HomeMy WebLinkAbout1996-008333 - retaining walls �...
PERMIT
CITY OF ORONO PERMIT TYPE:
' 2750 Kelley Parkway- P.O. Box 66 !Yl'r E�_[�EF T_�,E�,�}
Crystal Bay, Minnesota 55323 Permit Number: t�t�;-�:,�1�;
(612)473-7357 Date Issued: t�,���_�,��,;��,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — �i��=lic.���T. — OWNER:
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PLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� Total Fee: $ �! �' -� �' Date Received:
Entered B <� Permit#: � � ��
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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s 1-
THE APPLICANT IS: (circle one) OWNER OR C�NTRACTqR
JOB SITE ADDRESS: ��`` L� L� �`�`�� t ��'�' �r��� ZIP:
NAME OF OWNER: �`�C��"�� �''1�C j�!�'t PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: I�T-1;;f��P�fJ �f ����{F,;t ��-/J � V�`�.�'� � PAONE: ���i —�i, ���
CONTACT PERSON: t�i N -t,`�N�� MOBILE/PAGER: ���;' '-f�`���
MAILING ADDRESS: ��-i��-�1 I .���t��',a f�j�.� �-iU: l:'�1 CITY: '����✓����-��� ZIP: �r`=�'c'a 1
STATE LICENSE: # J
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New '� Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �-�����'�'�� ��'�'��- '�—� �'��� �`'�`'�'
STORIES: 5Q. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �,���' r�'
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: �> ' �'E ' ` '"lL
C"r%p�'! ,;'(,'?, +- �_,ini���..;lf t
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set focth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and incended use of che requesced data within the collecting§tate agency,polidcal subdivision,or stacewide sysum;
(b)whether he may refuse ot is legally required to supply the cequested data;(c)any Irnown consequence arising from his supplying or refusiag to supply
priva�e or confidendal data;and(d)[he idenriry of o[her persons or enddes auchorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv taz refund
instrucdons instead of on[hose 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, privace or confidential. Upon his further request,an individual who is the subjecc
of stored private or public dara on individuals shal►be shown the dara wi[hout any charge to him and, if he desires, shall be informed of the content
and meaning of[hat data. After an individual has been shown[he private data and informed of its meaning,che data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this secaon is pending or addidonal data on the individual has been collected or created.
The responsible authority shalt 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[he copies.
The responsible authority shall comply immediately,if possibie, with any request made punuant to this subdivision,or within five days of
the date of the requesc,excluding Saturdays,Sundays and legal holidays,if immedia[e compliance is not possible. If he cannot comply with the request
wichin that time,he shall so inform the 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 conceming himself. To exercise chis right,an individual shalt nodfy in wridng the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipiencs named by che individual;or(b)notify the individual that he believes rhe data to be correct. Data
in dispute shail be disclosed only if the individuai'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 reladng 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 fumish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your c}ualification for the pemut or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pemut or license.
3, The information may be shared with other local, state or federal agencies to the extent necessary to process
the pemut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
g. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
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Middle Last
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Addre��n � �� ��� � —
1 `_F��r••r
�ity State Zip Phone
I understand my rights as stated above.
� ���:,�
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: t�`1`1 l���=1-� �-�;'� t��,`���
PID:
DESCRIPTION OF WORK: �,.�:�xa��.,.,� �:, ,..�,��..._5
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ZONING REVIEW BY: � �,�._._.. DATE APPROVED: � � 3�'% `r �
BUILDING REVIEW BY: ' ' w�.— DATE APPROVED: ti�. �� `r k:
______������__�_�_�������_�_____��_�_��������T _�______�_______�______������________________�_��___�����������_�____��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �' No
PLAN REVIEW Yes '�" No SEWER CONNECTION
STATE SUR`�IAAGE Yes �� No WATER CONNECTION
INVESTIGATION-FEE Yes No �/' . PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC Units OTHER (specify)
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(' �ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side: v` k
�
� L Adjacent Structures: Wetland:
�
0�
�, Building Height: Def. Hgt. Peak Hgt.
6
Lot Coverage:
�� Grading: Staff Approval Date: By: Council Approval Date:
t
r Septic: Staff Approval Date: By:
Zoning File: # Resolution: � Resolution Date:
Shoreland Dist:ict:
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):
� 26
BUILDING REVIEW CHECK LIST
UBC: l�� � CONSTRUCTION TYPE: �^'
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
,�,
Estimated Construction Value: $ Ca,5�`
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover 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):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE NOTED ON PERMIT):
27
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DAT �: TIME
CITY OF ORONO CALLED IN 9' _ i
INSPECTION NOTICE SCHEDULED Y-� f/% 3 G�
PERMIT NO. �` -f� COMPLETED �_ �_
ADDRESS �Lc' �/ `�� �� `��''� /f'�
OW,NER ��c' r z�,� ✓ Su�r-��"—CONTR. �
r����-,�
TELEPHONE NO. �-j � — �� �� .2
� DESCRIPTION �L-�/� GCi--�`�
� 01 FOOTING 11 MECHANICAL RI 18IXCAV/GRADINd/FIWN(3
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORElWETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� OS FINAL�- 14 SEWER HOOK-UO O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMQ—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:�,YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED
W �, PROJECT COMPLETE
WC�CORRECT WORK 8 PROCEED �. ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITtON WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t spection 24 hours in advance.473-7357
OwnerlContra n s e:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice