HomeMy WebLinkAbout1996-007968 - remodel & deck PERMIT
t , C��"Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: ��t_f I 1-r7 j�I�"-�
Crystal Bay, Minnesota 55323 {;{i�'��„=
(612) 473-7357 Date Issued: ����i;Y;�_��,
SITE ADDRESS:
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DESCRIPTION:
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, �uii��i���� F'*�rri�it. TyF�� L;�—A��r'nEhli�ii�E!_
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — �;r��:�lic���it• — OWNER:
�I �,s sY�Fi � '=,i�+h!°�; I I�+:� 1�.7����c_r��� t•it�:t�f I�.L�it�a t-Ix�WAF�i
i���'�'�:J'� i�I t�t�?E 1 i=:fh�f�:A ��LV� 1 t'!� L`�t'►R� �!�E
D�E�`Hr�UEt�i ti�i ��:�°�� ��I;��i�E� h11�1 5�:�;°�1
' c;r,t�i :�?�-:��i��;7 t:r,i�::r t�?�,-.�;t=,:��,
T€-!F_ t 1��DEF"��I��i�l�� H;��CE�Y �:�c;�i J�`�=T:�; �'E�it�l i'3'=;I i��i�� i�=+ �•ir�F::� T�-ft� 'r;i=r'ji_ .i i•1�='�;t=+1��i•1�idT°=�
:=:���i:I F I Et�7 �{4�� t�[�Fi��:�=; i��:t ;iit� HLE._ �+t=_3Ftt��. ���I '-�`i�I i:T �:�:f,�F'?I�?i��:E ai i���� �:i._1... ��I s�' +=��
L a i�i_�t,�i:� i ihi�I I��tt�it�E°�: ���il� °r�i t�T�' i�i= t1 i��V4'�;+=f'TH L;!1 I I_�i�It,� C=���:�� �°C��:��?:.�:°i�i•i�:t,�..�,_; �
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APPLICANTi MITEE SIGNATURE ISSUED BY:SIGNATURE
� .Total Fee: � ���°` ' �'`'� DateReceived: ��; � :
DateApproved:
Entered By: �'(,��' Pernut#: �>(,, �
CITY OF ORONO - BUII.DING PERMIT APPLICATION
AI.L INFORNIATION viUST BE SUBNITT"I'ED IN FULL BEFORE PLAi�1 REVIEW WILL
BESTARTED
----- ------------------------------
---------------------------_��
TI3E �.PPLIC:�NT IS: (circle one) OWNER 0 ONT'RACTOR
JOB SITE :�DDRESS: ; ?�5 ��, v��+,•� �v�,�.��-'r _ ZII': S S3�f i
Nr�,��1E OF O`�NER: � -.-�. .^-fi �- L; (i /y1c.t�'VJ!l�.�i� PHONE: (home) L�7�a— $`����(o
(wori:) 3�)/— �'7�1/
v1AILING�DDRESS: .�/-I�Y�� CITY:�Rr/J� Z�:_��3Q�.
CONTR.ACTOR: ���, C��:��1(�i1�� �� � � � � PHONE: �-f�;��`Z7
i IOBILE PHO�IE/PAGER:
MAII.ING ADDRESS: I SC�S��./� INI T�-%t t��Ui� CITY:l��l�-`[���T/�- ZIP: c - c
STATE LICENSE: # oZ�1£5�5
ARCHI'TECT/ENGTivEER: PHO�IE:
MAII.ING ADDRESS: CITY: Z��
NAlV1E: REGISTRAT`ION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Larxi Alterarion
PROPOSED WORK(describe indetail): �-,,,��,,,� 0�l���� � L� ' , 2P,o I.c:tC� �-�1 r�
I,.1y � ►�0 �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVLS: GARAGE STALLS: ATT. DET.
EST��TEDCONSTRUCTIONVAI.UATION(eYcludingland): � G� ���
I hereby apply for a buildin� 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 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.
�._ , .,
APPLIC��1T'S SIG�tATURE: �''�'r.'�' :<' 4�---- DATE: �� ��'�b
NOTE! Parade of 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.
li
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information req�rired to be givm individual. An individual asked to supply private or confidendal data concerning himsdf shall
be informed of: (a)the putpose and inunded use of the roquesud data within the collecting§rate agency.Poliucal subdivision,or staoewide sysoem;
(b)whether he may tefuse or is legally nquired to suppty the csqucsted data;(c)aay lmown consequence arising frvm his supplying or cefttsing m supply
private or confidenrial data:and(d)che idenary of other pecsons or endaes authorized by state or fedecal law to teceive the data. This requirement shall
not app(y when an individual is asked to supply investigadve data,pursuant to secdon 13.82,subdivision 5,m a law enforcement officer.
The commissioner of revenue mav alace [he noace reauired under this subdivision in the individual income tax or aroDerev tau refund
inswcrions insuad of on those forms.
Subd.3. Access to data by indiridual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject
of stored dara on i�ividuals,and whecher it is classified as public, private or co�dendai. Upon his further request,an individual w6o is the subjecc
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 contenc
and meaning of[hat data. After aa individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months theteafter unless a d'upute or action pursuant to this section is pending or additionai data on the individuai has been collected or creared.
The responsible auchority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible aurhority
may require the requesring person to pay the actual cosrs of making.cerdfying,and compiling the copies.
