HomeMy WebLinkAbout1996-007906 - fence --- ,..r .— _
- - PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:t�;��,i i��z�
Crystal Ba�, Minnesota 55323 Permit Number: t�t+� .��a�,,
(612)473-7357 Date Issued: �}��e y�,:,Y�F.
SITE ADDRESS:
1:�7� RE'=�T �=`T �:u
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F' . I . P�!. . i 37—�. i 7—;�:;—::::�—���t.�:�;f
DESCRIPTION:
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t:�:ri��.ar: �`:;F���e �:�? A�.T . t�li:t���;E::�� .
REMARKS:
s:��r��i�i A��7 E=h�1�:E �'�t�i� T#�i C:N�i:�:: `�i T� 1_i t�(E:; t�7 Il�TEi�;'���;�:�T I�it�i FEr� �°E'=;;}:t JT I�=4i� .
FEE SUMMARY:
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CONTRACTOR: OWNER: — �����1 i c�nt. —
t�E��L I C:N�F'i I`1 T C':1-I��L.
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AP L�CANT/PER TEE GNATURE ISSUED BY:SIGNATURE
Total Fee: � '7(�_�'� DateReceived: ���. � �� y ��
Date Approved:
, Permit#: `7 `%_ C-
�Entered By: ,�("/�
CITY OF ORONO - BUIIrDING PERNIIT APPLICATION
AI.L TiVF'ORI�IATION ViLTST BE SUBMTTTED IN FULL BEFORE PLAN REVIEW WII�L
BE STARTED
---- ------------
THE APPLIC��tT IS: (circle one) O`VNER OR CONTRACTOR
� �_ �
JOB SITE �DDRESS: ��S J��� �%�i�,`�% ��, ZIP: S�� .-�G- �/
A !
N�l�1E OF O�VYER'1�� !/-�jaL� a� `����;�'�il;��. PHONE: (home) ��7Z- �z 1�j'
� � �work)
vIAILING ADDRESS:;:,�� �<�S���"����� ✓:�� CITY: ;�����Z��� ZIP: _ �3���
CONTRr�iCTOR: cJ�'��� �E r��-� PHONE:
1�10BILE PHOi�1E/PAGER:
MAILING ADDRESS: CITY: Z��
STATE LICENSE: #
ARCHI'I�CTIENGINEER: Px���
MAILING ADDRESS: CITY: Z��
N��,,�: REGIST'RATION �#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �-' Land Alt�ration
,— �
PROPOSEDWORK(describeindetail): � ��2��� ���''`�-����— ��� �s!��-�'� ������-�-
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOi�1S: GARAGE STAI.LS: ATT. DET.
�STL1���TED CONSTRUCTION VAi.UATION(escludingland): � � �C,�C? �
I hereby apply for a buildina 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 Buildin� Code; that I understand this is not a permit and work is not to star�
without a permit; and that the work will in accordance with the approved plan.
-� , �,
APPLIC��1T'S SIGNATURE�� � � � � � �-�'��-�_ DATE: �1 �,�
�,
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.
Sec.13.04 RIGH'TS OF SUB.TEC'I'S OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An indiv�dual asked to suppty private or confidendal data conceining himtelf sha11
be informed of: (a)the purpose and intended use of the requested data within the collecring'state agency, polidcai subdivision,or statewide rysoem:
(b)whether he may rtfust or is legally required to supply the requested data;(c)any known consequence arising from his supplying or tefusing to supply
privace or confidential data;and(d)che idenary of other persons or endries authorized by state or federal law to receive the data. This requirement shall
no�appty when an individual is asked to supply invesrigaave dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income raz or propem taz refund
ins[rucrions instead of on[hose forms.
Subd. 3. Access to data by individual. Upon request to a responsible aurhority,an individual shall be informed whether he is the subject
of stored data on individuals,and whecher it is classified as public, private or co�dendal. Upon his further request, an individual who is the subject
of stored pnvate or public data on individuals shall be shown che data wi[hout any charge to him and,�if he desires, shall be informed of the concenc
and meaning of that dara. After an individual has been shown the privace data and informed of ia meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this secdon is pending oc addiaonal data on[he individual has been cotlected or created.
The responsible authoriry shall provide copies of the private or pubfic data upon request by ihe individual subject of the data. The responsible authoriry
may require the requesdng penon to pay the actual costs of making, cerdfying, and compIling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with the request
within[hac cime,he shall so inform the individual,and may have an addidooal 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 norify in writing the responsible au[horiry describing the nature of the disagreement.
The responsibfe au[horiry shall within 30 days either: (a)correc[the data found to be inaccurate or incomp(ete and attempc to nodfy past recipien¢of
inaccurate or incompiete data, including recipienrs named by the individual; or(b)notify the individual that he believes the data to be correct. Dara
in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data.
The determination of the responsible au[hority may be appealed pursuant to the provisions of the administradve procedure act relating to
con[ested 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 fumish 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 retsse to supply data, but refusal may require that the Ciry 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 pernut 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 n .e is required to process this applicati r permit.
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First � �Middle � Last
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Add � ; ; i?r �.�� � J C.- �
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^State Zip Phone
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I understan � � ts as stated above. '�%R
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CHECK OFF LIST FOR ISSUAl�iCE OF PERMITS
. FOR OFFICE L�SE ONL�'� j (,.
ADDRE.SS OR LEGAL: ,. =� "J:�� l�-�-�% f �cu-r`. � /"� �.k-
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PID: '; - i� � ' -3_ :�-� �, ��Z� _>
DFSCRIPTION OF WORK: _ <----
ZONING REVIEW BY: �7 0„(1���,•.— _ DATE APPROVED: !t�"��-q s-
BUII..DING REVIEW BY��N�A DATE APPROVED: �_
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNEC'IION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify) ��_ _
-- - --------__------------
ZONING CHECK LIST Zoning District: L2'�� Shoreland District :
Fire Department:
Post O�ce: School District:
Lot Area: Sq.fr. 30,(0 3`1 _Acres .7 Width 1(�R�t..�uv►'►2- Depth
Survey Submitted: Yes 4�
No Date of Survey: I l� -27-��
Proposed Se[backs: �,
Front (Lake): ? S Right Side:
�N �l�. L�,�'-�C
Rear (Street): I.eft Side: �
Adjacent Structures: Wetl .
Building Height: Def. Hgt. Pe� a•
Avg. Secback:
Bluff S back: t Cove ge:
Exist' g Proposed
Hardcover: 0-75'
75-250'
250-500
500-10 '
Hazdcover Variance R uired: Y s No Date of Council Appr val: _______.____
Grading: Staff Appr val Date: By: Council Appro al Date:
Septic: Staff Approval Date: By�
Zoning File: l# ?.0 3 2
Resolution: � 3 S S� Resolution Date: � "�y y�S�
P;��y��gK,S (in house):
�
BUII.DI�i 1G REVIEW CHECK LIST
UgC; CO� TRUCTTO TYPE:
' Sq Foo ge $ er Sq Ftg
Basement z —
lst Floor —
2nd Floor x
Garage X —
x =
TOTAL
Estimated Construction Value: $ ,�"�"�-'
Inspections Required: Work Requiring Separate Permits:
Si[e Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
Final GradinglFilling Electrical (State Permit)
Other
RF,MARKS (IN HOUSE):
--------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY�
-------------------------------
RE1�iARKS (TO BE�'OTED ON PERi'�1IT): ,c�v�,-r�-�'- �/��.e- (/�� �o
Ll�G(C S!r� L IMP S R�T /N ri.'YZSc.�TlO,J p�/L /�-�'3 0�
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