HomeMy WebLinkAbout1998-010849 - attached garage w-
PERMIT
CITY OF ORONO PERMIT TYPE: _ ;������;
2750 Kelley Parkway- P.O. Box 66 Permit Number: i'`�'``�'=���� -
� Crystal Bay, Minnesota 55323 : £_'f`-'��`�s=°
Date Issued:
(612) 473-7357
SITE ADDRESS: �� ;,;,isL-�� ��;�;;;� r,}:�
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FEE SUMMARY:
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APPLICANT PERMITEE SIGNAT E ISSUED BY:SIGNATURE �.,; ; :
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Total Fee: $ �" � - � � � Date Received: � /� �t�-�,r
, ' Entered By: Permit#: i �-� �`� l
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 CONTRACTOR
JOB SITE ADDRESS: �j 'M � � a p R ZIP: 5 S 3 � �
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NAME OF OWNER: (�,�., ►'l o. �-�.b5 G� PHONE: (home) y 13�a 3 6 �
(work)
MAILING ADDRESS: �-}S �v1� R+�t,w�d� �CITY: QR�� D ZIP: S�J3 /
CONTRACTOR: �� �Fl S(<a g C o vvst'�„c,Tt 0�v PHONE: �7`�- � 3`�3 ��S-16 ��
CONTACT PERSON:pA�i� R as k�� MOBILE/PAGER: �65-7 6 0 7
MAILING ADDRESS: 1� 6 y a�.d�u� A.vZ_ CITY: V1/lec��NA ZIP: S�
STATE LICENSE: # �y� I
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NANIE: REGISTRATION#t
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration )0 Land Alteration
PROPOSED WORK(describe in detai�: RQ„vv�01/�, O 1 0� G ��. �' �2, v� l� �,.� ,",
1 0 ,i� � n. - 0" l G na�v�sZ- 6 X 1. 2,�d k�F�
1.' �4. dW 4.X�5�'rn.� �Oo � ��.�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ap
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ���bbb _
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 understan is is not a permit and work is not to start without a
permit; and that the work will be in corda ce with the ap roved plan.
APPLICANT'S SIGNATURE: s�.��� �—'DAT'E: �'�`�- ��
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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Sec.13.04 RIGATS OF SUBJECTS OF DATA .
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be gfven individual. An u�dividual asked to supply private or co�dendal data co�erning himself
shall be infomud of: (a)the pu�pose and intended use of the requested data within the collecting srate agency,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legaUy required to supply the requested data;(c)any known consequence arising from his supplying or
retusing oo supply private or wnfidential data;and(d)the identiry of other persons or enades audrorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The c�mm� ioner of reven�e tr�v nlace the notice reauired under this subdivision in the individual income tax or orocertv tax refu�
insavcrions insuad of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible audiority,an individual shall be informed whether he is the
subject of stored data on i�ividuals,and whether it is classified as public,private or confidential. 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 and,if he desires,shall be informed
of the content and,meaning of that data. After an i�ividual has been shown the privau data and informed of its meaning,the data need not be
disclosed to him for siz months thereafter unless a dispute or acaon pursuant to this secaoq is pending or addidomal data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible aud�ority shall co�nply immediately,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 compliance 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 the request,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Pracedure when data is not accurate or complete.�An individuat may contest the accuracy or completeness of public or
private data concernu�g himself. To exercise this right,an individual shall nofify in writing the.rosponsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)cortxt the data found'w be inaccur2te or incomplete and attempt to notify
past recipients of ic�accurate or imomplete data,i�luding recipients name8 by the individuai;or(b)noafy the i�ividual that he believes the data
to be correct. Data in dispute 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 administradve prceedure act reladng
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�iry of Orono or any of its departments may require you to furnish certain
private or confidential 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 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.
5. ve certain rights under M.S. 13.04(available upon request) to review private data on yourself.
6. Your 1 name is required to pr ess this application or permit.
� !`d
First �/ Middle Last
Z 2S D 7� Q�C�,i� �_4 �icl�
Address ` ^ / �! ��� ��� /j Q�
R �� " J l^ � !
Ci�y State Zip Phone
I understand rights as state above.
