HomeMy WebLinkAbout1995-007268 - above ground pool PERMIT
fi CITY OF ORONO � PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - - � .�
Crystal Bay, Minnesota 55323 Permit Number:
� (612) 473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS: _ '
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FEE SUMMARY:
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CONTRACTOR: OWNER: - ''r��-°�. = =: - �-� —
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
- CHECK OFF LIST FOR ISSU'��iCE'OF PERI��IITS
FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: S 2 �v P��� PID:
DESCRIP"TION OF `�'ORK: oo t
--------------------------------------- --------------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: S3�Z 3- �i s�
BUII.,DING REVIE`V BY: DATE APPROVED: 8•z3 - yS
-------------- --
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �' No SEWER CONNECTION
STAT� SURCHARGE Yes !/ No WATER CONNEC'TION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
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ZONI�i 1G CHECK LIST Zoning District: L2-�/L Shoreland District :
Fire Department: Po Of ice• i c �District:
� � �
Lot Area: Sq.ft. Ac �Wi Depth
Survey Submitted: Yes � No Date of Survey: �5 '�b'�l S
Proposed Setbacks: ,
Front (Lake): Iv�f�- Right Side: 1 S 5 L.
Rear (Street): (5� � Left Side: SS ` N w
Adjacent Structures: t y� Wetland: nJ �A
Building Height: Def. Hgt. eak Hgt.
Avg. Setback: Bluff etbac : Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500' /s`'ja Z3`l� Snri.�..�n.c� -�-�.��:" Uo�1 �¢..c.�G
500-1000'
Hardcover Variance Required: Yes � No �_ Date of Council Approval:
Grading: Staff Approval ate: By: Council Approval Date:
i
Septic: Staff Approval at : BY�
Zoning File: # Resolution: # _ esolution Date:
REMARKS (in use).
26
BtiILDI\G REVIE�V CHECK LIST �
UBC: �/ (� CONSTRUCTION TYPE: N��-
Sq Footage � Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $_��g C�c��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
� Footing Septic Sewer Connection
Framing Fireplace Lawn Imgation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
a- Final Grading/Filling pc Electrical (State Permit)
Other
REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
27
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Total Fee: � 1 .�L� , �� � DateReceived:
DateApproved:
Entered Bv: ��,�ti� Permit#: � .�ts �`
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
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THE APPLIC�'vT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � �' � ' ' Z�'�
NAlVIE OF OWNER: ' r' t:, ,- ; ' PHONE: (home)
(work) '
MAILING ADDRESS: CITY: ' ZIP:
CONTRACTOR: PHONE:
MOBILE PHONE/PAGER:
NIAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHIT'ECT/ENGTi�1EER: PH0�1E:
MAILING ADDRESS: CITY: ZIP:
��,�: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSEDWORK(describeindetail): ' �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VAI.UATION(excludingland): $
I hereby apply for a building permit and I acknowledae 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: DATE:
NOTE! Parade of Homes events require separate pernzit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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� ,,'�� _ .,� �j'y Crystal Bay,Minnesota 55323-0066
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DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data , we would like to
inform vou that your request for a permit or license from the Ciry of Orono or any of iu
departments may require you to furnish certain private or confidential 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
�ermit or ticense.
3. The information may be shared with other local, state or federal agencies to the
extent necessary tu p:ocess the permit or license.
4. If your requested permit or license requires Council action to approve, some
information may become puolic.
5. You have certain ri�hts under M.S. 13.04 (see following page) to review private
data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRIl\"T
� �,...
`'j;��,z, �. 'c� �. v v�n m �N��
First Middle Last
, � �� ..��� �'
Address
' �_� �`i I � � 1 nU� 0
�,,j �r���,,�-�-�p ..�''� w
City State Zip Phone
I understand my rights as stated above.
Signature
1'ELEPHONE-473-7357�FaX-473-0510
1�
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision 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 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 supply 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 may nlace the notice required under this subdivision in the
individual income tax or�roverty 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 meani.ng 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 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 tune, 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 authority shall within 30 days either: (a) conect 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
• HARDCOVER CALCULATION WORKS
' SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' - 250-500' S00-1000'
� �O�O
EXISTING HARDCOVER IN ZONE
A. House �"`�� x Z �7 = 1`S �2 3 S.F.
Lengch Width
x = S.F.
R = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway � � x 3 � _ �/q�_S.F.
R = S.F.
D. Sidewalk x — S•F'
R = S.F.
E. Patio/Deck x - = S.F.
, R = S.F.
r-} 8'i S.F.
F. Landscape '3 R � —
Underlain .3 x �� _ � S.F.
By Plastic � x ) `-I = YZ S.F.
Or Fabric � a- �
� � 7��
!a-
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - 33�7,3 S.F. A
TOTAL PROPERTY AREA IN ZONE - a��88 S.F. B
A 3��3 - s aa.t %8 R ioo = ,s %
PROPOSED HARDCOVER IN ZONE
A. House S— � x � � _ �S%3 S.F.
Length Width
R = S.F.
R = S.F.
R = S.F.
B. Garage x = S.F.
C. Driveway l� x 3 � = y9�, S.F.
R = S.F.
D. Sidewalk x = S.F.
R = S.F.
E. Patio/Deck x = S.F.
R = S.F.
F. Landscape � x � 7 = � I S.F.
Underlain ,� x � 7 = �/ S.F.
By Plastic ? x ! `i = ya S.F.
" ,� r- 3e o
. Or Fabric A� ,� t.- ��o
G. Other ���,�. ,5� z � � _ / 7 `�0 S.F.
TOTAL HARDCOVER IN ZONE - 5//3 ' S.F. A
TOTAL PROPERTY AREA IN ZONE �'a 9d S.F. B
p s� i 3 — s r3�a- ►B� x 100 = ,� %
14
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DATE TIME
CITY OF ORONO CALLED IN �' �'/I`S�S
INSPECTION NOTICE SCHEDULED 'v- �U �- n•'
PERMIT NO.�.-�j� `�,' connP�ETEo �O � �
ADDRESS ��� 5 ; -�:� f��_
OWNER � �' ti CONTR. �'
TELEPHONE NO. `7� 7� � `�CJ''���
� DESCRIPTION���'`Z�
lL� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 T VAL
Z 04 WALL BD. 12 WATER HOOK-UP 7 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGR
� 07 OEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS: St�,!'
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� CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ,,, PHOTOTAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra sit :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO ��� CALLED IN
INSPECTION NOTICE �''� SCHEDULED
PERMIT NO. coMP�ETE
ADDRESS � S � ` � L �
OWNER ONTR.
TELEPHONE NO.
� DESCRIPTION � �� � �f�-
� 01 FOOTING 11 MECHAN AL RI 18 EXCA /GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE AL
Z04 WALL BD. 12 WATER HOOK-UP 7 SITE INSPECTIO
Q O5 FINAL 14 SEWER HOOK-UP PROGRESS
� 07 DEMO-SITE 27 SEPTIC MA�NT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
T 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �KSATISFACTORY:PROCEED C PROJECTCOMPLETE
W CORRECT WORK&PROCEED = ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
[] CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILLRETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance.473-7357
OwnerlContrac or sit
Inspector. �
White Copyllnspector's File Ca�ary CopylSite Notice
583571 •
4
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CERTIFICATE OF SURVEY FOR
13AN � NfARTHA �UNIIVIIIV��
OF LOT 2, BLOCK 1, IVY ESTATES
HENNEPIN COUNTY, MINNESOTA
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'•. ' � ... . " ..` . � •' "y" CEGAL""�DESCRIPTION OF PREMTSES SURVEYED :
tis8 s3�
�� Lot 2 , Block 1 , IVY ESTATES
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'o � � " o : denotes iron marker set
• : denotes iron marker found
� Bearinys shown are based upon an assumed datum .
\
This survey intends to show the boundaries of
the above described property , and the location
of an existing house thereon . It does not
purport to show any other improvements or
encroachments . �
I hereby certify that this survey ����s prepared b�- me or under my direct super- ��arE 8-16-95
� � ` � � � � vision, and that I am a duly registered Civil Engineer and Land Surveyor under
„� the laws of the State of�Minnesota. scA�E J".30,
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Ivlark S. Gronberg Minnesota Licerise Number 12755 1�B��� 95-290
�-290