HomeMy WebLinkAbout1998-010548 - remove storm 2 story PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ���'I L ���f�s��
Crys�al Bay,�vlinnesota 55323 Permit Number: �j i i_1 c,�;_;
(612)473-7357 Date Issued: �i�;:`;��;�Y�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — t:;����� ; r,;;f. — :�;�' . �_i .OWNER:
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APPLICANT'PERMITEE SIGNA R ISSUED BY:SIGNATURE
, ,
' ' Total Fee: $ ���.3�. -�_ Date Received: 7 .- Z�'- `I�
�Entered By: Permit#: �'C��'�f
CITY OF ORONO - BUILDING PERMIT 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 O CONTRACTOR �
1 ,/�
JOB SITE ADDRESS: � ��� �C�f�-� ��-�-`�`" �ZIP: -�a��
NAME OF OWNER: l�'i� � PHONE: (home) � �f l "'~ �� J �
(work)
MAILING ADDRESS: { CITY: ZIP:
� -, �/ �; II�
CONTRACTOR: il.�i�� �)����=�� �� � PHONE: �.�"' �/�� -��.
CONTACTPERSON: C�'Y� l �- MOBILE/PAGER: �67-7��'.�
MAILING ADDRESS:�� C�a�—w�� �__CITY: ZIP: .�:�.J,�
STATE LICENSE: # � �)� v n�„
����/� r: .
ARCHITEC NGINEE� L PHONE: �7�- ����'
MAILING ADDRESS: a 4.3�- �' CITY: �Q.�.��' ZIP: -.5�„3 6
NAl��: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �_ ��- � :�
`Y� U cl,� S�
�
STORIES: �- SQ. FEET OF EACH FLOOR: �'��' �C�' ��'-���-
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
_'—
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /�?>��
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 acc nce with the ap oved plan.
�
APPLICANT'S SIGNATURE: � '� DATE: ��
e
NOTE! Parade of Homes events require separate permit approval by Police Department�m�
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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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. ,
Stibd.2. Information reqaired to be given individual. An individual asked ro supply private or confidential data conceming himself
shall be informed of: (a)the�urpose and intended use of the requested data withit►the collecting stau agency,political subdivision,or statewide
sysrem;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or
refusing ro supply private or confidential data;and(d)the idendty of other persons or entities authorized by state or federal law w 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 officer.
The commissioner of revern�e mav olace the noace rewired under this subdivision in the individaal income rez or nrocertv taz refund
instructions instead of on those forms. �
I
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the I
subject of stored data on individuals,and whether it is classified as public,private or co�dendal. Upon his further request,an individual who
is the subj�t 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 and meaning of that data. After an iruiividual has been shown the private data a�infomied of its meaning,the data need not be i
disclosed to him for six months thereafter unless a dispute or action pursoant to this section is pending or addirionai data on the individual has been �
collected or created. The responsible authoriry shall 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 cosu of maldng,certifying,and compiling the copies. ��
The responsible authoriry shall comply immediately,if possble,with any request made�wrsuant to this subdivision,or within five days
of the date of the request,eacluding Saturdays,Sundays anci legal holidays,if immediate compliance is not possible. If he cannot comply with
the request within that time,he shall so inform the i�ividual,a�may have an addidonal five days within which W comply with the request,
excluding Saturdays,S��ays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individuai may contest the accuracy or completeness of public or I
private data coc�erning 6imself. To ezercise this right,an i�ividual shall nodfy in writing the responsible authority 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 w notify �
past recipients of inaccurate or incomplete dara,including recipients named by the uidividual;or(b)notify the individiial that he believes the data ;
to be cornct. Daha in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of du responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating
to contested cases. i
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�ity of Orono or any of its departments may require you to furnish certain i
private or conf'idential information. !
You aze notified that: ',
1. The information you fumish 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 extent necessary to
process the permit or license.
4. If your requested permit or license requires Couneil action to approve, some informarion 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.
�"�,9-� ,� �f,�"� '
Fast ��J Middle� �� I.ast
I
�'�� V\.�JV
Address �� � ` S�� ��`�
City State Zip Phone
I understand ights as stated above.
/ �
Signature
� 6
CHECK OFF LTST k'OR XSSUANCE OF PERII�LITS
� FOR OFFICE USE ONLY
' ADDRESS ORLEGAL: _ '2�`�fd N0211-� .cSE4OtZ� �R1VCs .
