HomeMy WebLinkAbout1998-009997 - new residence {
PERMIT
CITY OF ORONO PERMIT TYPE:
2750�elley Parkway- P.O. Box 66 �.E,:T k_�,j;�t�
�Crystal Bay, Minnesota 55323 Permit Number: �}�`;,�,;�:��,
(612) 473-7357 Date Issued: - - - - -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:�
°����='t���TE �`E�:�1IT�� #�'�c�i�I���? F}i� F`L.�t�; t��rC:H, FIn��'��t:�, L���! i�;RiG�TIiif�l, s=ai�:�;
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FEE SUMMARY:
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CONTRACTOR: _ ,��,�,� �r,�;;�. _ <<: , ;,��: .OWNER:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATU
ir•....
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Total Fee: $ , '' 1 �` � Date Received:
� Entered By: � Permit#: `j`%�% %
,
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 OR ONTRAC�"��.
�
_._....____...._
. .,
JOB SITE ADDRESS: ,� y�3 5" N� S�^�..._ c�� �nf�'�ZIP:
I
NAME OF OWNER: �1,Ljc� (��N /l/ PHONE: (home) 7�3 ��
(work)
MAILING ADDRESS: ;��/ 3 5 !�j�' �S l��'!`CITY: �;'�,Y,_.'� ZIP:
( �
CONTRACTOR: ���t�`^� ;���•�--- ,�'`�i�" PHONE: 5!-�� -:,LS���'
CONTACT PERSON: i��k C���„�.-ll MOBILE/PAGER: �6 c --f'3�?
MAILING ADDRESS: ,��.�i Q,s��, ��-- ,�J S�7�ITY: i����,�,%'�,;�;� l'�ZIP: `����"
STATE LICE�'SE: # �.,1��
�( ( ,��
,S!"'��./I-+.���J ii�'� f�� ��v'�i�i."(j���J
ARCHITECT/ENGINEER: ��;�,� ,�.1�,,,�;�� PHONE: 7
�S�- �-�%��5,
MAILING ADDRESS:_ � -.� � {-� c,s�+�/ �rt` CITY:��;''_��-- r'1�ZIP: 5"�y.;�1
NAME: ::��'�.� :S�..l��::�-r�;-� REGISTRAT�ON#
� TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: ���3�,R•J'(r! �;�x,� �� �A i����i^ �'/G��'L
l�i�i^'! G./��'�� i.d�" ` �G,�^'-=.�5'� i y�����4'`1,`l j" - -
STORIES: __�____ SQ. FEET OF EACH FLOOR: �`i 5��
NO. OF BEDROOMS: GARAGE STALLS:�`-ATT. �_ DET.
� �,�-
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �f>�:����
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 Ciry and with
the State Building Code; that I understand this is not a permit and work is not to start without a
pernut; and that the work will be in accordance with the approved plan.
��_ ')
APPLICANT'S SIGNATURE: � I � 't�`�°�� DATE: � $ ` �'
NOTE! Parade o�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.
9
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Sec.13.04 RIGHTS OF SUBdECTS OF DATA
Subd. 1. Type of data. T'he 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 co�dential data concerning himsetf shall
be informed of: (a)the purpose and intended use of the requested data within the collecting§tate agency,political 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 confidendal dara;and(d)the idenary of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative data,pursuant to section 13.82; subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav place ihe noRce required under this subdivision in the individual income tax or nropertv tax refund
instrucdons 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 confidenrial. 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 thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created.
The responsible authority shall 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 cosu of making,certifying,and compiling the copies.
The responsible authority 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 time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Satutdays,
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 authoriry shali 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 sha(!be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon 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 pernut or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You aze notified that:
1. The information you fumish will be used to determine your qualification for the pemut 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 pemut 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.
�k .�- G��6S�'��
First Middle Last
a9�ss ��Y,�l.. .,�✓�- ,J
Address
�r�w-e,^ I'`'1�/ S—S'�3`f/ �`1"g—gS�9'�'
Ciry State Zip Phone
I un stand my rights as stated above.
