HomeMy WebLinkAbout1997-008981 - 3 season porch PERMIT
CITY Q�' ORONO PERMIT TYPE: .. _.
2750 Kelley Parkway- P.O. Box 66 �::r;._�>>.���-'.;
Crystal Bay, Minnesota 55323 Permit Number. � -•
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(612)473-'357 , Date Issued: '- ; :- -:�; il
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -- ��;�:�_ _ _ :.:-�t. — :- �. _- - OWNER:
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� Total Fee: $ =� � ` Date Received: �f- � - << 7
Entered By: Permit#: `' . '
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-----------------------------------------------------------------------------�=y...-----_�---------------------------
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR�
._----�
JOB SITE ADDRESS: ��`'� �-� t:� E% ��� �' /��J ZIP:
NAME OF OWNER: l�`��< ,/� �✓J� l��; PHONE: (home) ��� -`t���� �
/, (work)
MAILING ADDRESS: '�%�: �-�r/�c,�,<��° %" ,/� CITY: %�,` ,,:�� ZIP: S� ?�' /
CONTRACT012: I r='c✓ �� ���-�-� I� PHONE: '�/,��1�� %��/�
CONTA LT PERSON: i✓I�BILE/PAGER:
MAILIN�G ADDRES�: >>�Ci� � ��.-, ' '
_ ,�, _.,t:,,� �� CT'�'Y:,,`y ���,�,,- �,.�C ZIP: ���'-�`�
STATE LICENSE: # ..� �i� �'
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 detai�: ,x���,/✓ �� J Sr'�.��; ���c�� O-ti'
��;� ( ;��i, �',Y'.(„ _ 1 I.�:/i.�
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTI'VIATED CONSTRUCTION VALUATION (excluding land): $ f� ,�G�G
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.
;i
APPLICANT'S SIGNATURE: ��-f�l'(��,C'���� DAT'E: �- ��� �
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NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
5
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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 individual. 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 confidenrial 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 nlace the notice reauired under this subdivision in the individuat income tax or�rooertv tax 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 authoriry 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 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 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 conceming 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 foand to be inaccurate or incomplete and attempt to notify
past recipiencs 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 deternunation of the responsible authoriry may be appealed pursuant to the provisions of the adminisuative 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 fumish 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.
�-�� c ie �� �s��/w� �/
First Mi dle Last
�G/ a ,� - S
d�S� o�oU cs ��� /'��/ �S�Ll/� 9'0?�-93���
Ci�y State Zip Phone
I understand my 'ghts as sta ove.
;
Si tuce
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �G' �'�--C�-��-���� Q
PID:
DESCRIPTION OF WORK: � , � ", ��
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�
ZONING REVIEW BY: c� hv�L--- DATE APPROVED: -; - � s - �'7
BUILDING REVIEW BY: `' ����..�� DATE APPROVED: r- �5 - �i�7
------------' -------------------------------------y.-------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated B
PERMIT Yes �/ No
PLAN REVIEW Yes ✓� No SEWER CONNEC'ITON
STATE SUR:HARG� Yes � No WATERCONNECTION
INVESTIGA'I'ION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: {'�('�- ��- �
Fire Department: �.ti,rti�U�� lCz:_ Post Office: l� \� w ' " School District: �(��::n.;�
Lot Area: Sq.ft. yU� C,'t�ti%Cx: Acres Width Depth
Survey Submitted: Yes ;X No Date of Survey: Z'Z�y ct`-{
Proposed Setbacks:
Front (Lake): I Za� � Right Side: l 2 2� � W
Rear (Street): Z 5 L' { Left Side: g� � �' �
Adjacent Structures: �-n-�i�i-d� Wetland: J�.� (,�
Building Height: Def. Hgt. ��� Peak Hgt. �,k
Lot Coverage: C���
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: !t Resolution: # Resolution Date:
�Shoreland Dist:ict: __
,,F �`�-- Avg. Setback: Bluff Setback: L.ot Coverage:
�1 Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
• 26
BUII,DING REVIEW CHECK LIST
UBC: tZ � CONSTRUCTION TYPE: V YU
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ j�j,��� K�
—�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
;X Footing Septic Sewer Connection
_✓ Framing Fireplace Lawn Irrigation
X Insulation (Masonry) Other
.+�( Wall Board (Mfg.) Well (State Permit)
K Final Grading/Filling � Electrical (State Pemut)
Other
REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE NOTED ON PERMIT):
27
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9ATE TIME
CITY OF ORONO CALLED IN -� /.�7/�J
INSPECTION NOTICE SCHEDULED U �n
PERMIT NO. � �� '� � COMPLETED �_
ADDRESS � � �C% � ����.=�-�- ,� , � �-�,
-�,,�, �
OWNER ��// «c����� CONTR. :_ � cC���_�-'EC_
TELEPHONENO. ���`' '�%�`�"��
� DESCRIPTION
.�--�-,
� �01 FOOTING 11 MECHANICAL RI i8 EXCAV/GRADING/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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�� ORK SATISFACTORY:PROCEED
PROJECT COMPLETE
W C' CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O C' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,-- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73J�7
Owner/Contractor on sit .
