HomeMy WebLinkAbout1996-008122 - stairs to Lake .. PERMIT
�ITY OF ORONO PERMIT TYPE:
?750 Kelle Parkwa P.O. Box 66
�r stal Bay Minnesota 55323 Permit Number: E:E i�(..[���rit=�
y y Date Issued: �'�?�j���'��=
(612) 473-7357 ��i:'� i f'��,
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NA�iKS:
E SUMMARY:
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CONTRACTOR: _ A�,F,� ���}�� _ ,Y,-� �?�.. OWNER:
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APP I ANTPER TFF�IGNATURE . ISSUEDBY:SIGNATURE ��
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-, �
�, �Total Fee: � ''� � � ' � DateReceived: � - ,,1� '�j(�
Date Approved:
Entered By: r��%" Permit#: ��/ � "'-��
CITY OF ORONO - BUILDING PERII�IIT APPLICATION
ALL I'ivFORMATION vIUST BE SLB�IITTED I�i 1 FULL BEFORE PLr��1 REVIEW WII.L
BE ST�RTED
-------------------------------------------------------------------------------------------------------------------
THE �iPPLICA:�1T IS: (circle one) OWNER OR CONTR.ACTOR
JOB SITE ADDRESS: �� �� � .� �� h_ �t2 L��� Zg':
NANIE OF OWNER: -�—�C� l�_ � ��'��`��� PHOIVE: (home) � - ��>1
`� (work)
VIAILIi�'G ADDRESS: 7�b � a� l 1'�, �2.�}r CITY: {'�,� �-,.��; ZIP:
CONTRACTOR � �-c_ ►� � . �_ PHONE: �2�i ��� �
vIOBILE PHO�tE/PAGER: - ���,' ��,`�T_
MAILING ADDRESS:�� �' � e���,�'�. ,�� � � CITY:�'n��i,�.�LL � ZIP: �s/ i' �
STATE LICENSE: # �_o� �S �7T
ARCHI'I'ECT/ENGI�YEER: PHO�IE:
MAILING ADDRESS: CITY: ZIP:
�,T�V�; REGISTRATION #
TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteranon
PROPOSED WORK(describe indetail): ��I� j �L ('(� r, �C_ �� L�L� f
� � � 2 `�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
C� �-�_
EST��TED CONSTRUCTION VALUATION(escludingland): $ � � -_ •
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 City
and with the State Building Code; that I understand this is not a permit and work is not to stan
without a permit; and that the wor�k will be ' acco nce with the approved plan. '
�
� � �
APPLICAI�'T'S SIGNATURE: " DATE: r- / �
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.
��
. i
Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be scoced shall be as set forch in this secdon.
Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidential data conceming himself shall
be informed of: (a)the purpose and in[ended use of the requested data wichin the collecting§tate agency,poflacal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supp(ying or refusing to supply
private or confidendal data;and(d)che idendry of other penons or enddes authorized by state or federal law to receive the data. T'his requiremenc shall
not apply when an individual is asked to supply invesdgadve data, pursuant to secdon 13.82,subdivision 5, to a law enforeement officer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income cax or propertv tax refund
instrucaons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuais,and wherher it is classified as public,privace or confidendal. Upon his fur[her request,an individual who is the subject
of storod 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 individual has been shown the private data and informed of its meaning,the data need not be disclosed w him for
six months thereafrer unless a dispute or action pursuant to this secdon is pending or addiaonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. The responsible au[horiry
may require the requesting person to pay[he acma!cosu of making,cerdfying,and compiling the copies.
The responsible authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the cequest,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc
wi[hin that dme,he shall so inform[he individual,and may have an addidonal five days within which to 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 public or private
data concerning himsetf. To exercise this right,an individua!shall nodfy in writing the responsible authoriry describing the nature of the disagreemenc.
The responsible authoriry shail within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to noafy past recipiencs of
inaccurate or incomplete data, including recipiencs named by the individual;or(b)notify the individual 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 authoriry may be appealed pursuant to the provisions of the adtninistradve procedure act relaang 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 fumish certain private or
confidential information.
You are 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 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 action 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.