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Signature
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: �f S i'Vl ti2T�wodD ��
PID:
DESCRIPTION OF WORK: �-�� rT�a-G/fC,�
-------------------------------------------------- --------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: /d- ,�'--5�
BUILDING REVIEW BY: DATE APPROVED: �p • 5-7�g
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes (/ No
PLAN REVIEW Yes V No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: ��-1�
Fire Department: ��/.�r�,,q.� Post Office: W�—y�-y-�- School District: lA1RU'ZA T►�
Lot Area: Sq.ft. NO Gt��_Acres — Width — Depth "
Survey Submitted: Yes_ < No Date of Survey: p�--5� 4$
Proposed Setbacks: � +
Front (Lake): (,3 f Right Side: 33,
Rear (Street): Z�� t Left Side: fU//4
Adjacent Structures: ATT7-►t/f� Wetland: li✓��
Building Height: Def. Hgt. (�� (�- Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
�(.� Shoreland District:
�" Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
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BUILDING REVIEW CHECK LIST
UBC: �Z- 3 ' CONSTRUCTION TYPE: �/�
' Sq Footage $ Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
pv
Estimated Construction Value: $ Z�l� CJ�O �
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�C Footing Septic Sewer Connection
a Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
o<Final Grading/Filling o�Electrical (State Permit)
Other
REMARKS(IN HOUSE): �
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT�:
8
DATE TIME
CITY OF ORONO CALLED IN ' ��
INSPECTION NOTIC SCHEDULED 4—/ - • ��
PERMIT NO. � � � COMPLEfED
ADDRESS �
OWNER��1ldc �CONTR.
TELEPHONE NO. S�o 5 yb � 7
� DES
�y FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 0 AMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
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� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in ion 24 hours in advance.473-7357
OwnerlContractor it :
Inspector. -'
White CopyMspecto�'s Flle Canary Copy/Site Notice
ATE TIME
CITY OF ORONO CALLED IN ����
INSPECTION NOTICE �+ SCHEDULED <Y//`�/�Y / =�c�
PERMIT N0. 7 J COMPLETED � �h-
ADDRESS
OWNER CONTR. ��
TELEPHONE NO. O� �-�� �
� DESCRIPTION
t� 01 FOOTING 11 M HANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAMWG � 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
y�_
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-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 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED r; PROJECT COMPLETE
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� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ,- pHOTO TAKEN
INSPECTOR WILL RETURN
�: CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
L INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor o site:
Inspector. �-
White Copylinspecto File Canary CopylSite Notice
DATE /�TIME��
CITY OF ORONO CALLEO IN � �
INSPECTION NOTICE SCHEDULED �
PERMIT N0. COMPLETED _�� �_
ADDRESS S
OWNER CONTR. u �
TELEPHONE NO._�lo `S - Ql lod7
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� DESCRIPTION
t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
Q U TION 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �7 CITATION ISSUED
�INSPECTiON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
Owner/Contr� n s te
Inspector.
White Copyllnspector's File Canary CopylSite Notice
_ D�F TIM (.� �.
CITY OF ORONO /���� CALLED IN ; I��� J �
INSPECTIONNOTICE 'v SCHEDULED L�TT ��
PERMIT NO. COMPLETED �_ �
ADDRESS � 7��- ^� ��
OWNER -� '-f �i' CONTR.� /_"� / -�1.5 �C<il�
TELEPHONE NO. ��cS ` Q'(r,G'�
� DESCRIPTION _
l� 01 FOOTING /� 11 MEC A ICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING ` 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
h
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z .WIALL S.�D. 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINAL � 14 SEWER HOOK-UP 06 PROGRESS
� 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 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�' CITATION ISSUED
L INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr o ite:
Inspector.
\Nhite Copyllnspector's File Canary CopylSite Notice
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I hereby certify that ttrs is a true ard cwrect representatwn of a survey of F� �' . '
DEMARS - GABRIEL �^� ���$ �f t� sbo�e d°scribed land and of the bcatwn of aN W�IWngs, �Q�$7—B P R�PA R E D FO R -
LAND SURVEYORS� I1VC, �t any, tne�eon, and ax visib�e encroactxnents, it any, from a on sa�d Iand. B� P � • � . � � � � O �
: �
As surveyed by me this � day ot �p� , 19 � F�LE
3030 Harbor Lane No.
� Plyrtquth, MN 554s7
= Pflo��e: (612) 559-0908 ��y���� ���D�
Z �A�rxi. Reg. No. ?Z¢�¢ / .