HomeMy WebLinkAbout1999-011863 - garage/regraade PERMIT
CI1`Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 - - ° -
Cr stal Ba , Minnesota 55323 Permit Number: =_`..: 3 �.J:;,y�."s>;
y y Date Issued: `-'� �°=�=��-
(612) 249-4600 ;";=�,�€ �./`=;`�`
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: - Y;�;F: ; ; ; ;;�-,;. - _ _.= OWNER:
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APPLICANT-PERM E SIG URE ISSUED BY:SIGNATURE ��
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Total Fee: $ '��.3, � � Date Received:��'��;���
Entered By: �� , Permit#: // ,��3
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS:
��,5^3 1`"(�IR I� �f�l v G ZIP: S J�3 ��/
NAME OF OWNER: �j�Gn�T �G�vT IZc�TT PHONE: (home) y7,�-5 y�$
(work) S�w,.�.
MAILING ADDRESS: 1 �S 3 ��RK �R�v�CITY: Q�o� ZIP: SS 3��.
CONTRACTOR: �µrtt�R r�v� 1 a,r LvR ��►v�c-s PH���_ ��l�-y�S-lll�C�
CONTACT PERSON: �pv c� MOBILE/PAGER: 3��-G l�q (�!�)
MAILING ADDRESS: J[o l S �o �� CITY: M G-�,w� Z�� ^ �5
STATE LICENSE: # y 73 � •
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: N�w � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ��(}R,AG.E. �ETA�t�'�'n. - �`=z��.vt�/�-�'ro-•�..�
�� �18A-D in/6 l.�N�j
STORIES: _ J�� SQ. �EET OF EACH FLOOR:
NO. OF BEDROO S: GARAGE STALLS: ATT. DET.
��
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ -
3 ,C��o
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 witti
the State Building Code; that I under and this is not a permit and work is not to start without a
permit; and that the work will b m acc rdance w' 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.
5
Sec.13.04 RIGHTS OF SUBJECTS OF DATA I
Subd. 1. 1�pe of data. The rights of individual on whom the data is sWred or to be stored shall be as set forth in tlus section.
�
S�bd.2. Information req�rired to be given individual. An individual asked to supply private or confidential dara concerning himself '
shall be informed of: (a)die pn�rpose and inte�ed 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 laiown consequence arising from his supplying or �
refusing to supply private or confidential data;and(d)the idenary of other persons or entiaes authorized by state or federal law to receive the data. �
This requirement shall not apply when an individual is asked to supply investiga6ve data,pursuant to.section 13.82, subdivision 5, to a law '
enforcement o�cer.
I
The commiccioner of revenue mav olace the nodce rewired under this subdivision in the individual income tax or oronertv taz refund
instructions instead of on those forms.
� Subd.3. Access to data by individual. Upon request to a responsible authoriry,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 lus further request,an individual who .
is the subject of stored private or�blic data on i�ividuals shall be shown the data without azry charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an inciividual has been shown the private data and informed of its meaning,the data need not be
disclased to him for six months thereafter unless a dispute or action pursuant to this section is pending or additioual data on the individual has been
collected or created. The responsible authoriry shall provide copies of die private or public data upon request by the individual subject of the data.
The responsible authoriry may nquire the requesting person to pay die actual cosu of making,certifying,and compiling the copies.
The responsible authoriry.shall wmply immediately,if possble,with any request made pursuant w this subdivision,or within five days
of the date of the request,excluding Saturdays,Sandays and legal holidays,if icnmediate compliance is not possible. If he cannot comply with
the request within tl�at time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,
excluding Sawrdays,Su�lays and legal holidays.
S�bd.4. Procedure when data is not accurate or complete. An indiyidual may contest ihe.accaracy or completeness of public or
private data concerning himself. To ezercise this right,an individual shail notify in writing the•responsible authority describing the nature of the
disagreement.�Tl�e responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt w nodfy
past recipients of inaccurate or i�onuplete data,i�ludiag 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 authoriry may be appealed pursvant to the provisions of the administrative procedure act rela6ng
w contested cases.
-DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjecis of data", we would like to inform you that your
request for a permit or license from the Gity of Orono or any of its departments may require you to furnish certain
private or confidential information.
