HomeMy WebLinkAbout1996-008483 - pool __ ,-.�
� PERMIT
� CIT� OF ORONO PERMIT TYPE:
. 2750 Kelley Parkway- P.O. Box 66 �,t!T�i 7 T���
Crystal Bay, Minnesota 55323 Permit Number: ;_��_;:�,�;_;;;
(612) 473-7357 Date Issued: � f_y,� ��,��;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - �.��,�:�� i��;�,it. - OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
. .�.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �l S L v C� C��N C )2���C
PID:
DESCRIPTION OF WORK: �P p bL�
----------------------------------------- --,-,,/-�-�-------------------------------------------------------�_--_--------
ZONING REVIE� BY: � Uu►�-- DATE APPROVED: / 4� �i�
BUILDING REVIEW BY: h/�� DATE APPROVED:
------------------------------------------------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes r/ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECT'ION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: �/L ' ��
Fire Department: /►1/}P�P�+� Post Off ce: �M.C�UrV,� School District: �,L: �5��11�4
Lot Area: Sq.ft. Nu �i�`�i'Z Acres � Width � Depth —
Survey Submitted: Yes ;x No Date of Survey: C7N c=��
Proposed Setbacks:
Front (�.�j: �{.� f/�' Right Side: � � �
Rear (�eeE): f��, � Left Side: i �Cl� '�`
Adjacent Structures: S�j ' Wetland: /`� 1�'
Building Height: Def. Hgt. ti �/� Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By�
y�r Zoning File: # Resolution: # Resolution Date:
�
Shoreland District:
Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-lOOO'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
�► .
BUII,DING REVIEW CHECK LIST
UBC: N�O� CONSTRUCTIONTYPE: N�1/�-
Sq Foota�e � Per Sq Ft�
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ /��d���'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
;x Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Pemut)
„� Final Grading/Filling Electrical (State Permit)
Other
REMARKS (Pi 1 HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
RENIARKS (TO BE NOTED ON PER.�'�1IT):
27
, .� _
. 1 otal Fee: $ "s/ ';�- 'a��" Date Received: /�� � << `��-
Entered By: X�,. .�� 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) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �'I"S L�C�L.�l�1��YG� ZIP:
NAME OF OWNER: �' �L j1` PHONE: (home) ��Z --� }���
(work)
MAILING ADDRESS: �s' L>�1G�L.L�IIC;sI'�rY: Gi�G1�/�.L_ZIP:
CONTRACTOR: _�G�L �,�f1�f--�t� PHONE: �7�,1� —!lS��
CONTACT PERSON: ��S S MOBILE/PAGER: �(%�--G�'j �_
MAILING ADDRESS: � 3 !rr � 1�i�'!�Zl�17t�.�ITY: l�/I�'�'.Gt�ZIP: �
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �,�-' �/�'���/,-�� ��"���---
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $_�c'it'sc� ��'
I hereby apply for a building pernut 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 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: r� � �
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
_ � �
Sec.13.04 RIGHTS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqidred to be givea individual. An individual asked w suppty private or confidendal data concerning himself shall
be informed of: (a)the purpose and inunded use of the requested data within the collecting Ytate agency,polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally roquired to supply the requesud data;(c)any lmown consequence arising from his supplying or nfusing to supply
� private or confidcndal data;and(d)[he idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82, subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or aropertv tax refund
instrucrions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whecher he is the subject
of storod data on individuais,and whether it is classified as public,private or confidential. Upon his furrher request,an individual who is the subjecc
of srored private or public data on individuals shall be shown the data wi[hout any 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 ics meaning,the data need not be disclosed to him for
siz months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or creaced.
The responsible authority shall provide copies of the private or pubiic data upon request by the individual subject of the data. T'he responsible authoriry
may requiro the requesdng person to pay the actual costs of making,cerdfying,and compiling the copies.
The responsible authoriry shall comply immedia[ely,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 compiiance 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 ttte request,excluding Saturdays,
� Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may conrest the accuracy or compleuness of public or private
data concerning himself. To exercise this right,an individual shall nocify in writing the rosponsible authoriry describing the naturo of the disagreement.
