HomeMy WebLinkAbout1994-006366 - tennis court PERMIT �
CITY OF ORONO PERMIT TYPE: �^,i�i+��`��r�i�
2750 Kelley Parkway • P.O. Box 815 Permit Number: L�
Orono, Minnesota 55356-0815 `�"��'��`�'�'
(612) 473-7357 Date Issued: t���;;�-�:=;��a�.
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: -- ����°1 a.��t-,t. — ��:7� �_��. OWNER,;
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A LICANT/PE TE 6 GNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BIIIZDING PERMIT APPLICATION
. � -- Z z-��
Total Fee• $ '�is�1�.�C% Date Received: �
Date Approved:
yntered By: ',f`",�� � (� ti;�
Permit�:�.;��' (� J
ALI, INFORMATION MIIST B$ SIIBMITT� IN FOLL BEFORE PLAN REVIEFI WII�L B$ STAR�ED
(See Check-off List Enclosed}
--------------------------
T� APPLICANT ZS: (circle one) OWNER o CONTRACTO
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JOB SITE ADDRSSS: �i�ZS ��l N�-� ��'�� ZIP.
(work)
NAME OF OWNER: �����.f' T��'`�`�1� PHONE: (home)�7�-�Z�
1+�ATZ�ING ADDRESS: �? 2� f��l►'v��� . CITY: �►�a^�� ZIP: Sj� ,
� py �6a -«�s���� �s�
CONTF2�CTOR: l ���15 V v�-S�� PHON$:
-�/A 2 `�
�+►�ILING ADDRESS: �� �`�� �� CITY: ►" ' ` ` � t ZIP: �J�J
STATS I.ICENSE: � � ��2-� �v 1 Z� I
ARCHITECT/ENGINEER: �-�`���-- PHONE:
;iAILING ADDR$SS: CITY: ZIP:
g�: RRGISTRATION tt
2'YPE OF WORR: New� Addition Accessory Structure,� Move
Demo Remodel./Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : l�-L� � -t P�-���� �y� ����S �u��
�s`��G- V C. M��"t 1✓� � ��T-, CD�r�ve i�. r'Y��f'1.►-t� N6i`zS �..�
(pb � I ZZ� ( I/K-��x •
STORSES: SQ. FEBT OF EACH FLOO12: �
RO. OF BBDROOMS: GARAG$ STAI.LS: ATT. DET.
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ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ Z�����
= hereby apply for a building permit and I acknowledge that the information
:bove is complete and accurate; that the work will be in conformance with the
ardinances and codes of the City and with the State Building Code; that I
understand this is not a permit and wo k is not to start without a permit; and
that the work will be ' wi the approved plan. •
A�PLICANT'S SIGNATIIRE: DATE: v��_I 1
CHECR OFF LIST FOR, ISS�ANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z'7 ZS I����I �'��� PID'
DESCRIPTION OF WORR: "j-�(VF�11� �`�jZ''�
---------------------------------------------- : .
ZONING REVIEW BY: DATE APPROVED � Z 3'�'7�
3DILDING REVIEW BY: /U�I�` DATE APPROVED:
--------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes t/� �o SEWER CONNECTION
STATE SURCHARGE Yes •� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER ( specify)
--------------------------------
------------------------------------ � �g
ZONING CHECK LIST Zoning District: •
Fire Department: ost Office: Schoo7� District: N G
Lot Area: �lL Width: Depth:
Survey Submitted: Yes� No Date of Survey: S� z- S '"`t�(
Proposed Setbacks: ,
Front (Lake) : �/J� � Right Side: 1'O � ts
Rear (Street) : (t� � Left Side: �<-�r'� �/
'� Wetland: �v//�}
Adjacent Structures: 2S
BuiJ.ding Height: Def. Hgt. /U�/d- Peak Hgt. ��/4
Avg. Setback: /v �i J Lot Coverage: !l/�J9
Existing Proposed
Hardcover: 0-75 ' �
�� ��
75-250 ' /�}'
250-500 '
500-1000 '
Hardcover Variance Required: Yes No� Date of Council Approva� :_.
