HomeMy WebLinkAbout1995-006905 - 3 season porch � � PERMIT
, CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ���:_;_�
Crys�al Bay, Minnesota 55323 Permit Number: >'=,'_t;M<<-
(612)�73-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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CONTRACTOR: OWNER: - - .- -�
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��-C�L,
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j DateReceived: �/-(� � �-S
Total Fee: $ ;�,�, �.�-
Date Approved:
Entered By: ,Cl, Permit#: �f/�rj
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORiVIATION MIJST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
------------ -------------(-----------�-------- -----------------------------------------------------
THE APPLICAlvT IS: circle one OWNE OR CONTRACTOR
JOB SITE ADDRESS: �S
�c / z�: ��s'��
NAME OF OWNER: aC �CL ��� � �� � PHONE: (home) �/�3._���
J (work)
MAILINGADDRESS: �� OGr. �75' CITY: � � ZIP: �/� ����
CONTRACTOR: /�q���'� �C��V�//����/�U� PHONE: ���' �;�/�
MOBILE PHONE/PAGER:
MAILINGADDRESS: �C`�3?t� �CITY: l:nr�,;/�-�/v ZIP: S'�7/S�
STATE LICENSE: # ��</UW
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION #
TYPE OF WORK: New Addition Acr.essory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe indetail): ,�/ �` ��/� � IL�G�'!��'�/r'r'�f'I
STORIES: � SQ. FEET OF EACH FLOOR: �C/�p
NO. OF BEDROONiS: GARAGE STALLS: ATT. DET.
�n�
ESTLYIATED CONSTRUCTIONVALUATION(excludingland): $ 7 �ZO
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 approved plan.
APPLICANT'S SIGNATURE: �C� �=.._J���(�.�v_✓h.�2--- DATE: �. G" �� � /
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
9
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�! -� � C ITY of ORONO
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� � Post O�ce Box 66
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DATA PRIVACY ADVLSORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data , we would lil:e to
inform vou 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 confidenual uiformation.
You are notified that:
l. 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 aQencies 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 (see followin� page) to review private
data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRL'�'T
��c i� ��� L�z/ l L l ��-�a «���--�'l���
First Nliddle Last
� � �-�J�l� l��-(2��`( l� t � �—
Address
L c� �ir �;3� �- ti� r y �S'� �� `�"73 s^S- z v
Cirv State Zip Phone
I understand my riahts as stated above.
��.-��� L�G!��-�—�'_
Sianature
y T'ELEPHO'.V�--t73-73�7 • E��-473-0510
10
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision l. 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 concerning himself shall be informed of: (a) the purpose and
intended use of the requested data within the collecting 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 supp:y private or
confidential data; and (d) the identity of other 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 ma�place the notice required under this subdivision in the
individual income tax or propem rax 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 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 authority may require the requesting person to
pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply unmediately, 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 responsible authoriry describing the nature of
the disagreement. The responsible authority 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 data, including recipients named by the individual; or (b) notify the individual that
he believes the data to be correct. Data in dispute shall be disclosed only if the individual's
statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions
of the administrative procedure act relating to contested cases.
11
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS ORLEGAL: %�' �ic/'�'� '� ��, PID: i;; -f/.�-_,7� �%� �����Y
DESCRIPTION OF WORK: � � �—�- �'NLcl�
----------------------------- — ---------------------------------------------:----_�_________
ZONING REVIEW BY: � r ,, �.r _ DATE APPROVED• �{ �Z-�15
BUII�DING REVIEW BY: DATE APPROVED: �(-�2-�s
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r/ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes f/ No WATER CONNECTTON
INVESTIGATION PEE Yes No �— PARK FEE
SAC Yes No � STTE INSPECTION
Number of SAC Units OTHER (specify)
---------
ZONING CHECK LIST Zoning District: (Z-((3 Shoreland District : �(/8
Fire Department: � �� Post Office: .v C School District: C���,o
Lot Area: Sq.ft. 2.I� C��{S Acres , yY Width `3 7� Depth Z(1�
Survey Submitted: Yes D� No Date of Survey: //-�Z- S�
Proposed Setbacks:
Front (�ke): N//} Right Side: v��' 4�1
Rear (SEFeet): ��� ��' Left Side: �(S��'
Adjacent Structures: ,4mqci�c:'n Wetland: N//}
Building Height: Def. Hgt. �.�- Peak Hgt. b.k
Avg. Setback: N//�' Bluff Setback: il///�- Lot Coverage: (a�� "`—'
Existing Proposed
Hazdcover: 0-75'
75-250' �/�
250-500'
500-1000'
Hardcover Variance Required: Yes No OC Date of Council Approval:
Grading: Staff Approval Date: /1///-� By: Council Approval Date:
Septic: Staff Approval Date: /1! //� By:
Zoning File: 1# � Resolution: # Resolution Date: �
REMARKS (in house):
26
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BUII.DI�i 1G REVIEW CHECK LIST
UgC; 2_3 CONSTRUCTION TYPE: V ��
Sq Footage $ Per Sq Ftg
Basement R —
lst Floor X —
2nd Floor X —
Garage R —
R —
TOTAL
Estimated Construction Value: $ ��,Uo0°—"
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection � ,
� Footina Septic Sewer Connection
_�( Framing Fireplace Lawn Irrigation
_� Insulation (Masonry) Other
_�Wall Board (Mfg.) Well (State Permit)
p� Final Grading/Filling �_ 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
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Plat of Survey
far Richard W. Wa�man
of Lota L1 and 1�, Block �, Daniel's Long LakA Heights
Iiennepin Counwy, Minneaota 1�-(y,i SE�S o� PokCl-4
; �:� . cs�� o� ��o�o
�IT� t�..��J G�AI�iNG P�4..AN '
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I hereby certify that t�:ia is a true and correct representation of a .�1`:�' , � -.! `
• survey of the boundaries of Lots 11 and 12, Hlock 2, Daniel's Lc�ng Lako ��'�'
' Heights, arxd oS' the location �f all buildings, if any, thereon, end all '
' � visible encroaehmante, if anq, from or on said land. This survey is made x,`; * t f;;
onZy in conneation w�th a mortgagr� loan now being placed on the property; �- '�
and rio liabl.Iity ia aas�uned Fnceept to th� holder of such mortgag� or ar,q � ' �"
;' other intereat acquired by reaeon of auch mortgage. It is underatood a.nd , '�
� � agreed no monumPnto havo been' placq�f r the pur�se of establishing lot
lines or boundary corners. � .� � :
t .
( i i,___.�,_._._.��' �;
4hn. S. Kelley, Jr, Rc�,,� 'o. 1342 ' x i,
,; � . �rua� R. K�Iley RF�g. No. 5713 ' ;
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SQale: 1R = 50' '� . IS�+,LI��'Y & 1tET�T�EY, FY�gi.neera , • ;
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�t�.i Af�PRt)VF.0 --- CURRE�T & RESiia'�l7;
� .4•.e cCrt4!tnents �rd t�r your information_ Ail �.ro�ic shdli Ge t9ly'�r
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DATE TIME
CITY OF ORONO CALLED IN —� � `
INSPECTION NOTICE SCHEDULED ` �'Z` ` °:3D
PERMIT NO. � COMPLETED ►^ ��
ADDRESS
OWNE CONTR. 1f/r.e.,��
TELEPHONE NO. _3�c�``{ 3��
� D ION ��
01 FO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FiREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL RETURN PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR `�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE � TIME
CITY OF ORONO CALLED IN ` -5 �`S �J•s�
INSPECTION NOTICE �,� SCHEDULED S�-�s� //; �'-`'
PERMIT NO. � � COMPLETED � _IG�
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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 OS 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 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for ext spection 24 hours in advance.473-7357
Owner/Contr c r on s t :
Inspector.
White Copyllnspector's File \� Canary CopylSite Notice
��c-� DATE TIME
CITY OF ORONO � CALLED IN �r9'"�� "9-5 �
INSPECTION NOTICE;�r."� SCHEDULED (.� -/�3 9� i/: C��- a-�
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q FINA 14 SEWER HOOK-UP 06 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
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� BEFORECOVERING PERMANENT
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�NSPECTOR WILLRETURN
C STOP ORDER POSTED.CALL INSPECTOR ' ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Con�or n site:
Inspector. �
White Copylinspector's File Canary CopylSite Notice