HomeMy WebLinkAbout1999-011422 - shed . PERMIT
C1TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 _� ' �= i"`�;��ut�;;
Crystal Bay, Minnesota 55323 Permit Number: ">� fi a�>>�.
Date Issued: ��� ���SW M -
(612) 249-4600 . . -. . - -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- . , , .. ._ ._ . . -. _ --
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APPLI PERMITEE SIG E ISSUED BY:SIGNATURE
Total Fee: $ �,�.'7f� Date Received:
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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)
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THE APPLICANT IS: (circle one) OWNER,OR CONTRACTOR
�-.,--
JOB SITE ADDRESS: �� �j(� Q,��1 �.'��� ��Yl IUY , ZIP: �G 4'`
�
NAME OF OWNER: 9 I Vi(�,� C1 ��(� PHONE: (home)�7 L" I (p U �
(work)^;"�� 'I �' �'q'
MAILING ADDRESS: ll �(,� ��.7V`�1, �V'�b`Yl CITY: �'''�y'v'(�. C�' ZIP:_�(��
CONTRACTOR: �t ��- PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: b` G� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition ( Accessory Structure ` ��:�,
____-----
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �fl.L� X ( � �G� � � �( ('_ (�U`�-`'YL�V � �
�' - ^ i.; �, ` cl�'`1.,4% � ' 1,�' ._.. '� �y �
STORIES: ` I , SQ. FEET OF EACH FLOOR: �
NO. OF BEDROOMS: � GARAGE STALLS: ATT. `'�.DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �(�(� ��
I hereby apply for a building pernut 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 ac�ordance with the approved plan.
��` ' ,_
APPLICANT'S SIGNATURE: � /�----� DATE: �'" � � ��`�
NOTE! Parade of Homes events require eparate perinit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
Sea 13.04 RIGHTS 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 section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,poliacal 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 supplying or
refusing to supply private or confidential data;and(d)the identity of other persons or enriries authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesdgative data, pursuant ro section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav alace the notice reouired under this subdivision in the individual income tax or nrooertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be inforcned 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 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 to him for six months thereafrer unless a dispute or action pursuant to rhis section is pending or additional data on the individual has been
collect�d or cceated. The responsible autheriry 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 costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply 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 tune,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.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,including recipients 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 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 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 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 pemut 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.
� ,,'L� ci' � E � '� S°'�►
First Middle Last
y �� ��'' i'7`�� /��<� � �
Address� �� �'�/�`� � -� �� �� � � � ��'��
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Ciry State Zip Phone
I understand m,}c.r�g�s-as stated above. _
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Sig te_-—
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, �
y CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSORLEGAL: �TSO IVORTI� f1fLIM L�2
PID:
DESCRIPTION OF WORK: �Kt=/J
ZONING REVIEW BY: DATE APPROVED: S�-r�-$�
BUII.DING REVIEW BY: DATE APPROVED: �--�� -4 S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �' No SEWER COTtNECTION
STATE SURCHARGE Yes ci No WATERCONNEC'fION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: GQ '�Q
�o�l Fire Depaztment: Post Office: School District:
G�� \ Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes v� No Date of Survey: Gw �=�L�
Proposed Setbacks:
�e�(Lake): �' $l0` t Right Side: 2 �-(
�(Street): 1 Z� '� Left Side: Zbv �
Adjacent Structures: � � -r' Wetland: /✓�/9
Building Height: Def. Hgt. d 4 i�- Peak Hgt. �
Lot Coverage: a< �--
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
� ��, Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Vaziance Required: Yes No Date of Council Approval:
MARKS(in house):
7
� .
BUII.DING REVIEW CHECK LIST � � � �
UBC: (Z•3 CONSTRUCTION TYPE: � �1N
Sq Footage $Per Sq Ftg
Baseme�t x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
r� rx?
Estimated Construction Value: $ 7J��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical . Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit) �
�Final Grading/Filling Electrical(State Permit)
Other
REMARKS(IN HOUSE): ___
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI�:
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT SCHEDULED f� �
PERMIT NO. �����' COMPLETED �'a �
ADDRESS �� ��'����� �'
OWNER CONTR.
TELEPHONE NO. ������ �
� DESCRIPTION _ ������r�'"
� 01 FOOTING 11 ECHANICAL RI 18 EXCAV/GRADING/FILLING
.Q 02 FRAMING 13 MECHANICAI FINAL 19 LAKESHORE/WEfLANDS
y 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
14 SEWER HOOK-UP 06 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 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
a COMMENTS:
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d �11 IORKSATISFACTORY:PROCEED �pROJECTCOMPLETE
� � �CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner►Contractor on site:
Inspector. � -G�-r���J-S
White Copyllnspector's Flle Canary Copy/Site Notice
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