�
Signature
. *
CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2y35 +'�v�2Tt-� St-�o ct�, p R�v�
PID:
DESCRIP'rIONOFWORK: 1��,e3ut�.d t-tor+n� o�•t GX��t't�r� FOvniOfl'T1r�N
ZONING REVIEW BY: �,,,1 DATE APPROVED: 3-s-9 g
BUILDING REVIEW BY: DATE APPROVED: 3• S`-S8
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes �' No SEWER CONNECTION
STATE SUR:I�ARGL Yes r/ No WATERCONNECTTON
INVESTIGATION FEE Yes �io PARK FEE
SAC Ycs No _�___ SITEINSPECTION
Number of SAC Units �vrr Fn,�,,.�. OTHER (specify)
=---------__-------------------------------------------�-�`-''-`-°-----------------------------------------------------
ZONING CHECK LIST Zoning District: � Q ��
Fire Department: (,c�VG (,4�CG Post Office: (,o�'e� (Az� School District: OR�lUO
Lot Area: Sq.ft. �� �-�nlfec;Acres Width �2(C�'�vch�C. Depth
Survey Submitted: Yes� No Date of Survey: 0 N �f�f
Proposed Setba�ks:
Front (Lake): Right Side:
— �x�sn�
Rear(Street): Left Side:
Adjacent Structures: N (Q- Wetland:
Building Height: Def. Hgt. p.�<- Peak Hgt.
Lot Coverage: /(�(h`
Grading: Staff Approval Date: L�'TCtS?1.NC� By: Council Approval Date:
Septic: Staff Approval Date: N By:
Zoning File: # 1V � Resolution: # Resolution Date:
Shoreland Dist:ict: v�
Avg. Setbac��� �.�G. Bluff Setback: /V(,4- Lot Coverage: O-��'
Existing Proposed
Hardcover: 0-75'
75-250'
250-500' Le7�
500-1000' Z•f.
Hardcover Variance Required: Yes No� Date of Council Approval:
REMARKS(in house):
� 26
. � .
BUII..DING REVIEW CHECK LIST
UBC: .. R•3 CONSTRUCTION TYPE: �N
' Sq Footage $ Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Gazage x =
R =
TOTAL
Estimated Construction Value: $ �I l0,�oo�
Inspections Required: Work Requiring Separate Permits:
- Site .� Plumbing Fire
Hardcover Removal "� Mechanrcal Water Connection
, � Footing Septic Sewer Connection
�C Framing p� Fireplace � Lawn Irrigation
� Insulation _� (Masonry) Other
_�Wall Board (Mfg.) Well (State Permit)
� Final Grading/Filling S Electrical (State Permit)
Other
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
----------------------------------------------------------------------------------------------�-------------------------
REMARKS(TO BE NOTED ON PERMIT):
27
' ' HARDCOVER CALCULATION WORK(S���
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-50 ' S00-1000'
, EXISTING HARDCOVER IN ZONE
A. House '�o x .3y = v� 3��p S.F.
Length Width
x = S.F.
x = S.F.
x = S.F.
B. Gazage 3� x �� _ `�S� S.F.
C. Driveway 3o x = /og� S.F.
,�o x ro� _ ��—S.F.
D. Sidewalk 1"�" x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
�F. Landscape x = S.F.
Underlain x = S.F.
� By Plastic x = S.F.
Or Fabric
G. Other z = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE -- S.F. B
A 6?SSQ — B 5� .�c 100 = ,��o %
PROPOSED HARDCOVER IN ZONE
A. House x = S.F.
Length Width
x = S.F.
z = S.F.
z = S.F.
B. Gazage � x = S.F.
C. Driveway x = S.F.
x = S.F.
D. Sidewalk �j/ x 3� _ /� S.F.
x = S.F.
E. Patio/Deck ,�'�' x / = y/S S.F.
��n x � _ �05� s.F.
F. Landscape x = S.F.
Underlain x = S•F•
By Plastic z = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A � 3q — a a 3�sU x ioo = —��— %
14
ENERGY CODE DESIGN BY ACCEPTABLE PRACTICE
To Determine Compliance with the Minnesota Energy Code
(Section 602 of the State Amended 1983 Model Energy Code)
This form is only applicable to detached one-and two-family dwellings. The requirements herein ue based on Table
No. 6-11 in lieu of the criteria specified in Sections 602.2.1, .2 and .3.
Building Address a�� ,�� l�� S �--� c��
Contractor or Owner P G'��-er� �� � �
BuildinQ Element "R" Values Area (s4 ft) % of Ext. Walls
-Ceilings Design �r,lS�Req'd 38 c�7�
. Walls (exterior) Design,�(�o Req'd 20 .
(w/o fdn)
Floors (over unheated spaces) Design��Req'd 20 MM J� � ��,�
' r•
*Windows (in bldgs w/o L.v C- �„� � Design Req'd 12
sliding glass door) glass)
*Windows (in bldgs with a �o�u►� Design Req'd 10
sliding glass door) (glass)
Foundation Walls Design�Req'd 5 (when insulating full depth of foundation wall)
Design Req'd 10 (when insulating only to frost depth and
footings extend below)
Slab-on-grade floors Design�Req'd_(See Figure No. 3)
**Doors (1-3/4" metal faced) Design$�Req'd 3
* All windows shall be double glazed or have storm windows
** Conventional doors other than metal require a storm door
CERTIFICATION
I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy
Code.