You aze notified that:
1. The information you fumish 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 shar�d with other local, state or federal agencies to the eztent necessary to
process the permit or license. � � ' ' �
4. If your requested permit or license requires Council acdon to approve, some information may become
publia
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.
i
`'� � i� u..T'+4W5k.�
First Middle Last
��6�' � (�c a� ss�s� '
,
UYIEc��,ri ;Mti1 �F3� �f?.5=1160 • '
City State Zip Phone
underst my rights as ted above. �
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signa '
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' + CHECK OFF LIST FOR ISSUANCE OF PERMITS -
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: / e'�S .� Pa ✓' K D r i d� -
PID: 0 `7 � j17� 2� � z o022
DESCRIP'TION OF WORK: v� s�v r �"t a a� Y!y��/�
-------------------------------- --------------------- ------------------------------------------------ ----------
ZONING REVIEW BY: DATE APPROVED: Q�9 9
BUILDING REVIEW BY: DATE APPROVED: �=i y -� �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No �
PLAN REVIEW Yes �-�' No SEWER COrfNECTION
STATE SURCHARGE Yes `'� No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST zoning District: �/e- 1 �
Fire Department: /VGv�.•� Post Office: r�*��•�-•.•� School District: c•�'«�'^"'��'�'
Lot Area: Sq.ft.� ]� 1 S� Acres • � 1 Width J�2 � Depth 3�� ,
Survey Submitted: Yes � No Date of Survey: �Z-7
Proposed Setbacks: ! 1 _
Front(Lake): � N� Right Side: ��
� 1
Reaz(Street): g 9 Left Side: �
Adjacent Structures: 0 K Wetland: � �
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # �3 g S" Resolution: # �i 2�3 Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: L.otCoverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
f �n✓N� A-ttc�
�+PJ].��(lII�'1011Se): N�r o�-t cx V"`�
• 7
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• . �
BUILDING REVIEW CHECK LIST
usc: v- l CONSTRUCTION TYPE: �!�
Sq Footage $Per Sq Ftg
Basement x —
1st Floor x =
2nd Floor x =
Garage x =
' x =
TOTAL
Estimated Construction Value: $ 3 G,v�'' v
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_L( Footing Septic Sewer Connection
Framing Firepl�ce Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
� Final Grading/Filling Electrical(State Permit)
Other
REMARI�S(IN HOUSE): . _
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By:
REMARI�S (TO BE NOTED ON PERNIII�: G N�o��v c� �✓� t� ��A�-��
l�-�.,,,r,.* �` a`.'c...t u�'�" t�.,•s -c--. r..—c
8
�UG-3�-1999 16�31 BRENT BENTROTT 612 4?2 5?99 P.01
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TOTAL P.01
sE�r��cxzo�v�,: �cixc:L�:,� u�vi� u-�s� >>-�su� zso-soo� sao-iouo�
� EXISTINGHARDCOVI;R 1N ZONi; Q/Z 6ti-� �r �^/Tr'GTT �- �� GO
' A. House x - ` S.F.
l,ength W idch
� = S.F.
� = S.F.
_... h ___ _ � S.F.
-- � � � � ��
B. Garage � _ .,�`�9� ,�} ����� ` � F
C, Dnveway x =� S.F.
� - S.F.
D. Sidewalk x = S.F.__
x = S.F.
E. Patio/Deck ( 6'F/n�G �E/��>L'C��� ___ _ � -�j.j S.F.
..__. . �: = S.F._
F. Landscape x = S.F.
Underlain x = S.F.
BV Plastic � = S.F.
Or Fabric
G. Other __ x = 2 q S F. -S ToN�
TOTAL HAI2DCOVER Ii�17_ONE - I a4 S.F. A
TOTAL PROPERTY A.REA IN"LONE - __ ���S.F. B
._ A - B _ x 100 = _ �---��j %
PROPOSED HARLCOVI;R i�'ZONE�
� ' A. House x = S.F.
Leng,h \Vidth
� - S.F.
� = S.F.
_. _ . � - S.F.
B. Garage —_ _—_ x = S.P.
C. Dnveway _ _ _ � = S.r.
.�._ x = S.F
D. Sidewalk � = S.F.
--- � — _� S.F.
E. Patio/Deck x = S.F.
�c = S.F.
F. Landscape x = S.F.
Underlain � = S.F.
By Plastic x = S.F.
Or Fabnc
G. Other _ � = 2 9 S.F. ffG,v�
TO I A�.I-ItVZDCOVER IN ZONC - Z `� S.F. A
TOTAL PROPLRT�Y AI2EA IN ZONE - _ '��'�� �. S.F. B
A �3 --- x 100 = O. 7� %
__._ 1 j
_. SE'1'BACK ZUNE: (CIRCLE UNl) U-7�' 7>-2�U' 2�U-SUU' $OU-lUUU'
� - �XISTING HARDCovER IN zoNE P2 6��r Ftir/1 o r�
, ` A. House x . _ � � 7� S.F.
L,ength W idth
�. . _ 3 x 2,� _ � s.F.-�� ��
,
: :�.-;- _ _ x = S.F.
'-,. � _ �q , x C�.�2 - -- = S.F.-5"�n��3��25
B. Garage x = Jr7 8 S.F.
_ C. Driveway —�7f RIqV�L x = �27g' S.F.
x = S.F.
� D. Sidewalk x = S.F.
x - S.F.
. . _. ._ -�
E. Patio/Deck t = 3�� S.F.
- �--
......_ . .. � _ _ S.F.--
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic � a __ = S.F.
, Or Fabric
.' G. Other x = q S S.F.-STON E
� TOTAL HARDCO VE�.IN ZONE - �Q�S S.F. A
TOTAL PROPERTY AREA IN ZONE - R��D S.F. B
A = B x 100 = .��. �J`3 %
PROPOSED HARDc;OVER IlY ZONE' �����.p
`� . A. House 3.�__ x 7• _ -�' 29 S.F. � Ip+�
-3 �_---- —A DD T �I
. Length ._ Width .
x = S.F.
x = S.F.
_. _ x = S.F.
B. Garage x = i S.P.
C. Driveway \_ . _ _ S.F.
.,�_. . . _ - x = S.F�.-- -
D. Sidewulk � _ �' ��.3 S.F.
x • = 5.F.
E. Patio/Deck Y NET 3� �}2 S�S.F. 1�C-f1[S f R?r2C}
-- -EE�AIN,-� wEST S�aL
. � -�2� _ � 1 I f� S.F. ��f?GH-FRo��
F. Landscape x = S.F.
Underlain � = S.F.
- By Plastic x = S.F.
. _. Or Fabric
G. Other � x = S.F.
F- '�-' .
TOTP:L HARDCOVER IN ZON� - � � ' " -��.�2 S.F. A
TOTAL PROPERTY�EA:N ZGNE - 9!6.0 S.F. B
a = � x loo = 38, 4� °i�
_.... . . l; _ .
SETBACK ZUNE: (CIRCLE ONE) U-7�' 7�-2�U' 2�0-SUO' SUO-IUUU'
� EXISTING HARDCUVER L'�'ZONE , 9 �Q�
. /,�/Z F/v r F NT/,o T j
,'>
- A. House � = S.F.
", . Length �Vidth
- t = S.F.
_ x = S.F.
--._. \ -- = S.F.
B. Garage x = S.F.
C. Driveway x _ = 9 S 9 S.F.
: � � = S.F.
" D. Sidewalk x = S.F.
� -- = S.F.
,-
E. Patio/Deck �. , .. S�F.
..._.... . .. � _ ._.
_ � , — S.F:
- F. Landscape x = S.F.
` Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
. G. Ocher x = S.F.
TGTAL HAItDCOVEf.II�T ZONE - �Sq S.F. A
TOTAL PROPERTY AREA IN ZONE - 3 Za S.F. B
a = B h ioo = �6,4 °ia
- �'ROPOSED HARDCOVER IN ZOiYE'
� ''} A. House x = S.F.
. Length . Width .`.— _ .
x = S.F.
� -- = S.F.
_.. _ _ _ � = S.F.
B. Garage a = S.F.
C, Driveway _ �. _ . . S.F: -.
...._.. . . .. ,� _ _. S.F�.- -
D. Sidewalk x = S.F.
_ x = S.F.
E. Patio/Deck x = S.F.
_ x = S.F.
F. Landscape x = S.F.
- Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
- G. Ocher � x = S.F.
TOTAL.HARDCOVER IN ZONC - S.F. A .
TOTAL PROPERTY AREA IN ZON� - S.F. B
A = B x 100 = %
13
�T " T��IME�
CITY OF ORONO CALLED IN `� �
INSPECTION NOTI E SCHEDULED ���
PERMIT NO. �I �Cb� COMPLETED Q 2'�O V
ADDRESS I`t�=3 ��� �1�'
OWNER CONTR._I�i�Ij'1 V/n�TtZ.�./ILi� 1�YI'lPS
TELEPHONE NO. �� �SG- 7�/a�
� RI�TION �� C ,�✓�cf�2 .
01 FOOTIN 11 I�fECHANICAL I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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 FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: �C�D�I n � � G�S ����I�.z� s
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d �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP OROER POSTED.CALL INSPECTOR 'J CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspectoc/��Ce--v� G�v1�
White Copy/lnspector's File Canary CopylSite Notice