HomeMy WebLinkAbout1996-007687 - remodel PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Ftt .j 1> > y{
Crystal Bay, Minnesota 55323 Permit Number: 007/i;;—::--
(612) 473-7357 Date Issued: 01 '.2 f,_jE:,
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY: Vril _
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CONTRACTOR: OWNER: — ;='L'1 ?t A r It• —
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APPLICANTP TEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: S �.�JQ ` DateReceived:
Date Approved:
Entered By: Permit#: (ort 7
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORIMATION MUST BE SUBMITTED E4,4 FULL BEFORE PLANT REVIEW WILL
BE STARTED
_---------------------------------------
THE APPLICANT IS: (circle one) 4WNE OR CONTRACTOR
JOB SITE ADDRESS: jJ �. �yr�f� s ,rc �/Pc/[= C_aJ ZIP: ✓>,�6 Lam_
NAME OF OWNER: >�l TES 7�u�7n PHONE: (home) Z17g-05 2 Z
(work) �,/1►✓)MAILING ADDRESS: J/3CITY:
CONTRACTOR: cr PHONE: Z170'-G 5 2 Z
MOBILE PHONETAGER:
MAILINGADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECTXNGINEER: PHONE:
MAILINGADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X Land Alteration_
PROPOSED WORK(describe indetail): }'X Pcc^
STORIES: SQ. FEET OF EACH FLOOR: 960
NO. OF BEDROOMS: —I GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): S Lj DC), OCA
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 SIGNATURE: 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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CITYof ORONO
1':, 1 'I�•- - ,�+ Municipal Offices
Post Office Box 66
crystal Bay,Minnesota 55323-0066
`1kEsgog-
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 City of Orono or any of its
departments may require you to furnish certain private or confidential information.
You are notified that:
ll be used to determine our qualification for the
1. The information you furnish wi
permit or license requested.
?. 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 Council action to approve, some
information may become public.
5. You have cerain rights under M.S. 13.04 (see following page) to review private
data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRLN- T
c E� a��=�t..
T Last
First iviiddle
/1,30
,address
Ciry
State Zip Phone
I understand my rights as stated above.
Signature
TELEPHONE-473-7357• FAX-413-0510
s
93.04 RIGSTS OF SUBJECTS OF DATA
Subdivision L Type of lots- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section-
to
ect An.individuel asked to
to be given individual
Subd. Z. Information required himself shall be informed of: (a) the
supply private or confidential data concerning state agency,
purpose and intended use of the requested data within the collecting e °r legally
tem; (b) whether he may from his
political subdivision, or statewide system; known consequence arising
required to supply the requested data; (c) �Y and (d) the identity of
supplying or refusing to supply private or confidential data;
other persons or entities authorized by state or federal law to ply data,
ta. This.
oth p 1 when an individual is asked to supplyinvestigative
requirement shall not appy to law enforcement officer.
pursuant to section 13.62, subdivision 5, a
The commissioner of revenue ma lace the notice re uired under this
subdivision in the individual income tax or ro ert tax re and instructions instead o
on those orms. --- -
Subd. 3.
Access to data h�y individual• Upon request to a responsible
authority, an individuals be wormed whether h ri ateesubject of stored data on
or confidential. Upon his
Y and whether it is classified as p P public data on
individuals;
further request, an individual who is the subject of stored oim and,she desires, shall
individuals shall be shown the data without any data. After an individual has been
Se informed of the content and meaning the data need not this
disclosed to
shown the private data and informed of its u or action pursuant to this section is
him for six months thereafter unless a dispute n request by
pending or additional data on the individual h been
or public dataupon
req The
Pe g provide copies of the p require the
responsible authority shall p The responsible authority may uir► the
the individual subject of the cis certifying, and compiling
requesting person to pay the actual costs of making, Yi g'
copies. 1 immediately, it possible, with any request
The responsible authority shall complyof the
made pursuant to this subdivision, or within five aysi of the date)mpliance request,
igsu not
he
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot ce cc
omply with the request within that time, he shall so inform the
p have an additional five days within which to comply
individual, and may Sundays and legal holidays.
request, excluding Saturdays,
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
in writing the responsible authority
exercise this right, an individual shall notify i ible authority shall within 30
describing the nature of the disagreement. The resp° lete and attempt to
days either. (a) correct the data found to be inaccurate or incomPeci Tents named by
notify past recigients ononaccuhee individual
he believes tav dthe data to be correct.
the individual; or (b) Y disagreement is
Data in dispute shall be disclosed only if the individual's statement of
included with the disclosed data-responsible authority may be appealed Pursuant to the
The determination of the to contested cases.
provisions of the administrative procedure act relating
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 1139 N dRT\ s f*oAAe dZ
PID:
DESCRIPTION OF WORK:
ZONING REVIEW BY: NO DATE APPROVED:
BUILDING REVIEW BYDATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �' No
PLAN REVIEW Yes '� No SEWER CONNECTION
STATE SURCHARGE Yes -�� No WATER CONNECTION
INVESTIGATION FEE Yes No 4-- PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: Shoreland District:
Fire Department: Post Office: School Distri :
Lot Area: Sq.ft. Acres Wi th Depth
Survey Submitted: Y No to of Survey:
Proposed Setbacks:
Front(Lake): Right ide:
Rear (Street): Left de:
Adjacent S ctures: Wed
Building Height: D f. Hgt. Peak gt.
Avg. Setback: Bluff Setb k: t Coverage:
Existing Proposed
Hardcover: 0 75'
7 -250'
50-500'
00-1000'
Hardcover Vari ce Required: Yes No D e of Council Approval:
Grading: Staff pproval Date: By: Council Approval Dat
Septic: Staff A proval Date: B
Zoning File: # Resolution: # Resolution Date:
REMARKS (in house):
BUILDING REVIEW CHECK LIST
UBC: 9- 5 CONSTRUCTION TYPE: V�
Sq Footage S Per Sq Ftg
Basement x
1st Floor x
2nd Floor x
Garage x
R
TOTAL
Estimated Construction Value: $ 60 C
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
K Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
Final Grading/Filling __)e_ Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY:
REMARKS(TO BE NOTED ON PERMIT):
27
SPECIA!_ 't-10TE I
SEE R r TA�r�` 'C� ,r��::ET
FORS `
CODE REQUIREMENTS
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+:�r�'�• !tams rxrt srsC.ricti;'y now in the .47v.
_— — r;•r
!1.AN �"I tl'-t VfE AT ALL TIWID'.
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. 7 4' Y 7 COMPLETED S L,
ADDRESS ZZ-36
OWNER �� CONTR.
TELEPHONE NO. y7'Z `-/ys,s�
DESCRIPTION
LL
LQ 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKES H ORE/WETLAN DS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
1'` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
I
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
CC
W
CL
CC
J
O
cc
O
W
Cr
Q
Z
W
z-
W
QC
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W _ WORK SATISFACTORY:PROCEED PROJECT COMPLETE
QC C CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
O3 BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
Owner/Contra i
Inspector
White Cop /Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN; f-9�' �'C—C)
INSPECTION NOTICE SCHEDULED / 9 /P 3 a
PERMIT NO. �� k,7 COMPLETED
ADDRESS 113 0 '/2ek 6 h.
OWNER Wa-t--t- CONTR.
TELEPHONE NO. ya "" 8'3 3
DESCRIPTION
01 FOOTING 11 MECHANICAL Al 18 EXCAV/GRADINO/FILLING
h 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
QNS LATIO 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 W 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UO 08 PROGRESS
v 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
v 10 PLUMBING FINAL 38 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
c0„ COMMENTS:
o;
W
a
a;
O
O
cc
O
LL
W
cc
Q
12
2
W
D;
OW WORK SATISFACTORY:PROCEED ` PROJECT COMPLETE
cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
'hnmer/ContractorTtA�A
Spector.
White Copynnspector's File Canary Copy/Sits Notice
DATE ��7 TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED R ~ 141 .3
PERMIT NO. %(4,g 7 COMPLETED
ADDRESS /Oy f� 6''�
OWNER CONTR. _
TELEPHONE NO. (/7 ;-- 1 ys's�
DES TION �� t a.� ' �� Ae-
01 FOOTING 11 MECHANICAL RI 16 EXCAV/GRADING/FILLING
h 02 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO–SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
2 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 26 CEDAR SHINGLES 36 FOUNDATION REMOVAL
2 OWNERICONTRACTOR TO MEET YOU: YES_NO
y COMMENTS:
cc
w
C
O
cc
O
2
LU
cc
Q
12
2
ILLS
w
w
o:
j
X ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
CC
LU ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C0.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerfContra n :
Inspector. -'
it U4
White Copy/inspector's File Canary Copy/Site Notice