/Filling Electrical (State Perm.it)
----------------------- _____
REi1�IARKS (IN HOUSE): � - -----_----______
---------------------------------
REVIEW BY OTI3ERS: ----------------------------_�_------------
DATE:
Access: Eziscing New �
• Access Approval; Date
----------------------------------
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REMARKS (TO BE NOTED ON PERltiiIT): � .��;,,,,,, t � ��
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DAT . TIME
CITY OF ORONO CALLED IN ��� • �
INSPECTION NOTIC (/ C SCHEDULED � "I /c.'� �>
PERMIT NO. �-' r `J / COMPLETED i'
ADDRESS -7 � � % ���-
OWNER �C� CONTR. ��''Z-�
TELEPHONE NO. —t 7 -� � � f ��
� DESCRIPTION����-fZ-= / ��'��`L�""'�i ��-'�`2��D�-r_
ty� 01 FOOTING 11 MECHANICAL RI 8 EXCAV/GRADIN /FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FtNAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED f_": ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -, pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ' ' CITATION ISSUED
❑ INSPECTION REQUIRED.CA�L TO ARRANGE ACCESS.
Call for the next� spection 24 hours in advance.473-73�J7
OwnerlContra r s�
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
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