HomeMy WebLinkAbout1999-011855 - deck r � PERMIT
C1TY UF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 Permit Number: - ..�`!_`.`'�"`'
Crystal Bay, Minnesota 55323 ;�:�; ; ;=;;,�
(612) 249-4600 Date Issued: _ �,. �� l.j.M
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- . _ :. �_.... _ —
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APPLICANT/PERMITEE SIGNA URE ISSUED BY:SIGNATURE
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Total Fee: $ �(���`�` Date Received: ��/S ���j _
Entered By: Pernut#: J � gs.Sr
CITY OF ORONO - BUII..DING PERNIIT APPLICATION
All information must be submitted in full hefore plan review will be started.
(please print all information) �
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
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JOB SITE ADDRESS: I���p /1/, �YyJ �, ZIP:
NAME OF OWNER: ��/���,��,�- 0��'o��9 PHONE: (home) L,t 7/-/G oZ�'
S s N , m (work)
MAILING ADDRESS: l i�'1 d�i�q"/ D� • CITY: ZIP: S3�
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CONTRACTOR: 1�o m.e d w>v n..2 PH4NE: .
.. ...__..
CONTACT PERSON: MOBILE/PAGER:
MAII.ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHI'I'ECT/ENGINEER: PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�:
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET:
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
I hereby apply for a building pemut 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: ���d� DATE: u l�
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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.
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Sec.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.
S�bd.2. Information req�ared to be given individual. An individual asked to supply private or confidential data concerning himself
sUall be informed of: (a)the purpose a�intended use of the requested data within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the idenriry of other persons or entiaes 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 to section 13.82, subdivision 5, to a law
enforcement officer.
'I'he f wvamin m�v nlarr rt,P„�e;�p rwrn,;rrri nnriPr rhic c�i}uiivicion in the individual income taz or omcertv tax refitnd �
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 sWred data on itdividuals,a�whether it is classified as public,private or confidential. Upon his further request,an individaal who
is die subject of stored private or public data on individuals shall be shown the data without any charge to him a�,if he desires,shall be informed
of the content a�meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosed ro him for siz monthc thereafter unless a dispute or action pursuant ro this section is pending or additioaal data on the individual has been
wllected or created. The responsible audwriry shall provide copies of du private or public data upon request by the individual subject of the data.
The nsponsible authority may require the requesting person to pay the actual wsts of maldng,certifying,aad compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursvant to this subdivision,or within five days
of the date of the request,excluding Saturdays,Sundays a�legat holidays,if immediate compliance is not possible. If he cannot comply with
the request widvn 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 Qvhen data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private da�concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. 'Ihe responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccunte or incomplete and attempt to notify
past recipiems of inaccutate or i�omplebe data,inciuding cecipients named by the individual;or(b)notify the individual that he believes the data
to be correct. Data in dis�te shall be disclosed only if tt►e individual's statement of disagreement is included with the disclosed data.
The determination of the responsble authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng
w 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 fumish certain
private or confidential informarion.
You ue 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 eztent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve, some informadon 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. •
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First Middle Last
f 5S 0 /Z', /9,�i'r� ��
Address
�ny,v� /��r ss36� �7/-��O�S
Ciry State Zip Phone �
I understand my rights as stated above.
i��`/. �-�� /O�G�
Signature
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �s s-� Noit r�� Ah� �2 -
PID:
DESCRIPTION OF WORK: ��-z.t�
ZONING REVIEW BY: �---- ---------------------DATE APPROVED: 9.�'�•`i�i----
BUII..DING REVIEW BY: — DATE APPROVED: t.lq=�t S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes v' No
PLAN REVIEW Yes � No SEWER CONN�CTION
STATE SURCHARGE Yes �- No WATER COr(NECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC � Yes No STTEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: L�- J�l3
Fire Department: 1N�,u�Mp Post Office: 1�1rovv� School District: (�,[S7`fl�M.t �
Lot Area: Sq.ft. � J 503 b Acres - 3''( Width �d o.1 c. �`"� Depth /So•�Z- p''"�'
Survey Submitted: Yes C No Date of Survey: �-$ "g S
Proposed Setbacks:
� Front(�dte): _�S' Right Side: �'12�
Reaz(S'treet): "j b' Left Side: '��`
Adjacent Structures: A�'y�G[K.� Wedand: �+It�
Building Height: Def. Hgt. �J ��- Peak Hgt. —
Lot Coverage: ds-t�.
Grading: Staff Approval Date: By: -- Council Approval Date:
Septic: Staff Approval Date: -^ By:
Zoning File: # "-� Resol�tion: # Resolution Date:
Shoreland District: ---
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
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BUII..DING REVIEW CHECK LIST �
UBC: /L •'� CONSTRUCTION TYPE: 1/�!
� • Sq Footage $Per Sq Ftg �
Basemenfa=: . x =
lst Floor x =
2nd Floor x =
Gazage x =
�� �Z w t�z���R �o.00 =
TOTAL
Fstimated Construction Value: $ ( ��t 7�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechani�al.. Water Connection
( Footing Septic Sewer Connection
�Fr.aming .. , Fireplape Lawn Irrigation , .
Insulation (Masonry) Other
� -Wall Board ' ' , (Mfg.) Well(State Permit)
o� Final Grading/Filling Electrical(State Permit) � �
Other , t
REMARKS(IN HOUSE): . � . :
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMII�:
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I� ��� / BU(LDING -�R I t_Fj,(V ftEVIEW
� INSPECTOFR
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�-d 1C:rP 7NI5 Pi.AeV Sc i Oi�1 STE AT�ll l`IMES
� �'S ���s � �`�s
_ __-----.----�'�--,�_�e. �
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION O/TIC!,E _,_ SCHEDULED �'Z�p��� O�—
PERMIT NO.�!l J S 5 COMPLETED �'�' C`� �—
ADDRESS /SSa /Lr02�1 �1/l.w. UR.
OWNER ►1^ . pe���-� CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
,Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= mFINAL �eC-1�C 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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� �'7 VORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. n pHOTO TAKEN
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.473-73�J7
OwnerlContractor on site:
Inspector. /�'/�=����/�
White Copyllnspector's File Canary Copy/Site Notice
991179 '8i 117/23 PELTOLA, MARGARET �"
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AD VANCE SUR VEYING & ENGINEERING CO. ;�, ;, �, �: � ,.�,, _�.:. O OR�N4
; :;'������� - ������ r °c 51TE PLAN GR�Di1VG PLAP1
5300 S. Hwy. No. 101 Minnetonka, MN 5534� Phone (612) 474 7964 Fax (612) 474 8267 �� f � APPROVED �-�-c.��
� l� A�PR01�E0 WITH REV1SlOi+IS
suRv�FOR: MARGARET PELTOLA . i YD�� �
GRAPHIC SCALE 1 �ATE �- �Y-� �
20 0 �0 20 40 � so 1
SURVEYED: September, 1999 DRAFTED: September 8, 1999 �
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LEGAL DESCRIPT'ION: � IN � � '
Lots 15 and 16, Hickory Hill, Hennepin County, Minnesota.. � in�h = zo �t.
i
SCOPE OF WORK: I N 89'07'46" E +� __
--153.27-- � ;
1. Showin the len�,.�y, and direction of boun lines of the � "� �� `'
g �"' � FOUND 1/2"
above legal description. The scope of our services does not � FOUND 5/8' � � �
include determining what you own, which is a legal matter. � � � � ; `
Please check the legal description with your records or consult with °i i °' �
competent legal counsel, if necessary, to make sure that it is correct, '
and that any matters of record, such as easements, that you wish 40.3 7�^
shown on the survey, have been shown. °' 4.s ��
2. Showing the location of existing improvements we deemed __33___-- � � 1� STORY �
i.mportan� � N F�.AME #1550 / �
3. Setting new monuments or verifying old monuments to mark the � v N -
corners ofw e property. � � — L �__ 39.7 __ ___ 40.5/ '� i �
4. While e show proposed improvements to your property, we o N �ROPOSED oo �,
are not as familiar with your plans as you are nor are we as familiar a, ,�, � _ _ _ _ �_pECK _ _ - - - - - - N
with the re uirements of overnmental a encies as their em lo ees `�' o `` i s o :f'
Q g g P y � O FOUND HENN. � �
are., We suggest that you review the survey to confirm that the � � C0. ROW MON. �
proposals are what you intend and submit the survey to such Z � � � `"
governmental agencies as may have jurisdiction over your project � � /LL
to gain their approvals if you can. T �
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STANDARD SYMBOLS & CONVENTIONS: v � o
"�" Denotes 1/2" ID pipe with plastic plug beari.ng State License � ' �24.2
Number 9235, set, unless otherwise noted o 0
� GARAGE �
CERTIFTCATION: .� � 8' CHAIN LINK FENCE 24.2� � �
I hereby certify that this su.rvey was prepared by me or under my � �,-�� X f x X X X --� ' o
direct supervision and that I am a Professional Engineer and a � __ --146.97-- �� �`� ��
Professional Surveyor under the Laws of the State of Minnesota. ` FOUND 1/2� N 89'04'55" E 1}{E SOUTH UNE OF -�/ � �
C I ORTH OFGTHE LI E
�,.:�,.,-�.� � .���..�.
James I3. Parker P.E. & P.S. No. 9235
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JOB NO. 991179