HomeMy WebLinkAbout1999-011173 - convert 3-season porch into bedroom , PERMIT
�� CITY OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 Permit Number: ��`��'`-'' -
Crystal Bay, Minnesota 55323 `_?_ � _ :'=�.
(612) 473-7357 Date Issued: - �-� �- -
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SITE ADDRESS:
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REMARKS:
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�C T�FTCIGAN� PERMITEE SIGNATURE ISSUED BY:SIGNATURE
. Total Fee: $ /��'-. � c,� Date Received:
Entered By: + �� Permit#: ;!/! 'I�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) -
----------------------------------------------------------- ( --
---------------------------- --�-- --- ----
THE APPLICANT IS: (circle one) WN R R CONTRACTOR V ���'`� �
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JOB SITE ADDRESS: �`� S-� I�vr �� � �t,:�.�- ZIP: S�_> >
Ur�`�� `'�^r�
NA��IE OF OWNER: ��r�` �����'"� PHONE: (home �l �
�5 ) � s�-=��-���a
(work)
MAILING ADDRESS: `�`C S � �'� �'��S�y � CITY: (k���J y ZIP: >S ��"�
CONTRACTOR: �' EZ,� PHONE:
CONTACT PERSON: �;,�.,� ; /�i-����� MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGI"v'EER: S�L� L PHONE:
MAILING ADDRESS: CITY: ZIP:
NA1�IE: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_� Land Alteration
PROPOSED WORK(describe in detai�: ��kr.� > $�s••�;..�,.� �',, :N y�Z /�_-.,���•M"'
����'��k Y'�:�/� � ���` -
STORIES: � SQ. FEET OF EACH FLOOR: � �7 X (r
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ y�d 4'` '
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 accordance with the approved plan.
APPLICANT'S SIGNATUR�',�--�-o—'�� -- DATE: � �
NOTE! Parade of 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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Sec.13.04 RIGHTS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The rights of indi�idual oa whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Informatlon required to be gtven mdivfdual. An individual asked to supply private or confidential data conceming himself
shall be info�of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legally required to svpply the requested data;(c)any Irnown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of other peisons or emities audiorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked w supply investigadve data, pursuant to secdon 13.82, subdivision 5,to a law
enforeement officer.
The commissioner of revenue mav nlace the nouce rewired un8er this subdivision in the individual income taz or nrooertv tax refund
instructions instead of on d�ose forms.
Subd.3. Access to data by individual. tipon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is class�ed as public,private or confidential. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown d�e data without any charge to him and,if he desires,shall be informed
of d►e content and meaning of that data. After an indi�idual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six months thereafter uniess a dispure or action pursuant to this secdon is pe�ing or additional data on the individual t�as been
collected or created. The responsible authority shall pro�-ide copies of�e 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 resnonsible authoriry stiall comply immediately,if possible,widi any request made pursuant to this subdivision,or within five days
of the date of the requesc,excluding Saturdays,Sunday�s and legal holidays,if immediate compliance is not possible. If he cannot comply wid�
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 Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. M individual may cqntest the accuracy or completeaess of public or
priva�data wncerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreemem. The responsible audioriry shall within 30 days either. (a)correct the data found bo be inaccarate or incomplete and attempt to notify
past recipieras of iaaccurate or incomplete daffi,including recipients named by the iadividual;or(b)notify the individual that he believes the data
w be conect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authorin-may be appealed pursuant to the provisions of the admieistrative procedure act relating
w wntested 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 permit or license from the �in•of Orono or any of its departments may require you to furnish certain
private or confidential information.
You aze 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 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 pemut or license.
4. If your requested permit or license requires Council acdon to approve, some information may become
public.
5. You have certain rights under VI.S. 13.04(available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�,� c �c��'
First iddle Last
���'/Y s5�✓v�� 5�1,�-�- ��7�--- --
Address
�j•�.�.^'" �t�, � .�3 d� _
City Staie Zip Phone
I understand my rights as stated above.
