HomeMy WebLinkAbout1999-011102 - shed/bath remodel PERMIT
CITY OF ORONO PERMIT TYPE: _
� 2750 kelley Parkway- P.O. Box 66 - -'��-�'��v�=
Crystal Bay, Minnesota 55323 Permit Number: : ; �i�,;'�
(612)473-7357 Date Issued: ;_.� f;•� ; j�_;:i
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - ;�;�_-_ w i; _.;��. - =.� . ���:: .OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
Total Fee: $ � ��� � ��� � Date Received:
' Entered By: Permit#: `i/ G.;1_,
CITY OF ORONO - BUII.DING PERMIT APPLICATION
All infornaation must be submitted in full before plan review will be started.
(please print all information)
--------------------------------------------------------------------------------------------------------------------
THE APPLICA�'T IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � e�DD f'j/o^}h S�,or� �� , ZIP:
NAME OF O`�fi'ER:9 c. �c�c� C'� c�a�r PHONE: (home) Sa J- �/3���lS 7
(work) Sc�� - y�3- 7 3�°i
MAILING ADDRESS: CITY: u<�,z� ZIP:
CONI'RACTOR: � c,ve �c���e PHONE:�SSS-�'333
COi�1TACT PERSOti': ��;��e ��-; '�e MOBILE/PAGER: S�e 5s ���.
MAII�ING ADDRESS: �x�� f�u-t��,,, ��4s !�r, _CITY: R��� �'„��� ZIP: 5�3-7"
STATE LICENSE: # _��0�5303
ARCHIT`ECT/ENGINEER: PHO�tE:
MAILING ADDRESS: CITI': Z�:
rJ�,�; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure �
Move Remodel/Alteration�_ Land Alteration
PROPOSED WORK (describe in detai�: �ove �� oh �Xla kcr�� Sk���
�eplc,ce ���.; r s-F 11 �- �����e`� i� �}�,Il �c� vG� ► � sin� _
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDR00�1S: GARAGE STALLS: ATT. DET.
.�
ESTI�i IATED CONSTRUCTION VALUATION (excluding land): $ b'�J(� h��� ��J � �rtt„�
I hereby apply for a building pernut 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 Buildin� 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 accordan e with the approved plan.
;�_..�
APPLICANT'S SIGNAT'ITRE: .��i7,�p��-� DATE: )1 -/�l-5 �
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.
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Sea13.04 RIGFiTS OF SLTBJECTS OF DATA
Subd. !. Type o[data. The righcs of individual oa whom the data is stored or w be stoced shall be as set focth in this secdon.
Subd.2. Information reqirired to be givw iadiridual. .�n individua!uked to suppty private or confidendal dara concecning himself shall
be informed of: (a)che purpose and in[ended use of the requesud data wichin the collecang Stare agency,polidcal subdivisian,or scatewide rysum:
(b)wheehec he may refuse oY is legally eequired to supply ehe requesced data;(c)any fmown coasequeace arising from his supplying or refusing to supply
private or confidenrial data;and(d)the idenary of oeher persoas or enrides au[horized by snce or federal law co teceive t�e data. This requirement shall
not appty when an individual is asked to suppiy invesdgadve daa,pursuant to secdon 13.82,subdivision 5, [o a law enfocsemenc o�cer.
The commissioner of revenue mav vlace che nodce rcwired under this subdivision in the individua! income tax or erovem tax cefund
instrucdons insuad of on chose forms.
Subd. 3. Access to data by individual. Upon requesc to a�espansible authority,an iadividual shall be informed whe�her he is ehe subject
of stored dan on individuais,and whe�her it is classified as public,private or confidenaal. Upon his furcher requesc,an individual who is the subjecc
of stored privace or public data on individuals shall be shown[he dara wichout any charge to him and;if he desires,shall be informed of the content
and meaning of�hac data. After an individual has been shown che private dan and inforaud of irs meaning,the data need not be disclosed to him for
six mondu chereafur unless a dispute or acdon pursuanc to this secaon is pending or addidonal dara on che individual has been coilecced or created.
'Ihe respansible auehariry shall provide copies of che private or public data upon request by�he individual subjecc of�he daa. The rosponsible authoriry
may require che requesang person w pay the acaal cosu of making,cerdfying,and compiling the copies.
The responsible auchoriry shall comply immedia[ely,if possible,with any cequac made purruant to this subdivision,or wichin five days of
ehe date of che requesc,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot compty with the request
wi�hin rhat ame,he shall so inform the individual,and may have an addidooal five days wiehin wtuch to comply wi[h ehe request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest che accuracy or completeness of public or private
dara conceming himsetf. To execcise this right,an individual shall noafy in wridng rhe responsible auchoriry describing the naeure of the disagreemen�
The cesponsible auchoriry shall within 30 days either: (a)correcc[he data found ro be inaccucate or incomplece and atumpc to nodfy past recipienu of
inaccurate or incomple�e data,including recipien[s named by rhe individual;or(b)notify ehe individual thac he believes�he dara to be correct. Data
in dispuce shall be disclosed only if the individual's sta[emenc of disagreement is included wich the disdosed dara.
