HomeMy WebLinkAbout1996-008296 - remodel/repair garage : PERMIT
. CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �tf 1 j L�„f T h,{i�
Crystal Bay, Minnesota 55323 ����;�;:�'�r,
(612) 473-7357 Date Issued: {};;f�,::;f,�h
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — �1��F�1 i r�t-�fi. -- :��T . L 3�: OWNER:
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APPLICANT�PERMITEE IGNAT E ISSUEDBY:SIGNATURE
, . CHECK OFF LIST FORE US ONLyOF PERMITS
FOR OF �
� .�.,;.ti �,z;,.
ADDRESS OR LEGAL: �-� . - J i
:
; , -
P � - ��� �,:� .��
ION OF WORK: �1,�`t��-�n-� -- �..
DESCRIP'T ---------------------------------------
---------------------
---------------------------
---------------------------- DATE APPROVED:
ZONING REVIEW BY: n-� (��,, �"' `t t�
> � DATE APPROVED: 4, _ `.,
VIEW BY' �
BUILDING RE • - --------------
---------------------------------
---------� -----------
----
-------------
Misc. Fees Calculated y:
FEES TO BE CHARGED: YeS f No
PERMIT YeS �- No f SEWER CONNECTION
PLAN REVIEw ✓- No WATERCONNECTION
STATE SUR:�IARG� YeS No p�,RK FEE
INVESTIGAZ'ION-FEE YeS SITEINSPECTION
No
SAC Y�S - OTHER (specify)
Number of SAC Units __ ---"'
----------------------- Zonuig District:
ZONING CHECK LIST �
Post Office: Sc�ool District:
Fire Department: ,
�! W idth/�� Depth
Acres �
Lot Area: Sq.ft• , �
Survey Submitted:
j �,�t Yes No Dylte of Surv y:
� t
I �` '� ' '
Proposed Setbacks: � ' Right Side: �
Front (Lake)r ; �'
l � ` ,
Left Side:
Rear (Stree : �
Adjacent S ctures: ,
W etlaud:
� � ' Peak Hgt. -------- ..
Building Height: ef. Hgt. � _------
i � �E��
E � �
Lot Coverage: ;
� gy. Council A roval Date:
Grading: Staff A�pproval Date� �
� ' By:
Septic: Staff A proval Date: I ,�
!Resolution: # I T_ Resolution Date:
Zoning File: # ; ,
, i
Shoreland Dis .ict: - � Lot Coverage:
, ; Bluff'Setback: proposed
Avg. Setback: Existing
��
�—
Har cover: 0-75� I �—
75-250�! ---=
' 250-5�' _-----
500-100�' _—
Hardcover Variance Required: Yes
No
Date of Council Approval: ___
�M�gS (in house):
26
BUILDING REVIEW CHECK LIST
UBC: � ' � CONSTRUCTION TYPE: �J�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 3;5Z�' ��'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Inigation
i� 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 PERMIT):
27
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' Total Fee: $ � Date Received: �' � 3 � ��
Entered By: � Pemut#: �a 9�
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 O CONTRACTO
JOB SITE ADDRESS: 3� ,f'�,� ZIP: �.11 �i7.�i .�,�.J7��
NAME OF OWNER: ��/� ��DJ'/l��l rU PHONE: (home) - l
(work) 3 �-a
MAII.ING ADDRESS: .�.��'� .�ir��,,� ,G�,.�CITY: ZIP: ��3�'/
CONTRACTOR: c✓ � ,�HONE: a -- O 0
CONTACT PERSON: 7- MOBILE/PAGER: -
MAILING ADDRESS• CITY: ZIP:���
STATE LICENSE: # /U �' �/ a� �,y.�iG?�.!/��` .S'���� a�a
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition � Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: i - �
r- -�- G't�L v - ,�' �--`
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ ��d0 �
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
th� State Building Code; that I iinderstand this is not a pemut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: r' DATE: �-o�.�"�-6
NOTE! Parade of H�ome_s events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SLJB.fECTS OF DATA �
Subd. 1. Type of data. The righ[s of individual on whom[he data is stored or to be stored shall be as set forth in this secrion.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or co�denrial data conceming himseif shall
be informed of: (a)the purpose and iatended use of the cequested data wichia the collecang�tate agency,polidcai subdivision,or statewide sysum;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply
privace or confidendal data;and(d)the idenriry of other penons or enriaes au[horized by state or federal taw to receive the data. This requiremenc s6a11
noc apply when an individual is asked to supply invesdgadve dara, pursuant to section 13.82,subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or propem tax refund
insttucdons inscead of on those forms.
Subd.3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whe[her it is classified as public,private or confidendal. Upon lus further request,an individual who is the subjecc
of stored private or pub(ic data on individuals shall be shown rhe data wi[hout any charge to him and,-if he desires, shall be informed of the content
and meaning of�hat data. Aher an individual has been shown the privace data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to chis secdon is pending or addidonal data on the individual has been collected or created.
The rosponsibie authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible au[horiry
may require the requesting person to pay[he actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible, with any request made pursuant to this subdivision,or within five days of
the date of che request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannoc comply with the requesc
within that time,he shall so inform che individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shal!nodfy in writing the responsible authority describing the nature of the disagreement.
The responsibte authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomp(ete and attempt to nodfy past recipienu of
inaccurate or incomptete data, including recipients named by[he individual;or(b)noafy the individual thac he believes the data to be correct. Data
in dispute shali be disclosed only if the individual's statemenc of disagreement is inciuded wich[he disclosed data.
The determinadon of the responsible au[hority may be appealed pursuanc to the provisions of the administradve procedure act relaring 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 fumish 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 percnit 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.
X,�377�,P�11 7"l ,�h ifD��
Firsc Middie Lasc
Address �� / /� v
��. L/ Z/ .1/ �
Ciry State Zip hone
I understand my rights as scated above.
Signam
v
DATE TIME
CITY OF ORONO CALLED IN �-ZS/9�c
INSPECTION N TICE SCHEDULED B ��/9G !/: O o
PERMIT N0. �'1�o �COMPLETED �_ ���',�
ADDRESS —
OWNER CONTR.
TELEPHONE NO. 9�0� - ��� �7
� DESCRIPTION�' D�J7�. �
� 01 FOOTINO 11 MECHANICAL RI 18IXCAV/dRADINCi/FIWNQ
y 02 FRAMIN(3 13 MECHANICAL FINAL 19 LAI�SHOREIWETLANDS
Q ULATION" 24/2S WOOD BURNEFi/FIREPLACE 34 TREE qEMOVAL
Z . 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FlNAL 14 SEWER HOOK-UO 06 PRO(iRESS
� 07 DEM�SITE 27 SEPTIC NWNT. 21 COMPLAINT
J
� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PWMBINC�RI 23 SEPTIC FlNAL 35 HARO COVER REMOVAL
v 10 PLUMBINO FlNAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
y COMMENTS:
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d WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERT�FICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
O INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call fo ex nspection 24 hours in advance.473-7357
OwnedCon ra on si :
Inspector.
vn�ue copyn�s��ors�+�e ca�ary copy�sta Noace