HomeMy WebLinkAbout1998-010712 - deck replacement PERMIT
4 CI�Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:,t i�i I.._C,�t°�i;
Crystal Bay, Minnesota 55323 Permit Number: i�j S s;�i�
(612)473-7357 Date Issued: �,���;;���::;j:�;_;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: ` =��°�°1 i c��-�:. —
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APPLICANTiPERMITEE SIGN TURE ISSUED BY:SIGNATURE
Total Fee: a� /'� 3_ -1,' Date Received:
�ntere� By: �G� Permit#: /� f��'
CITX OF ORONO - BUILDING PERMIT APPLZCATION
All information must be submitted in full before plan review will be started.
(please print ali information) .
---------------- -- ---- -- - - ----
THE�APPLICANT IS: (circle one) �W�NE��R CONTR.ACTOR� � � .
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JOB SITE ADDRESS: � :j C�.S ��i r � �r, v�.. ZIP: �s.3(oy
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� NAME OF O��NER: �•:��'�1� K '� I�✓� 1-. � �►��^1 PHONE: (home) �'Zv S ��
� J (work)
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��G�D�S: I �� � � �i�. ��- . �,� ��: n.� V�.�,�c�. Z�:��
CO�"TRACTOR: I���'�'�� PHONE: �
C01�1'I'ACT PERSON: MOBILE/PAGER: �
l��ZAII�'iNG ADDRESS: CTt'I': ZZP:
STAT�E LICENSE: #
AP CHITECT/Ei\TGINEER �l�C%��-- PHONE:
;YIA1LlivG ADDRESS: CITY: ZIP:
r,*�,ME; REGISTRA.TION#
TYPE OF tiVORb: New Addition Accessory Structure
Move ' Rerr�,qdel/�eratior�� ✓ Land Alteration
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PROPOSED,'��ORK(describe in detai�: ..� �� °� �G�,c � ,� �a i��� c%�P �'
� ... ��1 �� G�Yc � y'�G��i�E�1ci =i;G�r� ��S � —
STORIES: SQ.FEET OF EACI3 F'LOOR: � -
NO. OF BEDROOMS: GARA.GE STALLS: ATT. DET.
. �
EST .n'i IATED CO�'STRUCTION VALUATION (eXCluding land): $
I hereby apply for a buildinJ 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 Buildi.n� Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be ' ac r�c ith the approved plan.
APPLICANT'S SIGNAT'URE: � ,,,,t.�, � DA'I'E: `���-U %�
NOTE! Parade o�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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See.13.04 RIGHTS OF SLIBJECTS OF D�T.1 r �' -
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Subd. 1. Type of data. The righes of icdividual oa whom the dara is stoced or to be swred shalt be u set torth ia this secrioa j � - ,
Subd.2. InformatIon reqtrired to be�vea indirldual. An individusl uYed w suppty privare or coafideatial daa,concerning himtelf shall
be informed of: (a)the pcupose aad iamaded use of the requesr�l dsra within the eotlecdng Stace ageacy,poliricai iubdivisioa,or srate.wide rysrem:�-: i ..•
(b)whechec he may refuse or is legalIy«quir_d ta suppty the raquesud dae;(e)aay lmown coacequeqce uising fcam his supplying or refusiag to supply
privace oc eor..�dead3l dars;ar.d(d)che idendry of other pecsoas or eariria au�horiz:d by sate'or federel law w teeeive che dam. This requiremeat 36a11�%�..:....;::�`s.
not appty whea an individual is uked co supply invesdgadve dan,pucsuanrto secdoa 13.82,subdivision 5,co a law enfo�cement office�. - -
'Ihe eamnissioner oC revenue mav ofaee che nodce reauir:d under chis subdivision in ehe individual income tax or orooectv az tefucd ,. •
inscrucaons inscead o[on thase forms. .
a,� Subd.3. Aceas to data by indiridual. Lipon requesc te a cesponsibie auchoriry,an iadividuai shall be informed whe�her he is the subject �
of smr:d dari on individuals,and whecher ic is etassifi:d as pubtic,privac�or confidenrial. Upon tiis turcher cequesc,aa individual who is the subjecc
of scored privam or publie data on individuals shall be shown the daca wi�houc any eharge to him and;if he desires,shall be infocmed of che eoatenc
and meaning of chat daa. Afur an individaal has been shown the priva�data and informed of ics meaning,the da�a need not be dis.losed to hua for
si�c monchs th.ereaiter unless a d'upute oc acdon pursuant w�his secdon is ptnding or addidoaal data on the individual has been collacc�d o�ereared.