Grading: Staff Approval Date: � •23 �5 `'( By: -��. Council Approval. Date:
Septic: Staff Approval. Date: ��/4- By�
Zoning File: # l �}3'7 ResoJ.ution # :`���G� _ Resolution Date:
REMARKS (in house) :
BUILDING REVIEW CHECR LIST " �
IIBC: JV`�" CONSTROCTION TYPE: /V�/¢-
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
o�c�
Esti.mated Construction Value: $ 2 �c�Od "—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
� Footing Mechanica� Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
�Final (Mf g.) Other
Other WeIJ. (State Permit)
Electrica7. (State Permit)
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REMARRS (IN HOIISE) :
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REVIEW BY OTHEFtS: DATE:
Access: Existing New
Access Approva� : Date By:
REMARRS (TO BE NOTED ON PERMIT) :
. , . �
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CITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Offices
•
� . � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
da$a", 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 Iicense.
3. The information may be shared with other �ocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Counci3 action
to approve, some information may become public.
5. �'ou have certain rights under M.S. 13.04 to review pri�a�e
data on yourself.
6. Yaur full name is required to process this applicatian or
permit.
�-
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First Middle Last
�1 ��� �� �
Address �,
�'C�°� � ✓I'ln'� — �3�S
City State Zlp
O . ������ �
Phonje
u ers my ghts as stated above.
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BU�.DING d!ZONiIVG—473-7357 • ADMINISTRATION at FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING '
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. � , ,
513.0.4 RIGSTS OF SIIBJP•CTS OF DATA � .
gubdivision L T9Pe of ��- The rights of individuals on whom the data is .
stored or to be stored shell be es set forth in this section.
Z. Information requi�red to be g��►� ����' An.individual asked to
. S�� himself shall be informed of: (a? the
� ' supply private or confidential data concerning
purpose and intended use of the requested data within the collecting state agency,
olitical subdivision, or statewide system; (b) whether he may refuse or is legally
p known consequence arising from his
required to supply the requested date; (c) any
su lying or refusing to supply private or confidentiel data; end (d) the identity of
PP state or federal law to receive the data. This_
other persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an individual is asked to supp y
pursuant to section 13.82, subdivision 5, to e laW enforcement officer.
The commissioner of revenue ma ole�t tax re�und mstructio uinsteadhoS
subdivision in the individuel income tax �r r .
on those orms. . - --- - - .
Ac� to �� � ��yl�. Upon request to e responsible
Subd. 3.
euthority, an individuel shall be informe�h u lic, pr'vateeor confidential.e UPon his
individuels, and v�►hether it is elassified p ublic data on
turther request, an individuel wbo is the subject af e to himriande if he desires, shall
individuels shall be shown the data witho of�hat da a. After an individual h�s been
�e informed of the content and meaning t� �� need not be �iisclosed io
shown the private dats and informed of its u���8ction pursuant to this section is
him for six months thereafter unless a d�SP �
ending or additional data on Lhe individu e h�ate or p blic dataruponarequest by
' p require the
responsible authority shall provide eoples o t P o�ible aut�rgy maY �in the
the individual subject oft�e aetual�cos h oi making, certif n , and comp g
requesting person to pay -
copies. if ssible, with any request
The responsible authority she]1 comQly immediately, po
ursuant to this subdivision, or within five days of the date of the request,
made p holida if immediate compliance 2s not
excluding Saturdays, Sundays and legal YS�
ossible. If he cannot comply with the request within thet time, he shall so in�ort� the
P have an additional five daYs Within which to comply
individuel, ar►d maY S��� �d legal holidays•
request, excluding Saturdays,
te or complete. An individuel maY
Subd. 4. Procedta'e when data is not acc�a �mself. To
contest the accuracy or cempleteness of public or private data concerning
�n yvriting the respcnsible authority
exereise this right, an individual sha]1 notify �ible authority shall within 30
describing the nature of the disagreement. The respo
days either: (a) correct the data found te be inae a�8e���ng pee�ipl��namedt by
notify past recipients of inaccurate or incompl �
the individusl3 or (b) notify the individual that he believes the data to �ement is
Data in dispute sh a l l b e d i s c lose d o n l y i f t h e i n d ividual's statement of disag'r
• included with the disclosed data. ealed pursuant to the
' The determination of the responsible authority �o��tes ed cases.
provisions of the administrative procedure act relating
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x SfTE PLAN i .
�'APPROVED � �
C7 APPROVED WITH REVISIONS o ,o�
❑ DfSAP OV �. � �
BY S
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