HomeMy WebLinkAbout1996-007903 - garage repair � PERMIT
�► ��ITY OF ORONO
PERMIT TYPE:
<'"50 Kelley Parkway- P.O. Box 66 Permit Number: �'�'-�`—�'�r'�`'
Crystal Bay, Minnesota 55323 ��t�!'=�'-j���
(612)473-7357 Date Issued: ;y�;;i�._,f,�F:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- �"�c�c��, i.r t�r�i:. -�
C�:�:���_iF:�=�i� u�s �
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APPLICAN ERMIT SIGNATURE ISSUED BY:SIGNATURE �-���
�
" Total Fee: S�?`S' S'_`> DateReceived:
Date Approved:
Entered By: (l Permit,�: -j��C �
CITY OF ORONO - BUILDING PERNIIT APPLICATION
AI.L INF'ORl�1ATION l�1UST BE SUB�IITTTED IN FULL BEFORE PLA��1 REVIEW WII.L
BE STARTED
THE APPLIC��tT IS: (circle one) OWNER R CONTR.ACTOR
JOB SITE �DDUESS: 4 v 4 i tv� '� (Z► N 5 t�0 �'� D P.�� r Zg'� � � 3 � `6"
�I�v1E OF O`VNER: 1�A L.� J r/I ���r"fZ�`� PHONE: (home) �--'7 2 - q-� � :�
(work) `�`
vIAILII�TG ADDRESS: 1}-0 4 i N o(ZT N 5 N�P_F D('�.CITY: (v� d v � p ZIP: S� � �4
�1 � 1<C A��E�'��c,J �Anif� � GAQ� -- i ��.n6rS�v�IA�.L..S `� 34--��3�
D f� �,r_ S'. M �.�v��� — �-!�!�-.0 L-�
CONTR.ACTOR: PHONE:
`�IOBILE PH0�1E/PAGER:
MAILINGADDRESS: P,� , 'U�:�C 4 4 � 3 J CITY: �D�n� Pf��11R�Fz�� 5�`3-9'
STATE LICENSE: #t
ARCHIT'ECT/ENGliYEER: PHO�]E:
MAILINGADDRESS: CITY: ZIl':
;v�v�: REGISTRATION #
TYPE OF WORK: New Addition Accessory S�ucture
Move Remodel/Alteration _� Land Alterarion
PROPOSED`VORK(describe indetail): �,� P �R � r �X� 5�'► �1 Cr (�E ► A� � t n`''�s-'
vV A L t- 5 A N D R C P A�� �� � 5'T i N (r � ►.t� L/� 2.. �r-A R.!�Cr- --�
� c=t= � r� � c:..�-t�tJ .
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.�_
ESTL1�iATED CO�'STRUCTION V�I.UATION(escluding land): � � �z��U�
cv, �a ��=� l'c�Y4�N,n.�� �,,4��5
I hereby apply for a buildin� permit and I acl:nowledge 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.
APPLIC�tiT'S SIGNATURE:` /� /` �" � L DATE: '4'�.2�-T�y b
����
NOTE! Parade o�Homes events require separate permit approval by Police Department and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
. . �
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type uf data- 'I!►e rights of individual on whom the data is srored or m be stored s1�all be as set fonh in this secdon.
Subd.2. Information req�rired to be given individual. An individual asked to supPlY Private or wnfidential data conceraing himsedf sha11
be mformed of: (a)the piupose amd inte�ed use of the requested data within the collecting�late agency,Polidral sabdivision,or staoewide sysoem:
(b)whether he may refuse or is leSallY requi�d to supply the requested data;(c)anY l�wn consequence azising from his supplying or refusinB m svQPIY
private or confidendal data:and(d)the idendry of other peisons or entides authorized by state or federsl]aw to receive the data. This requireme�shaII
nat apply when an individual is asked co supplY invesdgaave data,pursuanc to secdon 13.82,subdivision 5,ro a law enforcement officer.
The commissioner of revenue ma lace the noace re ired under dus subdivision in the individual iacome taz or ro m tax refund
insauctions instead of on those forms.
Subd.3. Access to data by iadividual. Upon request m a responsible authority.an individual shall be infora►ed whether he is the sabject
of soored data on individuals,and whether it is classified as public,private or confidendal.���er d����I��of the contenc
of stored private or public data on individuals shall be shown the data without aay charg
and meaning of that data. Afrer an individual has been shown the private data and informed of it�meaning,the data need not be disclosed w him for
six moaths theceafrer unless a dispute or acrion pursuant to tlus secdon is pending or additional data on die 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 resgonsible authoricy
may require the cequesting person to pay the actual casu of making,certifYu►S.and compiling the copies.