Signature
Date � ��[C�
BCSD 3-89
CC/SM/6593
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GUIDELINE TO (R) FACTORS FROM ASHRAE MANUAL
OF TYPICALLY USED PRODUCTS
AIR FILMS � SHEATHING �
Interior Air Film (Walls) 0.68 3/4" Wood Subfloor or Sheathing 0.94
Exterior Air Film (Walls 0.17 1/2" Plywood Sheathing 0.62
Interior Air Film (Vented Ceiling) 0.61 1/2" Particle Board 0.66
Exterior Air Film(Vented Ceiling) 0.61 Gypsum or Plaster Board 3/8" 0.32
Interior Air Film (Non Vented) 0.61 Gypsum or Plaster Boazd 1/2" 0.45
Exterior Air Film (Non Vented) 0.17 Gypsum or Plaster Board 5/8" 0.56
Plywood 3/8" 0.47
BLOWING WOOLS Plywood 1/2" 0.62
Approx. 3" 9.00 Plywood 3/4" 0.93
Approx. 4 1/2" 13.00 Sheathing, Reg. Density 1/2" 1.32
Approx. 6 1/4" 19.00 Sheathing, Reg. Density 25/32" 2.06
Approx. 7 1/4" 24.00 Nail-Base Sheathing 1/2" 1.14
�Approx. 14" 30.00
Approx. l8" 40.00 ROOFS
All other insulation materials Built-up Roofs 0.33
must be verified (R Factor) Asbestos-Cement Shingles 0.21
Asphalt Roll Roofing 0.13
INSULATION Asphalt Shingles 0.44
Insulation: 2-2 3/4" Fiberglass 7.00
Insulation: 3 1/2" Fiberglass 11.00 SIDING
Insulation" 6" Fiberglass 19.00 Aluminum Siding 0.61
Insulation: 3 5/8: Fiberglass 13.00 Aluminum with Backer 1.82
Insulation: 9" Fiberglass 30.00 Aluminum with Backer & Foiled 2.96
Insulation: 12" Fiberglass 38.00 1/2 x 8 Lap Siding (Wood) 0.81
Insulation: 8" Cellulose 29.00 7/16 x 12 Hardboard Siding 0.67
Insulation: 10" Cellulose 37.00 Asbestos Sidings 1/4 Lapped 0.21
Insulation: 12" Cellulose 44.00 Stucco (Brown and Finish Coat) ----
Insulation: 1 1/2" Thermax 12.00
Insulation: 2" Thermax 16.00 DOORS �
1 3/4" Solid Core Door .46
WOODS w/Storm, Wood .31
Fir, Pine & Similar Soft Woods w/Storm, Metal .26
1 1/2" 1.89 Pease Steel Door Insl/N/GL 7.45R .13
2 1/2" 3.12 Sliding Glass Door, Wood .65
3 1/2" 4.35 Metal .72
5 1/2" 6.87
WINDOWS
CONCRETE BLOCK All Windows
8" Concrete Block (S & G Reg.) 1.11 (w/Storms 1" to 4" Space) .56
(Filled with Vermiculite) 1.93 Removal Double Glazing (RDG) .55
12" Concrete Block (S & G Reg.) 1.28 Thermo or Welded 3/16"Air Space .69
(Filled with Vermiculite) 3.15 1/4" Air Space .65
8" Light Weight 2.18 1/2" Air Space .58
(Filled with Vermiculitep 5.03 (Other windows specifically tested
12" Light Weight 2.48 can use better ratings)
(Filled with Vemuculite) 5.82
20
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� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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Call for t ext spection 24 hours in advance.473-7557
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White Copylinspector's File Canary CopylSite Notice
ATE TIME
CITY OF ORONO CALLED IN l
INSPECTION NO�!CE SCHEDULED o a' // �3�
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Call for t xt ins tion 24 hours in advance.473-7357
OwnedCont c on si :
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White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �- /Z-` i�'���f d
INSPECTION N�TICE SCHEDULED .�13-%k %/.`�n
PERMIT NO. 'y j� COMPLETED
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White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDUL�� • �-�'
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Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor ite-
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO � CALLED IN
INSPECTION NOTICE c� �i`� � SCHEDULED ��
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? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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White Copyllnspector's Fi Canary CopylSite Notice
ATE G� TIME
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INSPECTION N TICE SCHEDULED -_��� ��-3�
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J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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Owner/Contract�n te:
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White Copyllnspector's File Canary CopylSite Notice