HomeMy WebLinkAbout1996-008158 - finish garage PERMIT
GITY.OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66
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Crystal Bay, Minnesota 55323 Permit Number:
Date Issued: S
(612) 473-7357
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: �-;T C OWNER:
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M I NNE j -itzH I t l=U,
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ANCE WITH Al I CITY OF
::PECIFIPD AND A,'!,REE!::; TO 00 ALL Wui IN TRICT CID-NP
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APPLICANT/PERMITEYSIGNATURE
ISSUED BY:SIGNATURE
' To_ral Fee: S l�/- D6 DateReceived:
Date Approved: _
Entered By: Permit#: /S
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
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THE APPLICAiNT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 91HO 000h o�ot� ROa.& ZIP: S3391
NAME OF OWNER: AVaN+ Susan 01GbOwe t PHONE: (home)
(work)
MAILING ADDRESS: 2qo IU(j CITY: n ma() ZIP:
CONTRACTOR: Royer t(.c N. q Co ft c,) ' i fc� o� PHONE: �f?sem 0l7
M B" PHONE/PAGER:
MAILINGADDRESS: (9a&3Tl,A AW)OL CITY: a t ZIP:
STATE LICENSE: # M6-9
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAiNIE: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration 'JL Land Alteration
PROPOSED WORK(describe indetail): n,�-�,;tAl.p Sheeiro,� a&l ,:j,,+.� tnaklev',
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. Y-�- 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 accordance with the approved plan.
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APPLICANT'S SIGNATURE: fi DATE: 6
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.
ANW
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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.
Subd.2. Information required to he given individual. An individual asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative dam, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals, and whether it is classified 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 the data without any charge to him 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 its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person 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 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. 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 authority describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 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:
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 permit 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.
First Middle Last
Sam- 0.T45�ej- 116P,1-d
Address
Cit, State Zip Phone
I understand my rights as stated above.
l
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSOR LEGAL: 2.40 N OR1-tA6A1t ilwbn
PID:
DESCRIPTION OF WORK: G A(2A&—L-, F i r4 St-t
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ZONING REVIEW BY: WA A DATE APPROVED:
BUILDING REVIEW BY: ---------DATE APPROVED: -7
---------------------------------------------- ------- , --- -------------------------------------------
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 ✓ PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitt Yes No Date of ury y:
Proposed Setba ks
Front Lak ): Right Side:
Rear ( treet) Left Side:
Adjac t Struc res: etland:
Building Heigh Def. H ak Hgt.
Lot Coverage:
Grading: Staff Approval Dat By: Council Approv Date:
Septic: Staff A proval Date: By:
Zoning File: # Res ution: # esolution Date:
Shoreland Dist ict:
Avg. etback: Bluff Setb ck:
Existing Proposed
Hard over: 0-75'
\j
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
POW
BUILDING REVIEW CHECK LIST
UBC: (Z'3 CONSTRUCTION TYPE:
Sq Footage S Per Sq Ft-
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value:
Inspections Required: Work 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.) Well (State Permit)
Final Grading/Filling pC 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
DATE TIME
CITY OF ORONO CALLED IN •� 5 e o,,w
INSPECTION NOTICE _ SCHEDULED 3G am
PERMIT N0. �y�� COMPLETED L4_
ADDRESS c<� 4
OWNER lhl CONTR._�
TELEPHONE NO. 4 `j - 3�-o 9 -1
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING____ 13 MECHANICAL FINAL 19 LAKESHOREIWETLANDS
p X63 IN ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
/ 12 WATER HOOK-UP 17 SITE INSPECTION
2 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEMO--SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
-� 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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O WORK SATISFACTORY.PROCEED ❑ PROJECT COMPLETE
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C =CORRECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY
W
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS.
❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO RRANGE ACCESS.
Call fo ane t' s ection 24 hours in advance.473-7357
Owner/Contr t n site
Inspector. 4
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN 6 /
INSPECTION NOTICE SCHEDULED i 9�
PERMIT NO. COMPLETED
ADDRESS
�j
OWN Ef�'1 _� ,,� Q L� CONTR.
TELEPHONE NO. 7 - 202 7
DESCRIPTION
t4i 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
04 WALL BD.' 12 WATER HOOK-UP 17 SITE INSPECTION
= FI 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
LQ 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
OOWNER/CONTRACTOR TO MEET YOU:_YES NO
COMMENT6"ZL •,1 Q,CC
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W �ORK SATISFACTORY:PROCEED X PROJECT COMPLETE
Cr ❑ CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑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�rlon 't :
Inspector.
White CopylInspector's File Canary Copy/Site Notice