HomeMy WebLinkAbout1996-008363 - deck PERMIT
. �CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 F;�11' ���E'�1�=�
Crystal Bay, Minnesota 55323 Permit Number: �_yt y;�;:�;;�:�;
(612) 473-7357 Date Issued: ��y:�� � f,��,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
'�=e=F`�ih'r=�TE F'EFit°i I i �����_?I�EG �z�t� t��r��i t�x�3/F i�L i t���� .
FEE SUMMARY:
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CONTRACTOR: OWNER: — �����3 i c�z�-Et. —
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r'.'PLICANT'PERMITEESIGNATURi_ ISSUEDBY:SIGNATURE
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. � Total Fee: $ �� '` �� ��� Date Received: ,)- :� � - '�-,
Entered By: �!�� Permit�#: j�'>r�� -
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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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: --5`E C:� �. ,<<.�_�_ ;\ /� r1 c,-,,,.T ZIP: �S �� �.ti
�j/L.r/�.i - Lt��.
I
NAME OF OWNER: ��� ( �l, � �.��i����. �c���� e��� � �t� � PHONE: (home) � 7(� � 3 Q �'
` (work) l_�: �%�'1. . �, ��/ - /�F� `{
MAILING ADDRESS: ,, t�� (�_ c{-�- S �j CITY: `. ; , ; ,. ` ZIP: �>5 �'_���
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ',J�c � Land Alteration
PROPOSED WORK(describe in detai�: —�t ��� ������ ��ri � � r� �� Z ti,--� .1�.��=.���' --
;
�; ; ; ,_� r� a
STORIES: SQ. FEET OF EACH FLOOR: _
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �; t �' < � ' ' +.
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 '�� " �-_� �/- -/��
�
�A � ' �`��u�
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.
6
� �
Sec.13.04 RIGH'TS OF SUB.TECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is scored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)[he purpose and intended use of the requested data wi�hin the collecting'state agency,polidcal subdivision,or stacewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any l�own consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the identiry of o[her persons or entides authorized by state or federal law to receive the data. 'Ihis requirement shall
noc apply when an individual is asked to supply invesrigadve data, pursuant[o secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav piace the nocice required under this subdivision in the individual income tax or proDertv tax refund
instrucrions 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 individuais, and whether it is classified as public, priva[e or confidentiai. Upon his furrher request,an individual who is the subjec[
of stored private or public data on individuals shall be shown[he data without any charge to hirn and, if he desires, shall be informed of the content
and meaning of that data. Aher an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereaher unless a dispute or action pursuant to this secaon is pending or additional data on the individual has been collected or crea[ed.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible au[horiry
may require the requesting person to pay the actual costs of making, cerrifying, and compiling the copies.
The responsible authoriry shall compfy immediately, if possible, wi[h 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 addidonal five days within which to comply wi[h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accu:ate or complete. An individual may contest the accuracy or completeness of public or private
data concerning 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)correc[the data found to be inaccurate or incomplete and attempt to notify past recipients 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 stacement of disagreement is included with the disclosed data.
Tne determinacion of the responsibie authoriry may be appealed pursuant to the provisions of the admuustrative 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 pernut 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 pernu[ 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 pernut 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.
(. Your full name is required to process this application or permit.
� �=� ��-� �� l I_� �, �� - ;�� ;c� ,,
First :�liddle Lasc
>>`{�� � �c� E ` �—
Address r�:i \ <, C� l � �� �l ��- �; J l��'
� i� C� r i i.:
C�ty State Zip Phone
I understand my,rights as stated above.
� .� �_
,
�Ll,i� � �� ;� --•--- --
Signature
. .
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 1 L��- ;��, ;_� .,j_ �
PID: �' ,f ,I 7 _ -�� 3 :� � G.� � S,
DESCRIPTION OF WORK: �:� �k-
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ZONING REVIEV�J BY: -- DATE APPROVED: `-�- �v �i�
BUILDING REVIEW BY: -" �'��' �� ��,�..-- DAT'E APPROVED: ��lo-`7�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes :/ No
PLAN REVIEW Yes +/ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No ^/' PARK FEE
SAC Yes No �/ SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZOl�'ING CHECK LIST Zoning District: !��'�-���
Fire Department: uu.�� U tG� Post Offce: �Nh �,4t,<.c� School District: U�'l.s;iyc
Lot Area: Sq.ft. N� LI-!�!�Acres — Width � Depth —
y
Survey Submitted: Yes �- No Date of Survey: t � � Z�: � �
Proposed Setbacks:
Front (�e): ���� Right Side: i S� '�'
�(11�0� V�S�L
Rear (�reet): !l-��� Left Side: '7v' �t �� ���„��.�,1��
Adjacent Structures: �4-�c�(t-r�' Wetland: �t,;�
Building Height: Def. Hgt. /✓(/F Peak Hgt.
Lot Coverage: �'� I�.
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
v�+- Shoreland District:
� Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
SOO-lOOO'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
BUII.DING REVIEW CHECK LIST
UBC: /° 3 CONSTRUCTTON TYPE: Y�'
Sq Foota;e S Per Sq Ft�
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
c�
Estimated Construction Value: $ �.�v� �
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_� Footing Sep[ic Sewer Connection
,+(� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_� Final _� Grading/Fillin Electrical (State Permit)
Other
REMARKS (Pi t HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By�
RENIARKS(TO BE NOTED ON PERI'�IIT):
27
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DATE TIW�E
CITY OF ORONO CALLED IN � � ��� �` ��''
INSPECTION NOTICE scHEou�Eo ` la- � � �' `�'«"�
PERMIT NO. � � ���� '` OMPLETED ��
ADDRESS � �� �g �' ,. �.,' <- , '
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OWNER /. a� t�-��Y�c..�(���e��G"ONTR. �Q�_-���E �����F,:���1�:��
TELEPHONE NO. �7 � � � /�� �> �-
� DESCR�PTION / ;.�
� ,�1 FOOTINC3 11 MECHANICAL RI 18IXCAV/ORADIN(3/FIWN(i
y 02 FFGUJIfNG 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANOS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
2 05 FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
�+ 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR
❑ CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for th t' pection 24 hours in advance.473-7357
OwnerlContract r n sit :
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Inspector.
White Copyllnspector's File Canary CopylSits Notics