HomeMy WebLinkAbout1998-010282 - kitchen remodel PERMIT
GITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �tt i j i �,j;s€W
Crystal Bay, Minnesota 55323 Permit Number: f���f f:�s;_;�
(612)473-7357 Date Issued: iY��r;t_���,�;�.
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: —� t,F:°�°J. 3 r�+.t?'�• — '_�T . L��: .OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
'2'otal Fee: $ b - �. Date Received:���/S`�
Entered By: Permit#: l0� $Z.
CITY OF ORONO - BUII.DING PERNIIT APPLICATION
All information must be snbmitted in full before plan review will be started.
(please print all information)
1'�iE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SI1�E ADDRESS: � 9•fG�'�F 5 f- (0,�4- C.�z�ZIP: .�5� 5��
NAME OF OWNER: ��' -�'r'no�.�..•-� PHONE: (home) `/
�3 - 7�-�z
(work)
MAILING ADDRESS: �a�.,...� CITY: ZIP:
C0��1'I'RACTOR: S1�N�-�.�s E /Ci,✓S PH : `�I 3'�-y y�
CONTACT PERSON: �"s MOBILE AGER• 9�9—6 f�'3
MAILINGADDRESS: �f?.� G: (zicic's!; CITY: �.✓,�•xy+� ZIP: 53�'�S/
STATE LICENSE: # 200 3y 53�
ARCHITECT/ENGINEER: ��✓ �'�s� PHONE:
M.4ILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition �-Accessory Structure
Move � Remodel/Alteration �� Land Alteration
PROPOSED WORK(describe in detai�: ,�r T�,y��/ ��C7»apc2
STORIES: SQ.F'EET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 2?, � � o
I hereby apply for a building permit and I aclrnowledge 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: � � 4!
NOTE! ��rade of Homes events require separate permit approval by Police Deparlment and
City Counci160 days prior to the event. Non permiited events will not be allowed.
,
Sec.13.04 RIGHTS OF SLlBJECTS OF DAT?i
Subd. 1. Type of data. 'Ihe righcs of individual on whom[he data is scored or to be scored shall be as set fonh in this secdon.
Subd.2. InformaCon reqirired to be given individual. An individual asked to supply private or confidenual dara conceming himsetf shall
be informed of: (a)the purpose and inrended use of the requested data wi[hin the collecdng�tate agency, polidcal subdivision,or sratewide rystem;
(b)whecher he may rofuse oY is legally required co supply[he requested data;(c)any lrnown consequence arising from his supplying or refusing to supply
• privace or confidenriai daa;and(d)the idendry of other peaoas or enrides auchorized by stace or federsl law to receive the data. This requiremenc shall
not apply when an individual is asked to supply invesdeadve data,pursuant to secdon 13.82,subdivision 5, to a law enforcement o�cer. -
The commissioner of re�•enue mav place the noace reauired under this subdivision in the individual income tax or oropem tax refund
instrucdans inscead of on chose forms.
Subd.3. Access to data by individual. Upon requesc w a responsible authoriry,an individual shall be informed whether he is the subject
of stored dara on individuals,and whe[her it is classified as public,private oc confidential. Upon his furcher request,an individual who is the subject
of stored private or public data on individuais shal!be shown che daca wichout any charge to him and;if he desires, shall be informed of the content
and meaning of that data. ARer an individual has been shown che privace dara and informed of iu meaning,[he data need not be disclosed to hitn for
six monchs[hereaher unless a dispute or action pursuanc to chis secdon is pending or addidooal data oa the individual has been collected or creared.
The responsible authoriry shall provide copies of the private or public data upon request by rhe individual subjecc of ehe dara. The responsible authoriry
may require the requesring person to pay the accual cosu of mafcing,cerafying,and compiling the copies.
The responsible authoriry shall comply immediacely,if possible, wich any request made pursuant to this subdivision,or wi�hin five days of
the dace of che tequest,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot camply with rhe requesc
wirhin thac time,he shalt so inform che individual,and may have an addiaonal five days within which to comply wich the requesc,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accurscy or completeness of public or private
dara concerning himself. To exercise ehis ri¢hc,an individual shali noafy in wricing the respoasibte auehoriry describing the nacure of the disagreemenc.
The responsible auchoriry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipiena named by che individual;or(b)nodfy the individual thac he believes che data to be cocrect. Data
in d'upute shall be disclosed only if the individual's statement of disagreoment is included with the disclosed data.
The determinarion of the responsible au[horiry may be appealad pursuant to the provisions of[he administradve procedure act reladag to
conrested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data",we would like to inform you tha[your request
for a permit or license from the City of Orono or any of its deparcments may require you to fumish certain private or
confidential information. �
You aze notified that:�
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse co supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with ocher 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�
First �fiddle Last
y2a E l�rcE`5�
Address ZZ� ,
��.�z�-�- �.✓ sr3g� y�3 -z
Ci�, State Z�p Phone
I understand my rights tated above.
E;� /
�
Signature
;� '
i.
, • CHECK OFF LIST FOR ISSUANCE OF PERlVIITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: __ QS (,C,�F �-
PID:
DESCRIPTION OF WORK: �L �ru+eny c2.�,`���—
---- --------------------------_w____---_�-----
ZONING REVIEW BY: /'U �� DATE APPROVED:
BUII.DING REVIEW BY: � DAT'E APPROVED: S:- Z9 '�t�
FEES TO BE CAARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �/' No SEWER CONNECTION
STATE SUR�HARGE Yes � No WATERCONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Y:.s No SITEINSPECTION
Number of SAC Units OTHER (specify)
--- ---- ----------------------------------------------i-
ZONIlVG CHECK LIST Zoning District: �f �O G���� �
� v
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): _ Right Side:
Reaz(Street): I.eft Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
I.at Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File; # Resolution: # Resolution Date:
Shoreland Dis�ict:
Avg. Setback: Bluff Setback: Lot Coverage:
• Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hudcover Variance Required: Yes No Date of Council Approval: �
REMARKS('in house):
• 26
BIJII..DING REVIEW CHECK LIST � '
UBC: )� ` 3 COVSTRUCTION TYPE: �l/�
' Sq Footage $ Per Sq Ftg
Basement . x =
lst Floor . x = �
2nd Floor � x = . � � .
Gazage x = �
z =
TOTAL
Estimated Construction Value: $ Z�,��o'=
Inspections Required: � `Vork Requiring Separate Permits:
Site oC Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
OC Framin8 Fireplace Lawn Irrigation
_p�Insulation (Masonry) Other
�Wall Boud (Mfg.) Well (State Permit)
F�� Grading/Filling _�Electrical (State Permit)
Other
REMARKS (IN HOUSE): � ----�-------- -----
REVIEW BY OTIiERS: DATE: �---------
Access: Existing New
Access Apgroval: Date gy; '
REMARKS(TO BE NOTED ON PERNIIT�: + ' '
.
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DATE TIME
CITY OF ORONO CALLED IN �t�� 3.`Oa
INSPECTION OTICE SCHEDULED � �:3 O
PERMIT NO. COMPLETED �_ �_
ADD SS
O N R . J CONTR.
TELEPHONE NO. `T�� ��f
�
� DESCRIPTION
� 01 F� 17 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O SULATION 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
� 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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� �ORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR FIEINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
rl CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra n�i�e:
Inspector. v
White Copy/lnspector's File Canary CopylSite Notice
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