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Home My WebLink About1997-008937 - extend deck� Total Fee: $ � � � 't'� Date Received: �f�,,2, ��97 Entered By: �'_ Permit#: ��;' �� r CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) ;�WNER;OR CONTRACTOR JOB SITE ADDRESS: ,i L.`.� l"lc�lI� � �G��'" : �l t�� ZIP: � 7 ;3 �� f NAME OF OWNER: � �-,; ,,f-� �c�, 7/ ��e��r�� , � PHONE: (home) �-�C-�-�� 1 (wark) ��z.�� "� `� 7�`/ MAILING ADDRESS: 11.,j f�� 4��c�r', �i'� /. CITY: � : ,� � 1 i ZIP: �5 3�r l CONTRACTOR: i��.��n�i l� I l� �`�f r� > >c�;, � PHONE: `7 3 � �� c %, CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: L�c yf. L�: k� I—',c.u�d ,, '�c- _ CITY: ��I�,�,�<,��u l� ZIP: �,;<< > ..Z STATE LICENSE: # ��, 3 i y ,5 � 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 detain: � t;4c� k.� �- a��,� '�� (r' � � .5� r c,. f��, i� r �� c�r`1 STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ _-�� (_(_, 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.{ �� ' � � i✓�.�_ DAT`E: ; r ;,� 7 �--- NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. 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 indi�idual. An individual asked to supply private or confidential data conceming 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 supply private or confidential data;and(d)the identiry 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 mav place the notice required under this subdivision in[he 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 authoriry, an individual shall be informed whether he is the subject of stored data on individuals, and whether it is ctassified as public,private or confidential. Upon his further request,an individual who is the subject of srored private or public data on individuals shall be shown the data without any charge to him and, if he desires, sha(I be informed of the content and meaning of that data. After an individuat 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 ro this section is pending or additional 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 responsibie authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,exduding 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 authority 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 nodfy 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 correcL 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 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. i �;. �1� '�r's �" � \��i. � `i'`1\�� i l��l 1� �-' �1 � First � � Middle Last r �C'S �I(:II[X i�l�t'� —RG�� • Address � i�c � �1��1 i�; '�'% .�`l l `/C r�-c.��. �� Ciry State Zip Phone I understar�d my rights as stated above. � � ' �,�, �I �= :�v ; . � Signature 6 � r ' ' CHECK OFF LIST FOR ISSUANCE OF PERiI�IITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: ��u� r-1��-`„'�N=�e.'L +�� PID: DESCRIPT'ION OF WORK: ��1, ;=t�. --------------------------------------------------------------------------------------------------------------------- ZONING REVIEW BY: � �,-,,,r�._ DATE APPROVED: �/. 3� �; 7 BUILDING REVIEW BY: `'.�;,�,�._ DATE APPROVED: Y-3:: �; 7 '_--'--------�-------------"'----_____�--__r _'----_��'__------_"'_"---'-----'___-_'_----_'_--___-'____"--------� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �" No PLAN REVIEW Yes �' No SEWER CONNECTTON STATE SUR`�iARCrE Yes � No WATER CONNECTTON INVESTIGAZ'ION-FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZOl�'Ti�1G CHECK LIST Zoning District: �Q�i C� Fire Department: Post O�ce: School District: t��y� � [Area: Sq.ft. Acres Width Depth Survey Submitted: Yes � No Date of Survey: Z��Z-E> 7 Proposed Setbacks: � Front (Lake): 1�'i� � Right Side: I 130 ' ' Rear (Street): �oS�� Left Side: �13� �— Adjacent Structures: !��:-�+c::i'� Wetland: �i I A Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: �, . Zoning File: # Resolution: /t Resolution Date: ��. Shoreland Dist:ict: Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' � 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): • 26 � i � BUII..DING REVIEW CHECK LIST usc: r-� covs�ucTTov �rE: �/;� Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 3_c�c•='` Inspections Required: �Vork Requiring Separate Permits: Site . Plumbing Fire Hardcover Removal Mechanical Water Connection �C Footing Septic Sewer Connection ,� Framing Fireplace Lawn Inigation Insulation (Masonry) Other Wall Board (blfg.) Well (State Pemut) � Final Grading/Filling Electrical (State Permit) Other REMARKS (Ti�1 HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERNIITj: � 27 DATE TIME CITY OF ORONO CALLED IN - O- 1` 7 INSPECTION NOTICE SCHEDULED �_ � PERMIT N0. `�3� COMPLETED �� _ ADDRESS �DS C��-C.