HomeMy WebLinkAbout1999-011332 - porch , PERMIT
' CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ��z_���.'�J�����r
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: `;� �'�-'��``
(612)473-7357 �:,���`_�=j``W:`=
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: _ -,,—, � �-�,, � _
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APPLICANT,PERMITEE SIGNATURE ISSUED BY:SIGNATURE �^t �
� Date Received:
Total Fee: $ ,;x?�,:�, ��
Entered B ' Permit#: " '
y: �..:/� �'I`�a �,;:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------��-_�-----------------------------------------------------
THE APPLICANT IS: (circle one) OWNER�R CONTRACTOR
,�/ n ; , ,�
JOB SITE ADDRESS: � � �� JY��J f�J���% �-�✓�- ZIP: �<�-�� �
� �� / �
NAME OF OWNER:�� c'_yj�l,1� (i�� L�L� PHONE: (home)����% � �
(work) 5/� i/'�=
� �' > _ �
MAILING ADDRESS: 1?l�' ��G��d�l�'�� �G�CITY: �C�l"���= ZIP: --�
CONTRACTOR: ��C_� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILI��1G ADDRESS: CITY: ZIP:
ST�TE LICENSE: #
ARCHITECT/ENGINEER: � ��--� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: N�w Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
L �2- � �
PROPOSED WORK(describe in detai�: � ��1(,�=1%� � �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTINIATED CONSTRUCTION VALUATION (excluding land): $ ��_`� ��C"';
��-
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 unde stand this is not-a permit and work is not to start without a
permit; and that the work will b in a cor�anc� i tl�.approved plan.
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APPLICANT'S SIGNATURE: �� � �.��`'` ����� �� DATE: � � �� /
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.
5
Sec.13.04 RIGH'I'S 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 conceming himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide
system;(bj 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 idenary of other persons or entities authorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav�lace the notice reouired under this subdivision in the individual income tax or orooertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,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 request,an individual who
is the subject of srored private or public data on individuals shall be shown the dara 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 this secdon is pending or additional data on the individual has been
coflected or created. The responsible authoriry shail provide copies of the private or public data upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall compty 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 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 dara conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the dare 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 disdosed data.
The determination of the responsible authoriry 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 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.
��� � �����..�n � � , i� ��� l����
First Middle Last
Address
Ci�y State Zip Phone
I un rst d my igh as 'te above. -- -�—
r`��C. �2 /�,,�//� _ ��� �,� l
G i7� L'
Signature
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 12,1 C� �'V 0 RTl-4 f�2� '�2
PID:
DESCRIPTION OF WORK: Po2c(�
__ �� --- --_�__----------------------------------------- �
Z0�1ING REVIEW BY: � � DATE APPROVED: 9a�1-/S-9
BUILDING REVIEW BY: DATE APPROVED; �/-►S�S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
PLAN REVIEW Yes 1�- No SEWER CONNECTION
STATE SURCHARGE Yes _�/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SIT'EINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning Disuict: L2 - r fs
Fire Department: ry�o�w v� Post Office: ��nr D School District: t�J esTU r•�1�
Lot Area: Sq.ft. 1 l�,O'�0 Acres .�°1 Width 1 n0 1�eP� 1�7 n•H
Survey Submitted: Yes � No Date of Survey: l Z-S-�i co
Proposed Setbacks:
Front(Lake): 7 N� 'F Right Side: SO� +
Reaz(Street): �i I� + Left Side: Z9 � +
Adjacent Structures: l�4"rTti°�c-1+cm Wetland: N(/�
Building Height: Def. Hgt. O.k-- Peak Hgt. C�,LL
Lot Coverage: 1 Q°�o
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — - Resolution: # Resolution Date:
Shoreland District: �
Avg. Setback: Bluff Setback: I.ot Coverage: t 0"70
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARI�S (in house):
7
�
BUILDING REV�W CHECB LIST
�C� �Z' � CONSTRUCTION TYPE: �f!l�
Sq Footage $Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor a _
Gazage x =
x =
TOTAL
Estimated Construction Value: $ �5�L�V�°�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_�Footing ` Septic Sewer Connection
,�o,_Framing Fireplace Lawn Irrigation
� (Masonry) Other
�-�d (Mfg.) Well(State Permit)
_�F�� Grading/Filling e,Q Electrical(State Permit)
Other
REMARKS(IN HOUSE): .
-------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
-----------------------------------------------------
REMARKS (TO BE NOTED ON PERNII�:
8
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HARRY 5. JOHNSON
ROBERT B. MEREDITH •
C. DONALD COULTER
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DATE TIME
CITY OF ORONO CALLED IN , �
INSPECTION NOTICE �z 1 SCHEDULED
PERMIT NO. ��� ��� COMPLETED 3 Q ��d P�}U
ADDRESS���� �U 1`1i'
OWNER CONTR. /�'��
TELEPHONE NO. ���"rI ��0 �
� DESCRIPTION
t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 tNSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL . 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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 ��CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector.�G�� ��-(/1�
White Copylinspector's File Canary CopylSite Notice
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D T TIME
CITY OF ORONO CALLED IN —1��`
INSPECTION NO I E SCHEDULED �/.t[3�y S %/ � 30
PERMIT NO. ��' COMPLETED � � �
ADDRESS � �
OWNER CONTR.
TELEPHONE NO. `� ! 'Z " � � �' �
� DESCRIPTION �'�l '
� 01 �ING,J /` 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FfNAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q O5 FINAL 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
� COMMENTS:
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W - WORKSATISFACTORY:PROCEED n PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. L', PHOTOTAKEN
INSPECTOR WILL RETURN
C I CITATION�SSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. '
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract on s' :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE n TIME
CITY OF ORONO CALLED IN 8�l v �l • aO
INSPECTION NOTICE SCHEDULED 8'1 J �- IU'.o0
PERMIT NO. �,3�— COMPLETED
ADDRESS _ 1 Zl lo NC�'}'�►'4�m �V -
OWN ER CONTR. 6WneY'
TELEPHONENO. y7�'� �g�2�
� DESCRIPTION
lL 01 OOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
AL 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
� COM ENTS:
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W� ORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR L CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
tnspector.�_/�/�Ce�l�- �.sq S
White Copyllnspector's File Canary CopylSite Notice
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