�. � �,�.- � �
p � . Middle Last
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Address �
�« ; /,����T► � L �- lv� � s� t �� � 3 �' � l
C��,�— State Zip Phone
I understand my rights as stated above.
signamre
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•' � CHECFi OFF LIST FOR ISSUr�iCE OF PERi�gI'S
FOR OFFICE USE ONLY
?,DDRESS OR LEGAI.: �� �3� ti���n`��� �'`��-
���;
PID: � �� � �� SS 5 ;�4�2>
DESCRIP'TION OF WORK:
Z0�1G REVIEW BY: ^,,..: _ DATE APPROVID: �2.��-�'� � -
`7 6
l DATE APPROVID: '1 -� -5,�
BUILDING REVLE`Y BY: �1:,_.. `
FEES TO BE CHARGED: Misc. Fees Calcular.ed By:
PER'vIIT Yes � �o
P�N ��� Yes V No SEWER CONNECTION
WATER CONNECfiION
STATE SL�RCHARGE Z'eS � No pARK FEE
INVESTIGATION FEE Z'eS No S� �SPECTION
SAC Yes
Number of SAC Units _______ OTHER (speciiy)
/ )�� Shoreland Disuicc : �� `'=
ZO�G CHECK LIST ZOIllIIa D1SLI7C[: �l`-��
Fire Department:
Post Offis,e: � oo District:
� � �� —
Loc Area: Sq.ft. � Acres � � �� Vd!id i � Depth
Survey Submitted: Yes
No ,x Date of Survey:
Proposed Setbacks: � �p
Fronc (Lake): �� Right Side:
Rear (Street): Left Side: �
Adjacent Stru res: W ��d' �,
Buildin� Height: Def. H .
Pe H�t. '
Av;. Setback: I Bluff Setback: ! L,ot Coveratge:
Ezisting Proposed
Hardcover. �-75' ;
75-250' �
250-500' — �
500-1000' -----
,____
� Date of Council Approval: �_
Hardcover Variance Required: Yes i o
Grading: Staff Approval Date: BY�
Council Approval Dac�:
Sepdc: Staff Approvai Date: By: `
�
Zoni.n; File: � Resoluuon: 7�� Resolution Date: --
�
��ViARKS (in house):
k
., r �
.. . a
BUII.DING REVIEW CHECK LIST _
UgC; �� 5 CONSTRUCTION TYPE: � �
Sq Foota�e 5 Per Sq Ft�
Basement x —
lst Floor x —
2nd Floor z —
Garage x —
x =
TOT�L
��
Estimated Construction Value: $ �`�J ���
Inspections Required: Wor�; Requiring Separate Permits:
Sice Plumbing Fire
Hardcover Removal �Iechanical Water Connection
_� Footing Sep[ic Sewer Connection
_�Framing Fireplace Lawn Irrigation
Insulacion (Masonry) Other
Wall Board (Mfg.) Well (Stace Permit)
__�Finai Gradin�/Filling Electrical (State Perm.it)
O[her
RF,MARh� (]N HOUSE):
REVLEW BY OTI-�RS: DATE:
Access: Ezisting New
Access Approval: Date BY�
REI�IARKS (TO BE�10TED ONPERI�IIT):
�7
�
G%'�
ATE TIME
CITY OF ORONO CALLED IN `7
INSPECTION NOpTICE SCHEDULED '� /U•.3 0
PERMIT N0. /1 ��.Z—' COMPLETED �
ADDRESS
OWNER CONTR.
TELEPHONE NO. ,�`85-�Co?�
� DESCRIPTION_�j,���d
W Ot FOOTINQ 11 MECHANICAL RI 18 IXCAV/aRADIN(3lFIWNQ
�
�Q INO 73 MECHANICAL FlNAL 19 LAI�SHORE/NIETLANDS
� 03 INSULATION 24/2S WOOD BURNER/FlREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL 14 SEVVER HOOK-UO O6 PROORESS
�
v 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINd RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YQU: YES_NO
y COMMENTS:
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d ORK SATISFACTORY:PROCEED
W� G PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOYERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next i pection 24 hours in advance.473-7357
OwnerlContract o
Inspector.
White Copy/inspectw's File Canary Copy/Sifa Notka
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