HomeMy WebLinkAbout1996-007914 - window replacement PERMIT
t CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:i,1��,[i i�yt�
Crystal Bay, Minnesota 55323 Permit Number: ;:;�},,,���
(612)473-7357 Date Issued:
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SITE ADDRESS:
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FEE SUMMARY:
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APPLIC T-PE ITE I ATURE �� ISSUED BY:SIGNATURE ,���yc�',� ,
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, Total Fee: � �; �> ,�5� DateReceived:
� DateApproved:
Entered By: �� Permit#: '�'j��1
CITY OF ORONO - BUII.DING PERIVIIT APPLICATION
ALL�TF'ORMATION�SUST BE SUB�IITTED IN FULL BEFORE PLAI�i REVIEW WII.L
BESTARTED
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THE APPLIC��1T IS: (circle one) OWNER OR CONTR.ACTOR
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JOB SITE ADDRESS: � ��� I�� {� � � ���I n 'F�Fz._ L���• ZIP:
NAtVIE OF OW�tER:��y�_L'�_�>T��_'� ����1 � ��� PHONE: (home)
(work)
VIAILI'�i 1GADDRESS: CITY: ZIP:
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CONTRACTOR:�O�!v .� � �\�;1`�{2_Z�J PHONE: �S O _ ( `� I ` %; -�"��
�IOBILE PHOVE/PAGER:
MAILINGADDRESS: �C�� C�'-�A��i"�'�}L f�-U��'' �' CITY:��`,J �'E��1� ZIP: > j� �
STATE LICENSE: # �,�QQ �I�3 p f
ARCHIT'ECT/ENGI�Ii EER: PHO�tE:
MAII.ING ADDRESS: CITY: ZIP:
�J�v�; REGISTRATION #
TYPE OF WORK: New Addition Acces�sery S�ucture
Move Remodel/Alteration �� Land Alteration
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PROPOSED WORK(describe indetail): �, `(�'��L��C��'��K.��� ���l�'�� 1.��.� l.�%'l)������
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET.
ESTTVi IATED CONSTRUCTION VALUATION(escluding 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 b� in �cco�rd�nce with the approved plan.
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APPLICANT'S SIGNATURE: �� � � � ���� �' DATE: `, _ � -- ' 1
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NOTE! Parade of Homes events requ�re s ar'�tte�ermit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stocEd shall be as set for[h in this secdon.
Subd.2. Information required to be given indiridual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and in[ended use of the requested data within the collecting'srate agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying oc refusing to suppty
private or confidential data;and(d)[he idenary of other persons or entities authorized by state or fedecal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesugative data, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertV tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals, and whether it is classified as public, private or co�dencial. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data wi[hout any charge to hun 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 ia meaning,the data need no[be disclosed to him for
six months thereafter unless a dispute or action pursuant to this secaon is pending or addirional 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 penon to pay the actual costs 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 requesc
within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Sarurdays,
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 concerning himself. To exercise this right,an individual shall notify in writing 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 recipients named by the individual; or(b)no[ify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authority may be appealed pursuant to the provisions of the administradve 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 are 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 pemut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the permi[ 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.
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First Middle Last
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Address �� ��—�_��'� � �"� �� ' �)���� � ���I�FA �� � ! � ( �
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Ciry State Z�p Phone
I understand my rights as sta d a�ove.i
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Signature ' i "'�,
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. CHECK OFF LIST FOR ISSUAl�iCE OF PERMITS
FOR OFFICE USE ONLY
ADDRFSS OR LEGAL: 3�6 f � v�v S��-o rt,�,S ►�2
PID:
DESCRIPTION OF WORK: w Lnr✓�o,.,.r ��lA csz���`
----------------------------
ZONING REV�W BY: �� DATE APPROVED:
BUII..DING REVIEW BY: DATE APPROVED: 5-3 - ��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _ / No
PLAN REVIEW Yes No ci SEWER CONNECI`ION
STATE SURCHARGE Yes �No WATER CONNEC'TION
INVESTIGA'I'ION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: _ Shoreland Distrisi :
\
Fire Departm t:l Post Office: 11 School District:
r�., I
Lot Area: S�.ft, � Acres Width Depth
Survey Submitte�i: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
,
Building Height: Def. Hgt. pe� Hb• I
Av;. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250' f
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
Gradi.ng: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: # Resolution: # Resolution Date:
�EMARKS (in b(ouse):
�
BUII.DING REVIEW CHECK LIST
UBC: � ' 3 CONSTRUCT'ION TYPE: V�
Sq Foota�e � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gara�e x =
x =
TOTAL
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Estimated Construction Value: $ C� U��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Sepcic Sewer Connection
�C.Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_� Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
------------------------------------ --------�------\-�-1--�---- ----------------------------
REVIARKS(TO BE NOTED ON PERNIIT): ✓�� S� �� �-e��� �5
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27
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DATE TIME
CITY OF ORONO CA��ED IN � '��'�� /•�� ir►
INSPECTION NOTICE SCHEDULED �5',�3 `I L fC:�'�`�F,Z,
PERMIT NO. YI �1�� COMPLETED �
ADDRESS �5 �I� ����CS'���� � �2�° �
OWNER v�� ����� CONTR. �� nn e < <�
TELEPHONE NO. J��� ' � �7 1 �
� DESCRIPTION���,���c��x�
� 01 F TINO 11 MECHANICALRI 18IXCAV/GRADINQ/FIWNO
�.FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INS� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= p$FlNA� 14 SEWER HOOK-UO O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
�Q 07 DEMQ—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBIN(3 RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED G pROJECT COMPLETE
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� ❑CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WiTHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR
❑ CITATION ISSUED
❑ INSPECTION REOUIRED.CA�L TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlCont ite:
Inspector. �
White Copyllnspector' File Canary CopylSite Notice