HomeMy WebLinkAbout1999-011621 - porch over deck PERMIT
CITY OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 �-;::i�_r,;�;;��i=;
Crystal Bay, Minnesota 55323 Permit Number: =_ � ; ;�.��
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Date Issued:
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(612)473-7357 �7�.':�`:``=�-
"ITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — �;�.s�� ��,�,-�t. — ��;� . ; �;�: .OWNER:
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APP ICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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'Tota.l Fee: $ � I��o-C�� Date Received: �P -- a?�- ��
Entered By: ' Permit#: -�� ��
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CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
--------------------
THE APPLICANT IS: (eircle one) OWNER CONTRACTOR
JOB SITE ADDRESS: 3�a � � ��<<% ��'� Z�:
NAME OF OWNER: G,`I� � ` ��e- PHONE: (home) -� 7 q 7 C�
(work) , ?la- � d
MAILING ADDRESS: Cc, ZQ�.`f� CITY: �'`�1�— ZIP:
CONTRACTOR: 0 k V V`L ���j PHONE:_
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: �(9 � 131 G c�� �CITY:��ev����d'��- ZIP: 5�3�.�
STATE LICENSE: # a0o 0 3d"1 l
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 detai�: C!� Y'�Pi E 0� ✓�� � v��
,1 i� ��i�( or� � �'c� ,
STORIES: �_ SQ.FEET OF EACH FLOOR: , � _
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� �vv «b b
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
the State Building Code; that I understand this is not a pemut and work is not to start without a
pernut; and that the work will be in ccordance with the approved plan.
APPLICANT'S SIGNATURE: �G�-" DATE: (J�(� S r 7 1
NOTE! Parade of Homes 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 SUBJECTS OF DATA
Subd. 1. Type of data. The rights of i�lividual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Informatton required to be given i�lividual. An individual asked ro supply private or confidential data conceming himself
shall be informed of: (a)the purpose and intended use of the roquested data withii►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 lmown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of ott�r persons or entiaes authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to sypply investigative data, pursuant to secaon 13.82, subdivision 5,to a law
� enforcement officer.
The commsssioner of rovernre mav nlace the notice reauired under this subdivision in Uie individual income taz or oronertv taz refund
instructions instead of on those forms.
Subd.3. Acccgs to data by individual. Upon request to a responsible suthoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further nquest,an individual who
is the subject of stored privaoe or public data on individuals shall be shown the daha without any charge W tum and,if he desires,shall be informed
of the content aad meaning of that data. After an individual has bcen shown the private 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 this section is pending or addi6onal data on the individual has been
collecoed or created. The respoacible authoriry shall provide copies of die private or public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the acmal costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant w this svbdivision,or within five days
of the date of the request,excluding Sauudays,Sundays and legal holidays,if immediate compliance is not possible. If he carmot comply with
the request within tbat time,he shall so inform the individual,affi may 6ave an addi6onal five days within which W comply with the request,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of Fwblic or
private data conceming himself. To exercise this right,an individual shall notify in writing the responsffile authociry describing the nature of ihe
disagreement. The responsible authority shall within 30 days eid�r: (a)correct the da�found to be imdccarau or incomplete and attempt w�tify
past recipients of inaccurnte or incomplete dala,including recipients named by ihe individual;or(b)notify the individual that he believes the data
to be correct. Data in dispuu shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions 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�ity of Orono or any of its departments may require you to furnish certain
private or confidenrial information.
You aze notified that:
1. The information you futnish 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 acrion 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.
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Ci�y State Zip Phone
I understand my rights as stated above. �
Signawn
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CHECK OFF LTST FOR ZSSUANCE OF PER��TS �
. ` FOR OF�T�E USE ONLY
AUD�tFSS OR LEGAL: � (G Z� r i �. � v-e v��, ��3 �r / !
PID: 1 � �- 117 � L3 �3� �0y � .
DES C�tIPTiOY OF VYO�: `c �r •��ti� o-Y�c V� �, .��� �x+s� � �',q �c�
. �
ZO�TiYG REVIEti�BY: - ' DATE APPROVED: � -Z`1-`I `� f
BU]ZDItii'G �tEVIE��BY: � . . DATE APPROVED: 7 - t� •.� g I
�'EES TO BE CI�2GED: • � � � . Misc. Fees Calculated By: � � � � �
PERMIT Yes No I
PLAN REV�W � Yes No SEV��CO�INECI'iON �
STATE SUR`�i�,RGr, Yes No �ATER CO�IYECI'ION '
IIVYESTIGAZTON-FEE Yes No PARK FEE
SAC Yes No STTEINSPECITON �
Number of SAC Units ���OTHER (specify) �
ZO�'G C�iECK l,IST � zonino Discricr � � - �C- � ------- �` . '~
, � � i,
Fire Deparanenr. �0 Post Ofiice: •Z ct/�t School District: � �� .
Lot Area: Sq.fc. No c i�NG� Acres — tiVidth _ Depth `�
Survey Submitted: Yes � No Date of Survey: �' � P— I L t
Proposed Setbacks: , /' ) �
- — — - Front (La.'ce): , �-f� � Right Side: _ - l �— _ --=-- ----- — =�=_--
-_ __ � � � y ►
Rear (Street): �-3� , Left Side:
. Adjacenc Structures: �Vetland:
z , _
Building Heioht: Def. Hot. �d Peak Hgt. �
Lot Coverage: _ N� C tf�v.c,�L
Gradin�: Stafi Approval Date: �— By: Council Approval Date:
. Septic: Staff Approval Dace: — By; • � .
Zoning File: � - �---- Resolu[ion: � Resolution Date:� � • .
Shoreland Disc.-ict: /�iU �
Avg. Setback: Bluff Setback: Lot Coverage: � .
' • Exiscing Proposed �
Hardcover: 0-?5'
75-2�0' . . � .
250-500' � � •
SdQ-1000'
Ha:dcover Variance Requircd: Yes No Date of Council Approval: _
' ' Y
RE1�L?�RKS ('in house): � —
. �
. i - � ' �
• '' 26
. . �� . •
. • .. .. .. • . � S
. BUIL.DING REYIEtiy CHECK LIST � ' : . - - . .
UB C: � i2�• 3 . . COYSTRUC3TOY TYpE: - .. � �
.. �/N . . .
� � Sq Footage . S Per S Fc � ' .
, Basemeat � x q g . : . - . .
. . . lst F1oor . ' � . . _ � .
�� � • 2ad Floor �x • , �� . � . . ... . . . : .
.� Garage . � •x .. • . • • �:. , - .-- . . . . . :
x , � . . .
X = _ . � .
• —_ .
. ?OTAL� � .
Estimated Construction Value: S . g- ��n � . � � �
- - - Xnspectioru Requ�red: • - . tiyork Requlring Separate Permits:
Sice . . •_.�Plumbiag � .Fire .. � • - .
Hardcover Removal M���� .. . . .
_Footing Septic - tivat�r Conaecdoa. . ,
=Fra,mip,g _ � Sewer Connectioa � - �
IasuIation ._. � Fueplace Lawn Irrigauon
______Wall Board ��0°�� Other � . . . � � ,� . - •
_�Final � • (�'ifg.) Well (Stat� Permit) . •
_____Ocher G�d���l�� -�Electrical (State Permit)
. 1�EMAR�aS (IN HOUSE�: . . • .
--------------------------------------�
REYIEVY BY OTHERS: • DATE: � � - w� .
� Accas: Ezisting � Netiv � -
• Access�Approval: Date .
----------------------------- By'
RE�IZA.R1iS('!'O BENOTED ONPER�I�IlT�, . � .
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. �.;�- �.'� . . . • • . . .
AT TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED �' �s ��w
PERMIT NO. ���Z� COMPLET
�DDRESS �lD �
OWN ER CONTF�C���l_,��-.-.�
TELEPHONE NO. 7'�i13 �-Z�/ �
� DESC TION�Ij /71C�J�c-c/ .
� OOTIN 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WA�I 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 70 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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W� �l WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W� O CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Cali for the next i ' n 24 hours in advance.473-7357
Owner/Con ct r on s e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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