The dearminaaon of the responsibte auchoriry may be appealed punuant to the provisions of the adminis�arive 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 pemut or license from the City of Orono or any of its departments may require you to furnish certain private or
confidencial 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 Ciry deny the permit or license.
3. The information may be shared with ocher local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Couacil 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.
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CHECK OFF LxST k'OR XSSUANCE OF PER�I�IITS
, � FOR OFFICE USE ONLY
- ADDRF�SS OR LEGAL: _ �3 Z oc� I�c��e-�R-+ �'[�2�. b�Z � �
PID: �:, - / 7 �- .� '� ^ / �ac%f .
DFS CRTP'�'I ON OF W ORK: _ . ���>� -�- �}-7- -� --�c-�p e L �
ZO�TiYG REVIE�� BY: � � DAT�APPROVED: /2 -�6 -�"d
BUILDl�i'G REVIEti� BY: � � DATE APP�tOVED: (z- 1 b.•ci�
�'EES TO BE CHA.RGED: • - � Misc. Fees Calculated By: w�M __
PEFZMIT -Yes ✓ No .
PLAN REV�W Yes ,/ No SEW�t COvi�TECTiON
STATE SL,��H��Gr. Yes �- No �ATER CO�EC'ITON
INVESTIGA'ITON-FEE Yes No PARK FEE
SAC Yes No STTEINSPECZZON
Number of SAC Units �`OTHER (specify)
ZONING C�CK I,IST zoning District: G2-/� �� � ~
Fire Depart��nt: �,v,�, � % Post Office: Cov�S(��� School District: _C9/LvNc� '
L.ot Area: Sq.ft._No C��v6�: Acres — tiVidth — Depth —
Survey Submitted: Yes_� No Date of Survey: QN ��c,,� � �-�0_oy$
Proposed Setbacks: � .
FrearfLa.�Ce): . �3� .=-- . --=`=�t►ghE Side: 30� � _ ,--
�
&�{Street): � (,� LeR Side: �(� �
Adjacent Structures: I �S ` �' tiVetland: N (,�
Bulldino Height: Def. Hgt. _ (� , (C Peak Hot.
Lot Coverage• —
GradinJ: Stafi Approval Date: -- By; -- Council Approval Date: —
Septic: Staff Approval Dace: — gy; � � .
Zonino Fite: � � � Resolution: � — Resolution Date:� — •
Shoreland Disc.-ict: v�P 5
Avg. Secback: p�)� BluEf Setback: n/ (� Lot CoveraQe: U. lC .
' - Existin� Proposed �
Hazdcover: 0-75'
75-250' ( '
250-500' . . �. )�
500-1OQ0'
Hardcover Vaziance Required: Yes No Z Date of Council Approval:
�
REI�Z.A.RKS ('in house): � �
� - _ . - .
� +,'' . 26
. ��� . .
BUILDING REVIE� CHECK LTST � : � . .
tBC: IZ_ 3 CONSTRUCTTON TYPE: �/�
. Sq Foota�e $ Per Sq Ft�
. Basemen[ X - - . � _
.. . . . lst Floor , � . . X . . _
� 2ad Floor . .. . - • . .z -. . . . _ : ..
Garage � , X . - � • � � � _
x .
. TOTAL �
Estimated Construction Value; � ��-3�� .
- - Inspections Required: • Work Re uirin� p �
Site q � a Se arate Permits:
.__•�,Plumbing Fire . �
Hardcover RemoyaI Mechanical � � "
Footin� Water Connection. .
Septic Sewer Connection
_�, Framing Fireplace �
Insulation . �wn Irri'ation
Wall Boazd (Mas°nrY) Other . • . . -
_�g�� . (11'if�•� Well (State Permit) . �
Other Gradin�/Filling __� Electrical (State Permit)
REiI�IA,RhS (!N I30USE): � -----------�"` -
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RE'V]E'�V BY OTHERS• DATE: ---- - ----------
Access: Eziscin� Netv -
---- ---_._
• ______-_ Access Approval: Date .
--------------- By�
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RE�FZKS (TO BEIV'OTED ONPER1tiiXT): . - -
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CERTIFIC/17E OF SURVEY
forLillian K . Qonander
, in Government Lot 1 , Section 8- 117-23 ��
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Hennepin Couni;y , Minnesota ti�'=��;:;:� �. - ' �
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I hereby certify that this is a true and
� � correct representation of a survey of
, The East 57 . 75 f2et of that part of Government
� Lot 1 , Section 8 , Township 117 , Range 23 ,
Hennepin County , lying North of County Road
No . 51 , and of the location of all existing
buildings and visible "hardcover" thereon .
It does not purport to show any other.
improvements or encroachments .
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /�— �—
PERMIT NO. COMPLETED
ADDRESS 3�� 'V��ff S!`f�� �.1�.
OWN ER CONTR.
, �:,: � >.�,�
TELEPHONE N0. �" �'"- ���'' "_���"�
� DESCRIPTION �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 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
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTAL�. 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� ❑WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECT�ON TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
TOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor 'te:
Inspector.
White yllnspector's File Canary CopylSite Notice