HomeMy WebLinkAbout1998-010653 - storm damage/deck --� PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 _:;�'1�,_i`s i��vi;
Crystal Bay, Minnesota 55323 Permit Number: y;�t,;�:,;:�;
(612)473-7357 Date Issued: i;;:;'��i ;'�i;;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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PPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATUFiE �� ,
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Total Fee: $ Date Received:
Entered By: �'�� � Permit#: �'�� -
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) OWNE OR CONTRACTOR
JOB SITE ADDRESS: � � �j j L;��1 a,,., 1_,,� ZIP: �-'� ;� �;�
NAME OF OWNER: ��ry C� ���y�� PHONE: (home) -� ,�1
s (work) `�j,��'- �tv,�
MAILING ADDRESS: /v�j Li� c�,.� �;�, CITY: ('��� ZIP: ,SS3 f�''�
CONTRACTOR: ,�� ( � PHONE: �,qL„+�-
CONTACT PERSON: �� MOBILE/PAGER:
MAILING ADDRESS: �' CITY: r � ZIP: ��
. #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration �C• Land Alteration
PROPOSED WORK(describe in detai�: 7rc k � (.,�r,��� ,4rr��r..d �� ,�PL-p
j���mblzr+ �iAj K:.� . -
STORIES: j t P-X}�yr��SQ. FEET OF EACH FLOOR: /`�5Z
NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. DET. ✓' �
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ g Q fl� �
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 Ciry and wi�
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.
APPLI�CANT'S SIGNATURE: � DATE: �
-�_.
NOTE! Parade of Homes e ents require separate permit approval by Police Department a�r�
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
5
F . ,
Sec.13.04 RIGHTS OF SUBJECTS OF DATA �
Subd. 1. Type of data. The rights of individuat on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqarired to be gtven mdividual. An individ�al asked to supply private or confidendal data concerning himself
shall be informed of: (a)the{wrpose 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 iden6ry of other persons or entides authorized by srate or federal law to receive the data.
T'his requirement shall not apply when an individual is asked to svpply invesdgative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revernie mav nlace the notice reauired under this subdivision in the individual income tax or oronertv tax refvnd
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an iadividual shall be iaformed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidenaat. 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 aad,if he desires,shall be informed
of the content and meaning of that data. After an individual has been shown the privau data and informed of its meaning,the daha need not be
disclosed to him for six months thereafter unless a dispute or acdon pursuant to this section is pending or addiaonal data on the individual has been
collected or created. The responsible authority shall provide copies of the private or�wblic data upon request by the u►dividual subject of the data.
The responsible authority may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible aud�oriry.st�all comply iromediately,if possible,with any request made pursuant to tlris subdivision,or within five days
of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if unmediate compliance is not possible. If he cannot comply with
the request witt►in that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,
excluding Saturdays,Su�ays and legal holidays.
S�bd.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 nodfy in writing the responsible authoriry describing the nature of the
disagieemecrt. The responsible authority shall widvn 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt w notify
past recipieots of inaccurate or i�omplete data,i�luding recipienu named by the individual;or(b)noafy the individual that he believes the data
w be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible autY►ority may be appealed pursuant to the provisioas of the administrative 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 Giry of Orono or any of its departments may require you to furnish certain
private or conf'idential 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 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 informarion 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.
�,^y C. �h.-rsc-�
First ,_ Middle �s�
l� �l� G,.��P.,-�► Ggn-c-
Aaaress
r�r�c�n� �'J?{'1 S`��3 6 `� N�02-o?3S'�
Ciry State Zip Phone
I understand my rights as stated above.
Signa
. 6
. .
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � OH S L i ny�eN (�°t�r t�
PID: =
DESCRIPTIONOFWORK: �Q�w� Q(ky�tq��, �Z.�,sp��� ,(�.� �- �}.,.�JSc.��P
------------------------------------------- --- --------------------------------------------------------------------S7`r4-c2S
ZONING REVIEW BY: DATE APPROVED: $- 7.d-7`�
BUILDING REVIEW BY: DATE APPROVED: � -7.�-�8
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes i/ No
PLAN REVIEW Yes i/ No SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: �/V c� C�-{-�q,,JG�
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:
Rear (Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peal: gt.
Lot Covera�e:
Grading: Staff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: B : • -
Zoning File: /# Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: LotCoverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: � " 3 CONSTRUCTION TYPE: \/N
, Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
�
Estimated Construction Value: $ �,(9(,'�—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�_Final GradinglFilling 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�:
8
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 1'31-SQS (: 3�
PERMIT NO. COMPLETED �� "�
ADDRESS (O4 S" C�tn��Q�✓
OWNER %��^► ��`'��'S�s.-� CONTR. a���
TELEPHONE NO. 4� Z--- Z35�1
� DESCRIPTION �d d� �'T ��`�c-�-
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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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� ❑WORKSATISFACTORY:PROCEED -: pROJECTCOMPLETE
W �CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑ 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
L� INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on 'te•
Inspector.
White Copyllnspector's File Canary CopylSite Notice