The responsible authoriry shall within 30 days either: (a)correcc[he data found to be inaccurate or incomplete and attempt to norify past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)noafy the individual that he believes the dara to be correct. Data
in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure acc relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2, "Rights of subjects of data", we wouid 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€urnish 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 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.
1 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.
���nG��_
F��� Middle Lasc
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signamre
DATE TIME
CITY OF ORONO CALLED IN i /� <
INSPECTION NO IC SCHEDULED /�� � ��'� ��
PERMIT N0. �� COMPLETED
ADDRESS `7`-5 � �
OWNER � CONTR. ��-�.� �
TELEPHONE NO. ��� " ��� ='
� DESCRIPTION
� i FO � 11 MECHANICAL RI 18IXCAV/GRADINO/FIWNd
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORENVETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAI
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEM�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 PLUMBINO FINAL 36 FOUNDATION HEMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �iVORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W
� L CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑ CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra i :
Inspector.
White Copyll�spector's Fil Ca�ary CopylSite Notiee
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SUR �� � � ' . � �.
�:; • �,� � x
� ,, ; .�y,�����ti % , :� Preparect By: �� �' � �
* :' :����:�;"� a� �� , ,:, ��� , r� 3��� ���� ���� ����
i ' ��:� �>. 1e� .k, , � � ° = , ...... i ��� t ' - ' yf - ��� � '� SGHOELL & MADSON, IN ������
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� �F � �` _ " ; __ , n , , � �' r� a ?�-� �� �—"-"- : Engineers • Surveyors • Planners • Soils Testin
M �. ,::}• �,�r� ` , , , , � � � � 9
-�-�" `- ��t�' � � ���, • �i � � � � ` � 10550 Wayzata Boulevard
{.��Fi� e � ` ,. � . `� = �. - � „ � t ka Mn. 55343
� .�,t,,,��� ; a � f �, � � _ .- . M i n n e o n ,
• a �� , � � Q' � � G �� Tei. 546-7601
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:,� :;:.�" � " . ' ., � ,-� .�\ r� , �` 5�tE� ,�DESCRIPTION:
.;wt��,Y!���,�����.� - . ,� _tl . . . Df � �� �� �J� � 1 ; V
� � �Ot 2,
.ak��. . I� � . ' O � �- �� � ,. . t�' : B�ock 1, PAINTERS CREEK.
,r~� , � � �� ��. ------ .
';Y�C�. v� + � � �� , � 1 �. , ���Ql�: '�" �_ _- " BENCHMARK:
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� '�� •� �` � � r , �"' t� ,1 ���� `,i,,; � op of 1-i nch i ron pi pe as shown. Elevation = 1023.3 ( )
�
NGVD-1929
ln .� '; .,.•'� � '� � , , . .� �`� ._�:.
� .:`y.�. _ � � - a�v ` � � :;�:; GENERAL NOTES:
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N ';�.: � � ) . , �., ,�4\ •�""
, :1:,�:� � � b • . � � � ,.._t,_ ;;�•: 1) o - Denotes i ron monument found.
• � � � , � , ' s� , 2) a - Denotes nail set.
'�; _ �: � ` , � ' ;_ '���',, , �� � k'�t� 3) ❑ - Denotes wood stake.
,� ` , �„ f � ' - � �' ° � � , �` 4) x1022.7 - Denotes existing spot eTevation.
4�� � . '.�' ���� , ;f�: . ; s� 5) x(1023.5) - Denotes proposed spot elevatfon.
`.p�� r ,� ti . , � �f �. �� ' • � - � 6) + - Denote5 direction of surface drainage.
�.� q � �' ` �' r ' ° . ��';� . '�� tt` 7) Proposed top of foundation elevation = 1023.3.
::h1�, ' � �'� ' �-.' �.,�5+ ,� -�� ' � 8) Proposed garage floor elevation = 1023.0.
,.
�; � ,j{ ' .,' • �� i .;� � ; ; , i •••.��� 9) Proposed basement floor elevation = 1013.8.
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