HomeMy WebLinkAbout1997-009478 - replace deck , PERMIT
. CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �f'�
Permit Number: °`.`-"'�;':``i�
Crystal Bay, Minnesota 55323 � - _ _
(612) 473-7357 Date issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: - - `
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A PUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� `
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• Total Fee: $ /�lg; �'G Date Received: /�-- j-U 7
Entered By: ,C�� Permit#: 9�7�
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) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 2?� S �(��� � ��N�� ZIp; SS 33 �
NAME OF OWNER: v��Es �u-�2 PHONE: (home)�� 1 - O`�7 l
MAII.ING ADDRESS: Z7(o S' !�i�, (work) �E�r� - Zs 3�
l Y 1�� crrY: �x���� z�: ..t�s33 �
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITy; ZIp;
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CIT'Y: ZIP: .
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
�,oq�-
PROPOSED WORK(describe in detai�: �N��-�-/��EG�p I�P(..,F�ca�J Er
dC.1D �Ec�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �'i o00 . o 0
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 SIGNA . DA�; � �' � —�7
NOTE! Parade of Homes e equire 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 SLJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom 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 conceming himself
shall be informed of: (a)the purpose and inte�ed 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 lrnown consequence arising from his supplying or
refusing to supply private or confidendal data;and(d)the idenary of other persons or enrities authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesrigative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
'j'hg cnmmiscinner of revenue mav nlace the nc�tice reauired under this subdivision in the individual income tax or nrooertv 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 dara on individuals,and whether it is classified as public,private or confidential. Upon his further request,an icidividual who
is tt►e 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 acui meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosecl to him for six months diereafter 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 st�all 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 addidonal five days within which to comply with the request,
excluding Samrdays,Sundays and tegal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private data co�erning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall withitt 30 days either. (a)conect the data fou�to be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)noafy 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 deternvnation of the responsible authoriry may be appealed pursuant to the provisions of the admuustrative 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.
���s F�w�- C�-����-
First Middle Last
Z�c� s 1�� c�c
Address
�.��-�Sl o (� 1't�r� �5�331 ��t -o ti� 1
C�iy State Zip Phone
I understand my rights as state bove.
Si ture
6
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFIC E ONL�j
ADDRESS OR LEGAL: �2 e rTv
PID:
DESCRIPTION OF WORK: Qc�
- ` t ----------------------------------------------------------
ZONING REVIEW BY: � V DATE APPROVED: �(�—���7
BUII..DING REVIEW BY: � DATE APPROVED: �D —t —Q7
FEES TO BE CHARGED: Misc. Fees Calculated By: ,
PERNIIT Yes � No
PLAN REVIEW Yes No SEWER CONNEC"ITON
STATE SUR�H?,RG� Yes No WATER CONNECTION
INVESTIGATION-FEE Yes No l-- PARK FEE
SAC Yes No � SITEINSPECTTON
Number of SAC Units OTHER (specify)
_ -----�------------------------------------- -
ZONING CHECK LIST Zoning Districr. Z-- � .
Fire Department: �� Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes� No Date of Survey:
Proposed Setbacks: � O /
Front (J�f: .�� Right Side•
Reaz(Sueet�:
r Left Side: �
Adjacent Structures: � Wedand: -� �
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Gradi.ng: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoaing File: # Resolution: # Resolution Date:
Shoreland Dis�-ict: .
Avg. Setback: Bluff Setback: Lot Coverage:
� Eusting Proposed
Hardcover: 0-75' .
75-250,
250-500' �
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
. 26 �
+
BUII..DING REVIEW CHECK LIST '
�C� � � CONSTRUCTION TYPE:
' Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x — �
2nd Floor x =
Gazage x =
x =
TOTAL
Estimated Construrtion Value: $ ��Q
Inspections Required: � Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
C Footing Septic Sewer Connection �
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
RF',MARKS (Il�T HOUSE): � �� -__
__________--------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By: �
REMARKS(TO BE NOTED ON PERD�II�: � ~ ' �
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DATE TIME
CITY OF ORONO CALLED IN z
INSPECTION NO C ,r� -, SCHEDULED i�'� �i> � ���
PERMIT N0. �� / � COMPLETED _� 'Yl
ADDRESS �.� �
OWNER �uJ-G�� C TR. ' _ �•�.-
TELEPHONE NO. �Z�' �L 7`�
� DESCRIPTION ��
W 01 FOOTIN 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
�
�Q ING 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
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEM�-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—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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� C' CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
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� L' 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
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContract si�e:�
Inspector. �U
White Copyllnspector's File Canary CopylSite Notice
.., _DA'TE!� TIME
CITY OF ORONO C���J CALLED IN __1� /� 3�
INSPECTION NOTICE `�Y7 SCHEDULED -�:-` � IC�•`.3 t�
PERMIT N0. � COMPLETED
ADDRESS � �J' ��
OWNER �����L�(Mi`�'� CONT . ��''�- �
TELEPHONE NO. � � -- U� � 7�
� DESCRIPTION / ��� T / �U��
ty� 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 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 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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O Ll CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
f i CORRECTUNSAFECONDITIONWITHIN HOURS. , pHOTOTAKEN
INSPECTOR WILL FiEfURN
O STOP ORDER POSTED.CALL INSPECTOR C' CITATION ISSUED
C; INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the nex inspection 24 hours in advance.473-73�J7
OwnerlCont�on i e:
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN 3 �
INSPECTION NOpT�ICE�1 SCHEDULED �
PERMIT N0. / �/� COMPLETED �
ADDRESS
OWNER C�NTR.
TELEPHONE NO. '7'S��'i -� �9`��
� DESCRIPTION �1�/
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA 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
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r o it :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN al— ' D a
INSPECTION N TICEQ SCHEDULED lo-I z 9S�
PERMIT NO. D COMPLETED fl"�/ •
ADDRESS vZ7�D J� I{��,�$-,
OWNER ��CONTR. a�'�/
TELEPHO E NO. �'I— 4 �f��
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� DESCRIPTION
ly Ot FOOTING i t MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WA ��12�ATER HOOK-UP 17 SITE INSPECTION
OS FINAL �,�Z�C./C,.1*l SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 OEMO-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
� COMMENTS:
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W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN � CITATION ISSUED
0 STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
OwnerlCont to on i -
Inspector. i
White Copylinspector's File Canary CopylSite Notice
DAT TIM�
CITY OF ORONO CALLED IN - �07' YSl d�,
INSPECTION NOT SCHEDULED �
PERMIT NO. 7 COMPLETED
ADDRESS �
OWNER CONTR.�YI �
TELEPHONE NO. �T� � �4`f�
� DESCRIPTION (�l"f�
� 01 FOOTING 11 M CHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION •
Q 5 FIN 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 MEEf YOU:_YES_NO
� COMMENTS:
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� ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. cj pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR
❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next i pection 24 hours in advance.473-7357
OwnerlContract sit
Inspector.
White Copyllnspector's File Canary Copy/Site Notice