The responsibie authority shall comply immediacely,if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,ezcluding Sanudays,
Sundays and legal hotidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compieteness of pubiic or private
data concerning i�imseif. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the disagreemenG
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and atumpt w nodfy past recipiencs of
inaccurate or incomplete data,including recipienu named by the individuaf;or(b)notify the individuai that he believes the data to be correcc. Data
in dispute shall be disclosed onty if the individual's statement of disagreement is included with the disciosed data.
The determinadon of the responsible authority may be appealed pursuant to the provisions of the adminisuative procedure act reladng to
contested cases.
DATA PRNACY 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 fumish 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 eztent 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 cenain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(, Your full name is required to process this application or permit.
'TO V►� F N�e.�+�v �. _
First Middle �L
2 O S O (��'4t.t�cU wr,� Y�t�
Address �
Lon�� La�ct ►N►►� �3 S G �l,S`-.'lrF��
City State Zip Phone
I understand my rights as stated above.
� f
Signacure
CHECK OFF LLST FOR ISSUAriCE OF PERMITS
FOR OFFICE USE ONLY
A.DDRESS OR LEGAL: t 2�s L`I�'►��4n1 �vG
PID:
DESCRIPTION OF WORK: (2�.nn.o��t't, t �����
ZONING REVIEW BY: C�^--- DATE APPROVED: .•�-�6 -gL =
BUII�DING REVIEW BY:
DATE APPROVED: S-/6• �t L �
FEES TO BE CHARGED• Misc. Fees Calculated By:
PERMIT . Yes f No
PJ�AI�J gEVIEw Yes v' No � SEWER CONNECTION
STATE SURCHARGE Yes �No WA"I�R CONNEC7CION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No _ STI'E INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: Q R-1 r3 Shoreland Disuict: I�t�
Fire Department: L o n�� Post Office: w A��it� School District: (�(��s c� _
Lot Area: Sq.ft. NO CM�^� Acres Width Depth
Survey Submitted: Yes _� No Date of Survey: S-� ��f�o
Proposed Setbacks: � _
Front (Lake): 1� �/�r Right Side: {6�
Reaz (Street): /5�� '!" �fr Side: 1 10 � '�
Adjacent Structures: A�'�7°►C.i}6� Wetland: ��� 'F-
Building Hei t: Def. Hgt. Pe� �•
Avg. Setbac Bluff Set ack: Lot Coverag :
Existing Proposed
Hardcover: 0-7 '
75-2 '
250-5 '
500-1 '
Hazdcover V 'ance Requir : Yes No Date of Co cil Approval:
Grading: St Approval Date. y: uncil Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: # R oluti n: # Resolution Date:
(in h0use):
BUII�DING REVIEW CHECK LIST
UgC: (Z''3 CONSTRUCTION TYPE: 'Y N
• Sq Footage � Per Sq Ftg
Basement R —
lst Floor z —
2nd Floor R —
Garage R
R -
TOTAL
ou
Estimated Construction Value: $ L t r�d
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical ' Water Connection
�C Footing Septic Sewer Connection
p� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
_�c Wall Board (Mfg.) Well (State Permit)
�F�� Grading/Filling oL Electricai (State Permit)
Other
P��V][AItI�S (IN HOUSE):
--------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY�
---------------------
RENIARKS(TO BE NOTED ON PERMIT):
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SP�CIAL NOTE ��' �� i;� 6'-8" nni�v. HEa�Roor� �
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S�E AT�f�CHED S9-�EET �� �� ;, � ,,
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36" MIN. 1-iE�G�T
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� A��ROVED WITN CG#�;i�u���'zOr�J� �`,S NOTED
s'w� NOT �EPr��OVED — CG�t�t��J' & RESUB�,�IT
�� car»r�tents are tor yeur intorm�tfp:i. AI; work sr.�stl e€ �ro-a
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� _ _-, � Af�#��i{)A1ED 'ba�%IT� C�J°r�tri i:�f gfJi�.f3. �S NOTEa
_ �. tVOT ��4iOV�D — C;.�t��t�.��' &. RtSI}8�r°.iT
�'y� coFr►e�uenta are far yaur ititorn;nrf%or;. RI� work she�;; se +��:s
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DATE T,�I �E,,Y
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DATE TIME
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INSPECTION NOTI E p SCHEDULED -� 96 � �3 O
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v 07 DEMO—SRE 27 SEPTIC MAINT. 21 COMPWNT
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White Copyllnspector's Fle Canary Copy/Site Notfce
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DATE TIME
CITY OF ORONO CALLED IN � /.�/��
INSPECTION NOTI E SCHEDULED �/7 �� �
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� 07 DEMa—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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CE EL ZABETHF MCM LLAN�R t+�O� ��.����
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IN LOT 2, BLOCK 1, ORONO ORCHARDS HIGHLANDS
HENNEPIN COUNTY, MINNESOTA
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[�APPROVED-- ���
❑ APPROVED WITH REVISIONS
❑ DISAPP� V��
BY �_
LEGAL DESCRIPTION OF PREMISES: DATE �-(� �� �
Lot 2, Block 1� ORONO ORCHARDS HIGHLANOS
This. survey intends to show the boundaries of the above
described property and the location of an existing house
thereon. It does not purport to show any other improvements
or encroachments.
Bearings shown are based upon an assumed datum.
o: denotes iron marker
I hereby certify that this survey was prepared by me or under my direct super- �A� 5-8-96
1 � 1 i '
! vision, and that I am a duly registered Civil Engineer and Land Surveyor under
� the laws of the State of Minnesota. �A� �„: �,
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Mark S. Gronberg Minnesota License Number 12755 los tvo. 96-2/a