Signature
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, � CHECK OFF LIST FOR ISSUAl�'CE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: `��/S� /V'c,r �1.� S�` z ��.. Y ,,��
PID: � 1 � I I'1 - 2 � 3 I �p c�'L
DESCRIPTION OF WORK:
----------------------------------- �-�..�--- --------------------------------------- . �/s
ZONING REVIEW BY: ,�.f' , �- ��._,_ DATE APPROVED• �
BUILDING REVIEW BY: .�Y, �;:,.. .��.__ DATE APPROVED: < ._��,,_`_�`�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t/ No
PLAN REVIEW Yes :/ No SEWER CONNECTION
STATE SURCHARGE Yes +� No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: L� -I�'s
Fire Department: �o u ri� Post Office: ��a`,r,� School District:
�
Lot Area: Sq.ft. �7, b�(� Acres � � �- Width I $ � Depth .� 7�
Survey Submitted: Yes ✓ No Date of Survey: `��z�/9 g
Proposed Setbacks:
Front (Lake): '�'��a Right Side: t�+st /S �
Rear (Street): ��� � Left Side: k,'�y t t�•z '
Adjacent Structures: �- `-� Wetland: %1/�
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage: „� 7 7� � /�` � `7�
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: /�/} By:
Zoning File: # Z y 2� Resolution: /# `// 2�/ Resolution Date: �� `t 9 b
Shoreland District: �- ��"//�
Avg. Setback: �,5 f Bluff Setback: -�A L.ot Coverage: Z � ��' �' � � � '`7�
Existing Proposed
Hardcover: 0-75' C? U
75-250' � 3 5 z 8 3 �7
250-500' Z d 2�3 Z O 7� (2►�y� ��Pr��Q<,I}
500-1000' u C�
Hardcover Variance Required: Yes ✓ No Date of Council Approval: ���g �9 g
REMARKS (in house):
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BUII.DING REVIEW CHECK LIST
UBC: � ` � CONSTRUCTION TYPE: ��
Sq Footage $Per Sq Ftg
Basement x =
lst`Floor x =
2nd Floor x =
Gazage x =
x =
TOTAL
Estimated Construction Value: $ �i, c9���
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hazdcover Removal Mechanical Water Connection
OC Footing Septic Sewer Connection
�Framing Fireplace Lawn Inigation
_�Insulation (Masonry) Other
_�Wall Boazd (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:
REMARI�S (TO BE NOTED ON PERMII�:
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--- CODE �::.��.{'���: � :�'t�!"�`�
� DATE TIME
CITY OF ORONO �j�, CALLED IN ��/��
INSPECTION NOTICE �I 1 J SCHEDULED ��L�L�9 = G
PERMIT NO. � co PLETED
ADDRESS "`{'�� S� `����'L� �t •
OWNER��r�a-.� CONTR.
TELEPHONE NO. �G��- d��'� ��
� DESCRIPTION ----
l� 01 FOOTING 18 EXCAV/GRADING/FILLING
� 02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 3 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z ��D. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� COMMENTS:
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� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
� ❑STOP ORDER POSTED.CA�L INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac o ite:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN _� __�//' 3 �
INSPECTION NOTICE _ scHE�u�E� �-'3 a
PERMIT NO. 1�// 73 COMPLETED
ADDRESS ���5 .� /� �`l�� �r"�'u�'''Q �,/��,�-t'—'
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OWNER - CONTR.
TELEPHONE NO. ��� �l��' �
� DESCRIPTION �" �
lu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. i , pHOTOTAKEN
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra�o site:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
IIdSPECTION NOTICE , scHeou�eo � - �"�� � � 3�
PERMIT NO. �� COMPLEfED
ADDRESS °"�`��� ���"� �S'f�� Ol2
OWNER �� �C�^�'�+^' CONTR. ��'�*�-
TELEPHONE NO. Y��' ���� � ��3Z' ���;
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� SCRiPTION ��� ��"� �
��OOTING 11 MECHANICAL RI 18 DCCAV/GRADING/FILLING
�02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREMIETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance.473-7357
Owner/Contra 't :
Inspector.
Whfte CopyMspector's Flle Canary Copy/Site Notice