HomeMy WebLinkAbout1997-008702 - bath remodel PERMIT
CITY OF ORONO PERMIT TYPE:
= 2750 Kelley Parkway- P.O. Box 66 t1 LiNC
Crystal Bay, Minnesota 55323 Permit Number: 0..t:/ �;:
(612) 473-7357 Date Issued: t i 1 / 1 :''a7
SITE ADDRESS:
180 ORONO ORCHARD RD
LSV -y d
P. I . N. _ 02-1 / . — . -2 -0010! ;`3 i
DESCRIPTION: r
RA f H REMODEL
!ODEL
Building Fermi t. Tv�=,� 3 -ADD/REMODEL
Building Wort:..
TyF RENOVATE/REriuDEL..
UBC Occupancy_ , ,ttC R-3
C o n s t r u e t.i n e i V VN
Census Codr+ 434 ALT . RESIDENTIAL
REMARKS:
SEPARATE PERM I T REO. i I RED FOR PLUMB I NG . STATE PERM I.T REO.0 I RED FiOR E _EC T R I C.
FEE SUMMARY:
VALUATION $10, 100
Base Fee
$174 . 75
Plan Review ;�1 r?'
Surcharge i5 . .
+'+ .. iFee $'.7"9: . 3_!
T
CONTRACTOR: - A P=1. i.'.:;.1.a41-71:::::.:1-364 '�'T . LIC: OWNER•
Ti iHh�i° OJ-L !Cia' DEE;I GN i;;�;t��t 7s:}` Rei;::t:E _TO°EPL
«;_ 15 COL t;ATE'AVE 1:�:t:� ORONO ORCHARD RD
MINNETONF�::A i1N !;=;•14 ORONO MN 55:_°== 1
(:F=12:? 473-1: 6ti (612)473-8271
THE UNDERSIGNED HEREBY REQUESTSPEI PII" SI N TD MADE THE REAL I PRD EN TS
SF'EC I F'ED AND AGREE . TO ,DO ALL u INS MF I c`E ,W H AL ,. CITY {F
1 RON} ORDINANCES AND STATE OF I NNESOTA BUILDING CSE REQUIREMENTS.
L J
APPLICANT'PERMITEE SIGNATURE
ISSUED BY SIGNATURE
RE
. Total Fee: $ 3' 3 Date Received: / -/,3 -q 7
Entered By: Permit#: ??C' 2-
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) OWNER ORCCONTRACTOTO
JOB SITE ADDRESS: 180 c RoNO O U-A Rj ZIP: S5-5 I
NAME OF OWNER: j e go f'K PHONE: (home) -(5-eZ-7 j
(work)
MAILING ADDRESS: ISO °oKo a L14 f)rD,CITY: Oco"O ZIP: X5391
CONTRACTOR: JOHNjDK -LLZ-fts 1)eS160) 5ttil►- ) PHONE: in - II�{
CONTACT PERSON: P+�1 -ate MOBILE/PAGER: q 56T �L�f
MAILING ADDRESS: ';2118 t',o�..( F AV CITY: MIT ZIP: -
STATE LICENSE: #
ARCHITECT/ENGINEER: ---- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration >k Land Alteration
PROPOSED WORK(describe in detail): fEmot>s t_ (9c-vt1 .1 .e
T. Lc-x.1- £ Nit Zinn R►5 Pc,g. 5 KE-T&4
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 101 D a •oC>
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 accorI .n e with the approved plan.
APPLICANT'S SIGNATURE: ' DATE: //3.7``—77
NOTE! Parade of Homes events requ' e separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
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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 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.
Tne 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.
t NAD. Geo i
First kiliddle Last
=)91 R r Ktv ✓ .
Address ^ _AN --).S-3115---
11� /S� I 1-4i)
City 1 V Y l I State Zip Phone `�1
I understand my rig st abo e.
•
Signature
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: /,9 - Cr, ,6v 2<<./l '/Lei,
PID:
DESCRIPTION OF WORK: BATS-} Kcm 0 6
ZONING REVIEW BY: !� A,,. DATE APPROVED: /L/4.4
BUILDING REVIEW BY: M'_!. I„ , DATE 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 PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
�.P
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
BUILDING REVIEW CHECK LIST
UBC: 12-3 CONSTRUCTION TYPE:
Sq Footage S Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
O.
Estimated Construction Value: $ I OO(0(3
Inspections Required: Work Requiring Separate Permits:
Site v� Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
$ Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
pc Wall Board (Mfg.) Well (State Permit)
pe Final Grading/Filling p( 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 •
SPECIAL NOTE,
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f: APMOVED %.1,f!Tf4 CC,, ,',,117.?:..174)FiS AF.: NOTED •
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NOT APPROVED — COCIF-6-.:..CT& /RESUBMIT.
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f!.....-se comments ant for your inforrneticx...All work stiati be dart* .• : : ! ,
, tutif corwipiiimce with el nppEtztilr!LIMN; & zoning cods;sit
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Atements including iterns not specifically noted in this
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<ELI-, THIS PLAN SEI ON SITE AT ALL TIMI . .
970,2_ DA/TSE TIME
CITY OF ORONO CALLED IN -a� T - y 1
INSPECTION NOTICE SCHEDULED / 'Z 7 %3 a
PERMIT NO. COMPLETED p
ADDRESS /r�� �../ ��r uh /[aj.9
OWNER 9.s-4i/4411 .06--14-i. 4 MA4 CONTR.J4ty f v.PLt-,z. / Yay
TELEPHONE NO. ���� >> /�
DESCRIPTION a" 2-t/1? ac' //� let
tti 01 FOOTING 11 MECHANI RL 18 EXCAV/GRADING/FIWNG
ct 02 FRAMING 13 MECHANICAL FINS 19 LAKESHORE/WETLANDS
• 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
• `n! 14 SEWER HOOK-UO 06 PROGRESS
07'EMO--SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 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
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
cc
W
CC
O
CC
O
W
cC
W
W
CC
WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W
CC ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
CISTOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for ex i spection 24 hours in advance.473-7357
Owner/Cont r on s
Inspector. I,R,
White Copy/Inspector's File Canary Copy/Site Notice
ATE TIME
CITY OF ORONO CALLED IN / • 7
INSPECTION NOTICE SCHEDULED • - 97 _4: 3 ()
PERMIT NO. 3-qe COMPLETED
ADDRESS /SC
OWNER CONTR.;2edzyds-9-,-2
TELEPHONE NO. /473 _ /3 6J
DESCRIPTION
01 FO G e-'"r11 MEC CAL RI) 18 EXCAV/GRADING/FILLING
hIN • 13 MECHAICAL NAL 19 LAKESHORE/WETLANDS
03 ULATION 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
tQ 07 DE 1 L 15 SEPTIC INSTALL 22 FOLLOW-UP
• PL G RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
O
a
O
W
W
W
WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W
0; CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
CISTOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call tort ex ` spection 24 hours in advance.473-7357
Owner/Contra r on sit
Inspector.
White Copyllnspector's File Canary Copy/Site Notice