�CC�rt�C�'t- �°� OWNER `��1 CONTR. � TELEPHONE N0. �� — �� DESCRIPTION �"R'�`�� 11 MECHANICALHI 18IXCAV/GRADINQ/FIWNG � 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS q 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER MOOK-UP 17 SITE INSPECTION e OS FINAL 14 SEWER HOOK-UP 06 PROdRESS I �` 07 DEM�SITE 27 SEPTIC MAINT. 27 COMPLAINT v W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBINQ FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O ti ti � Q � Z W � W � � � WORK SATISFACTORY:PROCEED W� -: PROJECTCOMPLETE W ❑CORAECT WORK 8 PROCEED � ISSUE CERT�FICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. r- pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR = CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. CaU for the next' spection 24 hours in advance.473-7357 OwnerlContract s' e � Inspector: White Copyllnspector's Fil Canary CopylSite Notice � D��9 9 7 .T_s� CITY OF ORONO CALLED IN ' INSPECTION NOTICE Z SCHEDULED :3d-�i 7 PERMIT NO. ��J� COMPLETED � ADDRESS �� Q�Y? OWNER �C p .c ��-!�:�CONTR. �#-1n1�,.. Cat.rO. TELEPHONE NO. _ �U� - U 3 Co � � DESCRIPTION � � � 01 FOOTINCi 11 MECHANICAL RI 18 EXCAV/GRADINO/FILLINd y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHOREJWETLANUS Q 03 INSULATION 24/25 WOOD BURNER/FlREPLACE 34 TREE REMOVAL Z 04; WP�BD. 12 WATER NOOK-UP 17 SITE INSPECTION = FINAL 14 SEWEH HOOK-UP O6 PHOGRESS ~ 07 DEMO–SITE 27 SEPTIC MAINT. 21 COMPLAINT J W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP Z 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBINf3 FINAL 28 CEDAR SHINGLES 36 FOUNOATION REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � 2 W � W � J � �ORK SATISFACTORY:PROCEED - PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ` ❑STOP OROER POSTED.CALL INSPECTOR '�CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspe tion 24 hours in advance.473-7357 OwnerlContractor o s' . Inspector. � White Copyllnspector's File Canary Copy/Site Notice � �� o � �' j Certificate ofi Survey for Paul J. Merz g� in Lots 4 & 5, Block 1 , HOLLY ACRES 2ND AD�tT10N 11�� Hennepin County, Minnesota � q0 y�� . �o Sfo� So �i� . �,3g��92 yy�wQ y , � . '-- NGt�corncr �=2 � 6 � oFLof�¢ ¢¢j3, � � Q �� /10 t� (� ^ a_3o �p �\ �� 3�38/ \ �� o � � cr� oF o� : � Q�DIN� IN�At� ��iv� � �C SITE PI.AN —�.e. ` .� ^�w�y 1�� APPROVED— '��-u � � 99,0( oFcof¢ � ` � , ❑ �gP�OVED W1TH R�VISIONS � �—_ � � i� �1�d�f'RROVE �� 2 � _�0- 5�1 \Q�� Uo.� ` DA�E z �o o�,`� �� _ �ti�' «�9� � � w ,9�.0, ° ! � \ �69' �y�� , \\ , r,,• 'a� •`o�.��---- ---l0 r ---------- --- �� ii �7.� ;� 4� y / .� �' i,._ i1: �2, Y �JO .. r`ql., iQ:T('W� :r � , ��oh, _ "t. y � �SQo "� � r�O -� �:� 02 S'' �9� 3d . �v ,�;�� q4?� �� ; ' , Q ' d.-�q.-J � � q � �� . �,, , �., SE cornei'o� �„!� i� �� .t�i;,��^� �-of4 _� �� C:'��.��^) _. '.:lili''�r��l'`��:i ��..��`� ; � ' ��,u�:f:4�i'�1ri.� � ;, � �� {� ir'��f\C; � � �� ;�)..�•1..� ��St,��is_��1, ;�J � '1��'' 1,,1-;t:r,.�,• �, � . �,�41)fi� ; �1 �Y _�� --- --�_:�_g�__� _.r � 51�1'I line I DP,i ��. ---- _____--- �8 of�Yts �8' � I hereby cert i fy that th i s i s a true and correct representat i on of a survey 1 SE cor�er of the boundaries of the following described property: _ % oF�ofs -� That part of Lot 4, Block 1 , HOLLY ACRES 2ND ADDITION, according to the recorded plat ; thereof, lying northerly of a line drawn northwesterly from the southeast corner of said 2j�j , '� Lot 4 to a point on the Northwesterly line of said Lot 4, distant 231 .69 feet southwest of the � Northwest corner thereof, ' ALSO That part of Lot 5, Qlock 1 , HOLLY ACRES 2ND ADDITION, according to the recorded plat thereof, lying westerly of a line drawn southerly from the nort_hw�st. corner of said Lot 5 to a point on the Sout.hwest- erly line of said Lot 5, distant 231 .37 feet northwest of the soutl�east corner thereof, the location of all existing buildings, if any, thereon, and the proposed location of a proposed building. It does not purport to show any other improvements or enc��oachments. � COFFIN & GRONBERG, INC. 7��„��t,Z.�� Scale: 1 inch = 50 feet Mark S. Gronberg MN. Lic. No�. 12755 Date : February 12, 1987,r« 6-2'-8� Gordon R. Coffin f�1N. Lic. No. 6064 o : Iron marker Engineers, Land Surveyors, PlannPrs rl,-4� : Spot elevation (assurned datum) Long Lake, Minnesota '7-•��`