Inspector. �
White Copyll�spector's File Canary Copy/Site Notice
D TE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 9' 9: 30
PERMIT N0. S9 �� COMPLETED � l(_
ADDRESS
OWNER CONTR.
TELEPHONENO. 9.Z-ri -�..3'Sl-Zi
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 IXCAV/GRADING/FIWNO
� 2 F N 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 FINAL 14 SEWER HOOK-UP O6 PROGRESS
F` 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBIN 28 CEDAR Sy1NGLES 36 FOUNDATION REMOVAL
� OWNER/�TO MEET YOU:«YES_NO
� COMMENTS:
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� �WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
W
� L. CORRECT WORK&PROCEED :iSSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR
G CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContr n�ite
Inspector. � �`,
White Copyllnspector's File Canary Copy/Site Notice
DATE TIM
CITY OF ORONO CALLED IN 30 �'/ � �
INSPECTION NOTICE SCHEOULED � ��- �i 7 ��
PERMIT NO. COMPLETEO �
ADDRESS
OWNER�1'JQ�i��,c...v CONTR�
TELEPHONE NO. � - � 3 �
� DESCRIPTION ����-r� 61(��j
� 07 FOOTINCi 11 MECHANICAL RI 18 IXCAV/ORADIN�/FIWNO
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORElWETLANDS
0 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
ITE 27 SEPTiC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL. � 22 FOLLOW-UP
= 09 PLUMBIN(3 RI 23 SEPTIC FlNAL 35 HARD COVEii REMOVAL
v 10 PLUMBINQ FINAL 2$CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED
W� PROJECT COMPLETE
W L CORRECT WOAK&PROCEED ; ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILI REfURN
❑STOP ORDER POSTED.CALL INSPECTOR '^ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCont o te:
Inspector.
White Copylinspector's Fi Canary Copy/Site Notfce
, ��� ,�/�//Q;���,- ,��•��� 6005�• I2 � ��?�s� (��• o��
SUI�V�Y FOR; STE11�lE� AN1J �COpAL�'1�?AN, �NC. . Prepared By: `
} ?9 , � SCHOELL & MADSON, lNC.
� I ?3. . r�j �S � ENGINEERS • SUAYEYORS
. '• , �3 0�0�o M�/��
p. � �-Te�. rlSe�' . •, •••••••••• _�-PLANNERS • SOIL TESTtNG
��S �� .--. 10550 WAYZATA BWD.
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DESCRIPTION ' 455.25-... ���—'..�� -
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Lot Z, Blocic 1, Holly Acres, according to the recorded plat thereof. 2 0.0:•.�
.. . �-•` � '
. . . . .. • . . .. -. : . . • . 30�
GENERAL NOTES: �
1. • - Denotes iron monument found.
2. a - Denotes nail set. I hereby certify that this survey was prepared under my supervision and that I
am a Licensed Land Surveyor under the laws of the State of innesota.
Date: October 1, 1990 �
Febrvary 28� l99� Theodore D. Kemna
� Land Surveyor MN Lic. No. 17006 -�
