HomeMy WebLinkAbout1999-011233 - replace window/remove dec PERMIT
CIT;� OF ORONO PERMIT TYPE:
,2750 Kelley Parkway- P.O. Box 66 `��'?�?_�.��_���
Crystal Bay, Minnesota 55323 Permit Number: �=;� ; ;-:_;_;
(612)473-7357 Date Issued: � _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — ��=��l �.c�a��. — OWNER:
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APPUCANT PERMITEE SIGNATURE ISSUED BY:SIGNAT
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
` FOR OFFICE USE ONLY
ADDRESS OR LEGAL: S"vU 11Jdti�'� i9,��
PID:
DESCRIPTION OF WORK: l,��N�O c.,�
--- --- __--____--------------------------------------------------------------------
ZONING REVIEW BY: ��- DATE APPROVED•
BUII.,DING REVIEW BY: DATE APPROVED: � �.V—�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �� No � SEWER CONNECITON
STATE SURCHARGE Yes �/ No WATERCONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: N� Cr��p
�`
Fire Department: Post O�ce: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Reaz(Street): Left Side:
Adjacent Swctures: Wetlan :
Building Height: Def. Hgt. Peak H t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By: `
Zoning File: # Resolution: # esolution 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):
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BUILDING REVIEW CHECK LIST �
UBC: /Z • 3 CONSTRUCTION TYPE: VN
Sq Footage $Per Sq Ftg
Basement � x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
v�
F,stimated Construction Value: $ ��d0
Inspections Required: Work Requiring Separate Permits:
� Site Plumbing Fire
Hazdcover Removal Me,chanical Water Connection
Footing 'Septic Sewer Connection
�Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
�Wall Boazd (Mfg.) Well(State Permit)
inal Grading/Filling �Electrical(State Permit)
Other
REMARKS(IN HOUSE): �
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
,
REMARI�.S (TO BE NOTED ON PERMI�:
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'Total Fee: $ Date Received:
Entered By: 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: 'rj o� NO✓'"f� ri�'� �r% ZIP:
NAME OF OWNER:�r V c t �O�n So� PHONE: (home) �f 72- �/(7
(work)
MAILING ADDRESS: CITY: (�YON� Z�:
--v
CONTRACTOR: � ; o(,' CO'� HONE:_ � � 3'��3 7 G�
CONTACTPERSON: �a,� �Q�cr M ILE/PAGER: �/�f g - �070
MAILING ADDRESS:�O_ C�oX G R(3 CITY: Wa Y Za-iq ZIP: S 53 q /
STATE LICENSE: # t�C�o 5�,17��
ARCHITECT/ENGINEER- - � e.T PHONE:
MAILING ADDRESS: � CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
�Z�
PROPOSED WORK(describe in detai�: �. o ' C ✓S a�
y�{n/q cG twl��-f In tv<< r..�low S ^ uo ��E-vu��,t v,�— ' ✓k..a v��wl o Ve.
��X t�5-�F' �o r ( C.o yt 5'�"v uc�`a o�( d+�c�B C - v�o K et.v o(e c,k
STORIES: ��� S Q�FEET OF EACH FLOOR: rt.-{- -t�In�S -��w�� .
NO. OF BEDROOMS: � GARAGE STALLS: ATT. �_ DET.�
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �'d� �
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 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: Z'Z'�"�'9 I
NOTE! Parade o�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 iiuiividual on whom the data is stored oc to be stored shall be as set forth in ttils section.
Subd.2. Information req�rired to be glven individual. An individual asked to su�ly private or confidendal data conceming himself
shall be informed of: (a)the purpose a�inteaded use of the roquested data within the collecting state agency,polidcal subdivision,or statewide
system;(b)whether he may retuse or is legally required to supply the requesoed data;(c)any larown consequence arising from lris supplying or
refusing to supply private or confidential data;and(d)the ideatiry of other persons or entiues aud�orized by state or federal law to receive the data.
This requirement shall not apply when an.individual is asked w supply invesdgative data,pursuant to section 13.82, subdivision 5,to a law
enforcement officer. •
T1,P�nmmiccinrwr nf fCVEtIIP IILV DI3Cp the noticp rea�ired Lnder this subdivision in the individual income hax or orocettv tax refund
instn►ctions insuad of on diose forms.
Subd.3. Access to data by indivi�lual..Upon reqdest to a responsible authority;an iadividual 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 request,an individual who
is the subject of stored private or public data on individuals sl�all be shown ihe data without any chazge 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 infocmed of its meaning,the daha need not be
disclosed to him Sor six months thereafter unless a dispute or.acyon pu►�aut to this secdon is pending-oc additional data on the individual has been
collected or createcl. The responsible authoriry shall provide copies of d►e private or public data uppn request by the individual subject of the data.
� The responsible suthoriry may require the requesting person to pay the actuat costs of making,certifying,and compiling the copies.
The responsible authority shall comply icnmediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the reqaest,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 additional five days within which to comply with the request,
excluding Saturdays,Sundays and legal holidays.
� Stibd.4. Procet]ure when data is not accunate or lomplete. ,An indiyidual,may cOnt�.ct the acc,uracy or completeness of public or
privaot data CBncerning�himself. To exercise this right,an individyal shpll notify in writing the respoesible authoriry describing the naNre of the
disagreemetrc. The responsible aud�oriry shall within 30 days either. (�)cohect d�e da�fafnd oo be inaccurate or i�ompleoe and attempt to�tify
past recipients of inaccutat�or iacomplete data,icxluding recipients namead by�tMe udiyidual;:pr(b)�dfy 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 deumtination of dre rospoasible authority may be appealed pursusiit t0 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 Gity of Orono or any of its departments may require you to furnish certain
private or confidential information.
You are notified that:
l. The information you furnish will be used to determine your qualification for the permit or license
, _ , requested.
;;.;. , 2.. . ,You maX refuse to supply data, hut refusal may require that the City deny the permit or license.
Y 3. � The information�may�be shated with�othei local, state or federal agencies tp the extent necessary to
;. . � ,. ' ~process the pei�miCor'ticense` ', � , . " '. , �. _ . '
' : 4: � • Ifyour requ�sted permit of�'li�eese`�equires�eouncil acrion to:approVe; some�iuformation�may become
. � , . •pubfic. � �
5. , You have certain rights under M.S. 13.04(available upon requestj to review private data on yourself.
6. � Your full name is required to process this application or permit.
First Middle �s�
Address
C��y State Zip Phone
I understand my rights as stated above.
Signature
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D E TIME
CITY OF ORONO CALLED IN � �"
INSPECTION NOTICE SCHEDULED — `���� /'C) � ���'
PERMIT NO. � 3 COMPLET D
ADDRESS --� -
.
OWNER CONTR.
TELEPHONE NO. ��� 'C�7�1�
� DESCR ON ��1�.�,�i
l� 1 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 0 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
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 COMPLAINT
v 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/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN [- CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ext inspection 24 hours in advance.473-73rJ7
OwnerlContr r site:
Inspector.
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