The responsible auchority shall comply immediacelY.if possible,with any request made pursuant to this subdivision,or within five days of
the date of the requesG excluding Saturdays,Sundays and legal holidays,if immediace compiiance is not possible. If he cannot compiy with the requesc
w;thin thac time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,ezcluding Saturdays,
Sundays and legat holidays.
Subd.4. Procedure when data u not accurate or complete. An individuai may contes�the accuracy or completeness of public or private
data concerning himself. To ezercise this righ4 an u►di�idual shail noafy in writing the resgonsible authoriry describing the nature of th�Rc r��o
The responsible authority shall wirhia 30 days eidier. (a)correcc the data found to o��e.��°.ivi ual�hac he believ�esmthe data to be correct Dara
iaaccurate or incomplete data,including recipients named by the iadividual:or(b) �Y
in dispute shall be disclosed only if the individual's statement of disagree�me u���t��pro�ions of the adminisccative procedure act relating to
The detecminadan of the responsible authority may Ue apPea� p
contested cases•
DATA PRIVACY AD�'ISORY
In accordance with M.S. 13.04,Subd.2, "Rights of subjects of data",we would likeou to furnish certain private or
for a permit or license from the City of Orono or any of its departments may require y
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 requu'e that the City deny the permit or license.
3, The information may be shazed 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 Council action to approve, some information maY become
public. .
g, 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.
� �LL � M�c � MGGVI�.A `r
Middle �
F,nt o T�-1 S N a R.� D It i �!�
40 �+- I nl °
Address � �J . �S 3 6 4- 6 Z G S3
M D V � S�� Zlp Phone
cicy
I understand my rights as stated above.
c
3ignaaire
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` CHECK OFF LIST FOR ISSUA.riCE OF PERMITS
FOR OFFICE USE ONLY
r�iDDRESS OR LEGAI.: �-f v`I 1 No�-�'t <S/t�/z-�� m!L
PID:
DESCRIPTION OF WORK: �A�6L4-6� �'
ZONING REVIEW BY: /`� �'4 DATE APPROVID:
BUII.DI'iVG REVIEW BY: DATE APPROVID: �- /- �I C
FEES TO BE C�-IARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
pL�,rJ g���,y Yes No :/ SEWER CONNECTION
STATE SURCHARGE Yes _L�' No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTE INSPECI'ION
Number of SAC Units OTHER (specify)
-- --------------------------
ZOiVL�1G Cf3ECK LIST Zoning District: _ Shor land District:
Fire Department: Post Office: Schoo i trict:
Lot Area: Sq.fr. Acres Width Depth
Survey Submitted: Yes No Date of Su ey:
Proposed Setbacks:
Front ( e): Right Side
Rear (Str et): Left Side•
Adjace Structu es: etland:
Building Heigh . Def. H t. Pe� HDt•
Avg. Setback: Bl ff Setback: Lot Coverage:
E isting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover ariance Requir : s N Date of Council Approval:
Grading: taff �pproval D e: y: Council Approval Date:
Sepdc: S Approval Date BY�
Zoning File: � Resolution: Resolution Date:
��MAR� (in house):
• �
BUII.DING REVIEW CHECK LIST
jJgC: r/— ( CONSTRUCTTON TYPE: y^�
' Sq Foota�e S Per Sq Ftg
Basement x —
lst Floor x =
2nd Floor z —
Garage X —
x =
TOTAL
Estimated Construction Value: $ ��Z� �'�
Inspections Required: «'ork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Weli (State Permit)
_ � Final Grading/Filling Electrical (State Permit)
O[her
REI2ARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY�
REi�IARKS('�O BE NOTED ON PERNIIT):
27
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DATE TIME
CITY OF ORONO CALLED IN �_ �n
INSPECTION NOTICE � � SCHEDULED 4'�� � = - C7
PERMIT N0. COMPLETED n �
ADDRESS M� S�a�e
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTINO 11 MECHANICAL RI 18IXCAWCiRADINCa/FIWNO
�Q 02 FRAMINO 13 MECHANICAL FlNAL 19 LAI�SHORE/WETLANDS
� 031NSULATION 24/25 WOOD BURNER/FlREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HQOK-UP � 17 SITE INSPECTION
� p5 FlNAL 14 SEWER HOOK-UO O6 PROORESS
�
J 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
�Q 07 DEMO—FlNAL 1b SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTIC FlNAL 35 HARD COYER HEMOVAL
�I 10 PLUMBINO FlNAL 36 FOUNDATION REMOVAL
Z OWNER/CANTRACTOR TO MEET YOU: YES_NO
y COMMENTS:
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d �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ❑CORRECT WORK$PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
OwnerlContra n e•
Inspector.
WhHe CopyMspectoPs Fl e Canary Copy/Site Norice