The rsponsible aa�horiry shall provide eopies of�he priva�e or public dan upon cequest by ehe individu�l subjecc of che daca. Zhe respansible auehariry
�nay cequire che requesang peaon w pay the accual cosu of ma3cing,cecrifying,and eomp�7ing the copia.
The responsible authoriry shall conply immediatety,if possible,wich any request made purntant to rhis subdivision,o�wi�hin five days of
the dac�oE the requesc,ezctudiag Saaic+days,Sundays and legal holidays,if immediate eompliance is aot possible. Ithe cauaot comply with the requesc
wirhin thac dme,he shall so inform the individual,and may have an addidoaal f ve days wichin which ro comply wich the requat,exciudiag Saturdays,
Sundays and legal hotidays.
Subd.4. Procedure whea data Ls not accurate or eomplete. An individual may contesc ette accuncy or eompleteneu of public oc private
daca eonceming ti�nself. To ezeccise this cighG an individual shall noafy in wridng the responsibie au�horiry deseribing the natuce of the disagreement
The cuponsible authoriry shalt within 30 days ei�her: (a)corr:cc�he dan fourtd oo be inaccurate or incomplete and accempt to nodfy past reeipieau of
inaccurdte or incomplete data,including recipiencs named by[he individ�al;or(b)aodfy the individual that he believes che dara to be cocmt Data
in dispute shall be disclosed only if the indir•idual's sc3tem:nt o[disagre:meat is induded with[ha d'uclosed daca.
The decerminadon of the responsible auchoriry may be appealed punuant to the provisions of che adminis�aave procedure act retadng w
contesttd eases.
DATA PRIVACY ADVISORY � _
In accordance with M.S. 13.0�, Subd.2, "Rights of subjects of data",we would like to inform you that your request
for a pernut or license from the Ciry of Orono or any of its departmencs may require you to furnish certain private or
confidencial informacion. "
You aze notified that:•
1. The information you furnish will be used to determiae 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 excent necessary to process
' the permit or license.
4. If your requested permit or license requ'tres Couacil actibn to approve� some information maq become
pubtic. _ .
5. You have certain riQhts 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 permic.
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Add�ess �C�`(�(� I i �� ��� / / ����
Ciry Sate Zip Phone . .
I under tand my ri�hhcs as scated above. .
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Signacu:e
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` � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �3(�� �A�'-K 1p 2
PID: �-n�-�-✓� :
DESCRIPTION OF WORK: n C G(c (��va-� �r�r✓� �S y_ � 5�-t•V< r�-ec.�<
ZONING REVIEW BY: � � DATE APPROVED: 4 -L-�P�
BUII..DING REVIEW BY: DATE APPROVED: � -Z� g 49
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t� No
PLAN REVIEW Yes ✓' No SEWER CONNECI'ION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
---------------------------------------------------------------------G��"Vlf-- /---------------------------
ZONING CHECK LIST Zoning District: /�l, �p(_
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
Reaz(Street): Left Side
Adjacent Structures: etland:
Building Height: Def. Hgt. eak Hgt.
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 Setb ck: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-5(TO'
500-1000'
Hazdcover Vaziance Required: Yes N Date of Council Approval:
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 =
�e�ec. l,l9 � ?� x � ��(,d•d!= J1L
TOTAL
Estimated Construction Value: $ Z�ov`'`'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
oL Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
_�Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE): �
REVIEW BY OTHERS: DATE:
Access: Eusting New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI�:
8
CITY OF ORONO CALLED IN ��E�� •�
INSPECTION NOTICE SCHEDULED � �'3 �
PERMIT NO. /O�7�� COMPLE o " �'`
ADDRESS �� �Jr �t�.�� �.../�^'�-� _
OWNER CONTR. _�2.��
TELEPH E NO. � � S
� DESCRIPTION
l� 01 FOO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� LAT ON 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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 FINAI 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
�G�RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance.473-73�J7
OwnerlContl�on '
Inspector.
White Copyllnspector's File Canary Copy/Site Notice