HomeMy WebLinkAbout1996-008285 - remodel/repair PERMIT
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CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 BUILDING
Permit Number:
Crystal Bay, Minnesbta 55323 0 OFF?:35
Date Issued:
(612)473-7357 08/71/96
SITE ADDRESS:
405 OLD CRYSTAL BAY RD S
LSV
P. I .N. ; 04-117423-24-0004 '
DESCRIPTION:
REMODEL/REPAIR
Building Permit. Type SF-ADD/REMODEL
Building Work Type RENOVATE/REMODEL
UBC: OccUPancY R-3
CrIntruc t.ion Type VN
Census Cade 47.4 ALT . RESIDENTIAL
REMARKS:
SEPARATE STATE PERMIT REQUIRED FOR ELECTRICAL .
FEE SUMMARY:
VALUAT ION $1'5,000
Base Fee $349 . 75
Surcharge
112-5,Q
Total Fee $362. 25
CONTRACTOR: OWNER: - Applicant -
BECKMAN JOHN
344 HARRINGTON DR
LONG LAKE MN 55356
(612)47::1-4596
I
THE IJNOERSIGD HEREBY FQUESTS PERMISSION TO MAKE THE REALL 1 '"I'VEMCNTS
SPECIFIED AND AGREES TO Do ,ALL WORK IN STRICT COMMIANCgiW,TTO ALL CITY OF
ORONO OROINAI4ES AND STA'TE OF MINNESOTA, jULDING CODE REQUIREMENTS. j
L
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: $ .S'ea a' DateReceived:
Date Approved:
Entered By: e-.dA-J j Permit#: 61'02-1'S'
CITY OF OR(NO - BUILDING PERMIT APPLICATION
ALL INFORMATION MU IT BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
THE APPLICANT IS: (circle one) ‘W-7-1E-1.-DOR CONTRACTOR
JOB SITE ADDRESS: S/013-60•®!p7 e:Zyh1 9.7 .AO ZIP: Ss36"6
NAME OF OWN. ER:.14 L a3 6eK01 y� -1►1 /7 tie PHONE: (home) 1173-ys'yG
(work) 5.0 AV'I.
MAILING ADDRESS: 344< ,zz�.�,!=.v p . CITY:Ae,Jy X,41(E. ZIP: 3S3 5
CONTRACTOR: PHONE:
MOBILE PHONE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHTTECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X Lath Alteration
PROPOSED W/O/RK(describe inddtail): �'�,'r,e</ eD e,,/ y' ,c�joQ..e' - ��jl�L 5d
sL&£i /t0G IL' -/vee cJ �Ous� �/o�' 5 51 D.IN/r i occ - -
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. DET. Z
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 025000.
I hereby apply for a building ermit and I acknowledge that the information above is complete
and accurate; that the work w 11 be in conformance with the ordinances and codes of the City
and with the State Building C de; that I understand this is not a permit and work is not to start
without a permit; and that the work will b in accordance with the approved plan.
APPLICANT'S SIGNA -2167c1-4v/ a,— DATE: 8/1//9
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.
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 be 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 data,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.
Xi-1J.07,`/
rrst
Middle Last
�35/� tie•
Address ,
City State Zip Phone
I understand rights as stated above.
ture
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: '405 0c.,(0 cAts7 13A1 t
PH):
DESCRIPTION OF WORK: tZ,eru-c.rat,_ VA-t(Z.-
ZONING
(ZZONING REVIEW BY: N(0 DATE APPROVED:
BUILDING REVIEW BY: c�, , k_ DATE APPROVED: B Zi
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t, ' No
PLAN REVIEW Yes No 't- SEWER CONNECTION
STATE SURCHARGE Yes f/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC , es No SITEINSPECTION
Number of SAC Units 1` OTHER (specify)
ZONING CHECK LIST :oning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. •Cres/ Width Dep
1
Survey Submitt d:1} Yes No / Date of Survey:
I
Proposed Setb.cks:
Fronr(Lak : Right Side:
Rea (Street : Left Side:
A. acent Strictures: W tland:
Building '-ight: Deft Hgt. 'eak Hgt.
Lot Cove age:
Gradin_ Staff Approval Date: By: / Council Approval Date:
Septic: Staff Approvil Date: UM By:
Zo • g File: # Resolution: # ;Resolution Date:
Sho'eland District:
Avg. Setback: Blu f Setback:;
E sting /I` Proposed
Hardcover: 0-75'
75-250' 1
250-500'
500-1000'
Hardcover i ce Required: Yes o Date of Council Approval:
REMARKS (in house):
10
BUILDING REVIEW CHECK LIST
UBC: - —3 CONSTRUCTION TYPE: V/"
Sq Footage $ Per Sq Ftg
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
A Wall Board (Mfg.) Well (State Permit)
"-Final Grading/Filling e7Electrical (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
INSPECTION NOTICE SCHEDULED !' `C9U
PERMIT NO. ;( COMPLETED lit,
ADDRESS 0 (9-r-t - ,Illi
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
tti 01 FOOTING 11 MECHANICAL •1 18 EXCAV/GRADING/FIWNG
yING 13 MECHANICAL NAL 19 LAKESHORE/WETLANDS
O SOLATION 24/25 WOOD = • ER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK P 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK
= 06 PROGRESS
I` 07 DEMO SITE 27 SEPTIC MAI 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INST 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PWMBING FINAL 38 FOUNDATION REMOVAL
• OWNER/CONTRACTOR TO MEET YOU: YES NO
o COMMENTS:
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•/ORK SATISFACTORY:PROCEED E PROJECT COMPLETE
CC 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑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 ARRANGE ACCESS.
Call for the - i pection 24 hours in advance.473-7357
Owner/Contract Ir. site.
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice