HomeMy WebLinkAbout1996-008159 - interior remodel PERMIT
� CITY OF ORO�JO PERMIT TYPE:
2750 Kelle Parkwa P.1�. Box 66 E a i�1 3 F�'�lij
Crystal Bay, Minnesota 55323 Permit Number: �;�;�=y y,�
(612) 473-7357 Date Issued: €�y7��.7 f,aF,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS: '
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FEE SUMMARY:
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CONTRACTOR: � OWNER: — �=�����1 i_��a-�t. —
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APPLICANT%PE IT E SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ �.2d. �' DateReceived: %-�/- y�,
Date Approved:
Entered By: ;�'� Permit#: �"/S �'
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BESTARTED
------------------------------------------------------------ ------ ------- -
- -------------------------------------
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: 2�G� ����,n� �c,�D ZIP: �'=j?�� j
�_�
NAME OF OWNER: ���c ��-,-�-� � , aN; � ,r�) PHONE: (home) �-7) -��I�`�
(work)
MAILINGADDRESS: Z7C'US ��-1��drs �'D CITY:�xC_EL;;�� ZIP: ��331
CONTRACTOR: PHONE:
MOBILE PHONE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHTTECT/ENGINEER: PHONE:
MAILINGADDRESS: CITY: ZIP:
NANIE: REGISTRATION # (
�
�
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TYPE OF WORK: New Addition Accessory Structure !
Move Remodel/Alteration < Land Alteration �
PROPOSED WORK(describe indetail):Gri✓�ti�a �i���G ,t'�.�� �
-�-a �-t�� �ow�2—
rZ��M , I ��;-,�_ ��w C',�a3�N�rs � c r-�s �� J-�,.z�-rc��1 �
,
STORIES: � SQ. FEET OF EACH FLOOR: f-S�C��
NO. OF BEDROOMS: � GARAGE STALLS: ATT. -�� DET. ,
ESTIMATED CONSTRUCTION VALUATION(excludingland): $ �`7, UOC��C.�
I hereby appl_y for a building permit and I acknowledge that the information above is complete j
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.
APPLICANT'S SIGNATURE:\ � ,���- �;� �---DATE: '7 f!' ��
NOTE! Parade of Homes events require separat'e permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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 conceming 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 confidendal data;and(d)the idenrity of other persons or entities authorized by state or federal law to receive the data. This requirement sha11
not apply when an individual is asked to suppty investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv tax refund
instrucrions 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. Aher 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 authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the acmal costs of making,certifying, and compiling the copies.
The responsible authority shall compiy 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 authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomp(ete data, induding 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 thar.
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.
(�-;-rt��,� � �Ja(--�/`��r`�
First Middle Last
27US -�'r-f��.�N'T ��
Addr��G�LS� O�-- f"t � �i�J�� �� �—� � I 1
��h, State Zip Phone
I understand m� rights as stated aboye. /
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Signatur ��
1 I
r _c CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR AF�ICE USE ONLY
:� `C�" ' l�c:x ci,�%���'''� /��`�
ADDRESS OR LEGAL� �/, / - � 3 �� ��r c� %
PID: �9 ,,� – s r� `�-----------------------------
w0�: ,
DESCRIPTION OF ------ApPROVED: N I /�-
------------------------ -------- ------- ------------------ DA1'E �PROVED: '�-�'1-`� b
ZONING �VIEW BI'� DA'I'E
... ------
�t BY: ----------------
BUILDING �VIE -----------
---- -------------------
----
----""'------ Calculated By:
----------------------------- No —
GED: Misc. ees
FEES TO BE CHAR YeS � SEWER CONNECTION
PE�IT Yes � NO — w�,TERCONNECTION
PLAN REVIEW �i•l No __
STATE SUR`HARGE YeS — No c� pARK FEE
INVESTIGA'I'ION-FEE YeS -- No �/ SITEINSPECTION
Y�S -- OTHER (specify)
SAC --------------
• -------------
Number of SAC U�ts �— ----------"'
----------------
---------
ONING CHECK LIST Zoning District:
School District:
Post Office:
Fire Departtnent: Depth
Width
Acres
L.ot Area: Sq.ft.
Yes �
No__ Date of Survey:
Survey Submitted:
Proposed Setbacks: Right Side:
Front (Lake):
Left Side:
Rear (Street):
Wetland:
Adjacent Structures:
Peak Hgt.
�� Building Height: Def. Hgt.
` Lot Coverage: roval Date:
By: �
Council App
Grading: Staff Approval Date:
By: _
Septic: Staff Approval Date:
Resolution: #�--
Resolution Date:
Zoning File: #_�
Lot Coverage:
Shoreland Dist:ict: - Bluff Setback: proposed
Avg. Setback: Existing
�—
0-75' --� -----
Hardcover: 75_250'
�— �--
250-50�' �— �—
500-100�' -�—
No __
Date of Council Approval: _�—
Hardcover Variance Required: Yes __
�M�,ggS (in house):
26
�- .
BUILDING REVIEW CHECK LIST
UBC: Q ' 3 CONSTRUCTION TYPE: v�
Sq Footage $ Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 2�, 0�
Sa-
-�
Inspections Required: Work Requiring Separate Permits:
Site OC Plumbing Fire
Hardcover Removal /� Mechanical Water Connection
Footing Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
_d Insulation (Masonry) Other
� Wall Board (Mfg.) Well (State Permit)
Final Grading/Filling oL Electrical (State Permit)
Other
REMARKS (IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ON PERMITj:
27
DATE - TI
CITY OF ORONO CALLED w " '� �''��� -'%�-
INSPECTION NOTJ�E _ scHEou�E� `�� - f: �;� -'�� - - � "i��
PERMIT N0. Y� ��� I COMPLETED _le� �
AODRESS -� � G:: / ;,�_ , ,;< < ; ,°:,
" 'c� ,�cU�,�,.__
OWNER " � CONTR.
TELEPHONE NO. ��//�%''
� DESCRIPTION ,,-; _ � .�'l� � ,l
� 01 FOOTINO 11 MECHANICALRI 18IXCAV/ORADINd/FIWN�
y ,02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UO 06 PROGRESS
F` 07 DEMQ--SITE 27 SEPTiC MAINT. 21 COMPLAINT
J
�Q 07 DEM�FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YQU:_YES_NO
� COMMENTS:
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d ' WORKSATISFACTORY:PROCEED �] PROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED L ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL REfURN -
❑STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance.473-7357
OwnerlContrac i e:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN ��'i.z� >b
INSPECTION NOTICE SCHEDULED i '�� `�E• %' 3 ��
PERMIT NO. COMPLETED N �_
ADDRESS:��'��^ J l i'�''/'��,r� t:��:
OWNER s�:r��« ��� CONTR._�,�
�
TELEPHONE NO. ��- .-�=�f -� O.� ' /�� 7 - _��C%'G' -Z-
��--�
� DESCRIPTION _�..i�' o�,�rc�o,� .
� 01 FOOTINO 77 MECHANICALRI 18IXCAV/(3RADINQ/FIWNO
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAI�SHOREM/ETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 W�BO. `�.'� 12 WATER HOOK-UP 17 SITE INSPECTION
Q
� `�INAL~ `�;`- �' 14 SEWER HOOK-UO O6 PROGRESS
� 07 iSEAA�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBIN(3 RI 23 SEP11C FlNAL 35 HARD COVER REMOVAL
���8R6Up�l�INO FINAL 36 FOUNDATION REMOVAL
OWNER ONTRACTOR TO MEET YOU:�ES_NO
� COMMENTS:
a u.S ° c/ S 0 ' � ��S t'�
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d C WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� ❑C RRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O CORRECT WORK,CALL FOR REINSPECTION TEMPOHARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR
G CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContrac on t :
Inspector.
White Copyll�speclor's Fi e Canary CopylSite Notice