HomeMy WebLinkAbout1999 - no permit DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED lo -Lo -SS
ADDRESS �7 S S�''Ow�✓
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLIN
.� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAND
y 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 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
� COMMENT :
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d ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANC
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN ❑ PHOTO TAKEN
�STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract n site-
Inspector.
�-YC.G O�'N
White Copylinspecto�s Flle Canary CopylSite Notice
— — —�: � r � _
PERMIT
w CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 - _�
Crystal Bay, Minnesota 55323 Permit Number:
(612) 249-4600 Date Issued: _ ; _
S
ITE ADDRESS:
_. .> . _ _ . . ._... . ��:;�i�; ';�.? 'I
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DESCRIPTION:
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`.:'':�::'3' . �:_??� �i''^.._ �._f-#;'•af' �__ ; %�`.:-�i 1 i_'sfc;
REMARKS:
FEE SUMMARY:
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w�i}7'E�;',=i1"!�rs _..�_......._._� __�� � »
9 r;i'[.:�t I (—��;j+ .�.Ci-i�— -
CONTRACTOR: OWNER: -- _ _.. . . --
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— ^PPI i�iNT PERMITEE SIGNATURE ISSUED BY:$IGNATURE
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Total Fee: $ .S�-.S� Date Received: %-� _�
- Entered By:, �f;�- Permit#: o�
ITY OF ORONO - BUII.DING PERNIIT APPLICATION
All ormation must be submitted in full before plan review will be s d.
(please print all information)
----------- ------------------------------------- ---------- -------------------------_—__- ---
TI� APP�.ICANT IS: (circle one) OWNE R CONTRACTOR ��N___
i
JOB SITEI ADDRESS: 3 � �'..S .'T�,a����'�►�,.►,�, /� ZIP. SS �.5�
NAME O�' OWNER: /'1��C��4�o/ �r PHONE: (home) l Z �f,l63 0
(work) G �� .,p
MAILIN�ADDRESS: �I �S �.�4�1 ,�,�CITY• :�S3S C
CONTRA�ICTOR: D� ��Z,:�,S�C.' PHONE:_
CONTA T PERSON: , MOBILE/PAGER:
MAILIN ADDRESS: CITY: Z :
STATE I�,ICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAIL.ING ADDRESS: CITY: Z :
NAME;� _ REGISTRATION#
TYPE aF WORK: New Addition Accessory Structur
; Move Remodel/Alteration Land Alteratio �_
PROPOSED WORK(describe in detain: �'% r S
STORI�S: SQ.FEET OF EACH FLOOR:
NO. O�' BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlV�TED CONSTRUCTION VALUATION(excluding land): $
I hereb� apply for a building pemut and I acknowledge that the information above s complete and
accurat�; that the work will be in conformance with the ordinances and codes of City and with
the Sta�e Building Code; that I understand this is not a permit and work is not tq� start without a
permit� and that the work will be in accordance with the approved plan. i
.
APPL CANT'S SIGNATURE: ,�,r� ��� Q�._.�.� DATE: !/-
- - �
NOT ! Parade Q f Homes events require separate permit approval by Police eparlment and
City uncil 60 days prior to the event. Non permitted events will not be allo ed.
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA -
Subd. 1. Type of data. The rights of individual on w6om the data is swred 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 d�e collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is IegaUy requ'ued to supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identity of other persoas or entities authorized by srate or federal law to receive the data.
T6is cequirement shall not apply when an individual is asked to supply investigative data,pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissio�r of revern�e mav nlace the nodce rewired under dvs subdivision in the individual income taz or�ronertv 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 class�ed as public,private or confidential. Upon his further request,an individual who
is the subject of swred private or public data on individ�als shall be shown the data without azry 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 acdon pursuant ro this section is pending or addidonal dara on the i�ividual has been
collected or created. The responsible authoriry shall provide copies of the privaoe or public data upon request by the individual subject of the data.
The responsible authoriry 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,exclnding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request withitt that time,he shall so inform the individual,and may have an additional five days within which W comply with the request,
ezcluding Saturdays,Su�ays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individaal may contest the accuracy or completeness of public or
private daha concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the ttadue of the
disagreement. The responsible authority shall within 30 days either: (a)correcc the data found to be in�ccurate or incomplete and aaempt to no6fy
past recipients of inaccunte 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 detemvnarion of the responsible authority may be appealed putsuant to the provisions of the administradve 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�iry 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 shazed with other 1oca1, 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) �o review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature
6
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� , � � � �
� . CHECK OFF LIST FOR ISSUANCE OF PERMITS '� .
� FOR OFFICE USE ONLY
ADD SS OR LEGAL: 3�7 � �"�A t��
PID:
DESC ION OF WORK: F !
- --------- ---------------------------------------- ---l-------------
ZONIl�G REVIEW BY: DATE APPROVED: / -
BUILD�NG REVIEW B : DATE APPROVED:
_---______+___---_--__________ -------------------------------------------------------- -----------------
FEES T�O BE CHARGED: G/�ar�p��.�, Misc. Fees Calculated By:
PERMI'� Yes ��''�� No
PLAN I�,EVIEW Yes No SEWER CONNECTIO
STATE �URCHARGE Yes No WATERCOrfNECTIO
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Numbek of SAC Units OTHER (specify)
ZONING'�,CHECK LIST Zoning District: NO c�ra+^�'j- � I
Fire Deparmhent: Post Office: School District:
Lot Area: Sq.ft. Acres W th Depth
Survey Submiitted: Yes No ate of Survey: �
Proposed Set�acks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjaaent Structures: Wetland: �
Building Height: Def. Hgt. Peak Hgt. I
Lot Coverage: I�
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By: I
I
Zoning File: # Resolution: # Resol ion Date: �
Shoreland District:
I
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcov�r: 0-75'
75-250'
�I
250-500'
'� 500-1000'
Hardcov Variance Required: Yes No ate of Council Approval:
REMARI�S(' house):
i
7 I
.�. .
, .
BUII.DING REVIEW CHECK LIST �
UBC: "'— CONSTRUCTION TYPE: �--
Sq Footage $Per Sq Ftg
Basement z =
1 st Floor x =
2nd Floor x =
Garage x =
z =
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical. Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�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 PERMII�:
8
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` PR�FI?�EO L_0? DIVISIOV
� I=Or� ,�Af�i� � AidD i�fARYA�4P1 MC�OWAiv
� GF LOi i , BLOCK 1 , L1BtRTY ACRE�
, � � H�i�NEPIi�d COUhJTY , MINfJESOTA
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� -� , !' �'iT \ _ � Brc/d.'w'rtiwl. / �G�
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•- \ I �/ > o SCALE : 1 " = 1 00 '
~ �' �'�/ s / �0� �,'�� DATE : 1 -2-87
� 4 r�v. 2-i�-e7 r,r,�o�r .4C
�IT�' Of O�R�VO ° <
, ' cui���s�s�.ai� o
Cld. 3-/1-87 /ot/:nt �
X �ITE PLAN GWADl�VG PI.AN � ,o�'a8� '"' 3-��-s� ,�`•;"�
J�APPROV�D— r=i�� > �ti� �..�s« f D�`sa��2
❑ APF�U'J�D WlTN REYiSI�NS y�R�f
❑ Di$�� � i c'
BY �5°
' �_ Dr•ar'n�� �,
tX'1 1 L— //- `( � ? e7 U+��;�y �aSeh7enf\
����o ���
;�: hereby certify that this is a true and correct r?presen�ation of the location of an existing
house and barn in relation to the boundari �s of Lot 1_ , B1ock l , Liberty Acres , and the approx-
imate location of an existing drainfie � a . it does no} DUr�rrt to sho;y an� o�her improvemen�s
or encroachments .
COFFIN a GRCi��tRG , iNC .
,���.�'�.�'��
r a�� . ron erg r�n Lic . rTo:�� i5�
tngineers , Land Sui,veyors , Plannei�s -
Long Lake , i�1innesota