PID:
DES CRIP'I'ION OF WORK:, STp{Z �
ZOYlNG REV1E'�BY• -- =DATE APPROVED: 7. L� -�S£3
BUII.DING REVIEW BY: �
. . DATE APPROVED: 7-2Sg,•.gfi
FEES TO BE CHARGED: - � Misc. Fees Calculated By: ~�
PEFtMIT Yes t/' No '
PLAN REV�W Yes �/' No SEWF��CO�TNECTION
STATE SUR`HARG c ye,s_IC No WATER CONNECTION
INVESTIGAZ'ION-FEE Yes No PARK FEB
SAC Yes No SITEINSPECTION
Number of SAC Units � OTHER (specify)
____��---------------- - ----
ZONING CHECK LIST zoning Districc: �fo � �� ��
, � �i .
Fire Department: Post Office: School District: ' '
Lot Area: Sq.ft. Acres Widch . Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: .
Front (Lake): . Right Side: . �
Rear(Street): Left Side:
Adjaeent Struccures: Wetland:
Building Heiaht: Def. Hgt. Peak Hgt. �
Lot Coverage:
Grac�iag: �Staff Approval Date: � � � By: Council Approval Date: '
Septic; Staff Approval Date: gy; � .
Zoni.ng File: # - Resolution:� Resolution Date:�
Shoreland Dis�-ict: � �
Avg. Setback: Bluff Setback: LotCoverage: �
' E��g Proposed � �
Hazdcover: 0-75'
75-250' . . • •
250-500' . . .
500-1000'
. Hudcover Vaziance Required: Yes No Date of Council Approval:
. �
RENLA�2KS('m house)s_�.K- d� C7.z�a�/t.. P� s ec.r ��•., �o . 0 3 g.,r3� S �
z __ , . .
• y'°'�ZA., - 26
BUILDTNG REVIEW.CHECK LIS3' � - � : ' ,
v�ac: _ . (Z� 3 covs�rxvczzov�E: �[N . - _
. . Sq Footage $ Per Sq Ftg
. Basement X . _ � .
. . lst Floor . . . X _ . . �
� . 2nd Floor . .. . • . .x ... _ . ��
Gazage . X _ . . . . . .
x
TOTAL . .
Estimated Construction Vaiue: $ ����5—�� •
- -- Inspections Required: • Work Requiring Separate Permits•
Site ,�_plumbing Fire
Hazdcover Removal _�Mechanical Water Connection
OC Footing Sepcic Sewer Connection '
_ o�Frami.p.o Fire lace �
_�.Insulation ��o�) O���gation .
_o�Wall Board (Mfg.) � Well (State Permit) �
°� F�� � Grading/Filling _�Electrical (State Permit)
Ocher
. REitiZA.�tKS (IN HOUSE�: ' _~
----------------------------------------__ �
------------------------___
RE'VIEVV BY OTHERS: � DA1'E: --��_�
Access: Euscing New �
• Access�Approval: Date �Y. •
RE1��A.RKS(TO BE NOTED ON PERd�II'I'): �,-�p ��� •�� _ -
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❑ APPROVED RS SUP�(��f!Ti�D � ' � '
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AQquiraments ir:ci!„1�^g i`e„��r�t {.�u�ir,a�y�.r,cted in this review. �' !
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DATE TIME
CITY OF ORONO CALLED IN _�� �"�C�
INSPECTION N TICE SCHEDULED G= b- �,�-� d
PERMIT NO. O.� COMPLETED �
ADDRESS J' � �� �Vi�• �iL�✓��
OWNER CONTR. � .�P.�'�
TELEPHONE NO. ��O 7— � �Y G��
� DESCRIPTION
� 01 G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� t�-' 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
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� �7 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑ CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. n PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDER POSTED.CALL INSPECTOR �1 CITATION ISSUED
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White Copyllnspector's Ifile Canary CopylSite Notice
DATE TIME
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Q 05 FINAL 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
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White Copyllnspector's Fil Canary CopylSite Notice
DAT TIME
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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White Copyllnspector's File anary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN L��J�
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Owner/Contra��n te:
Inspector.
White Copylinspector's le Canary CopylSite Notice