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Home My WebLink About1997-009397 - interior remodel ,, PERMIT f CITY OF ORONO PERMIT TYPE: _ 2750 Kelley Parkway- P.O. Box 66 _ - Crystal Bay, Minnesota 55323 Permit Number: (612)473-7357 Date Issued: SITE ADDRESS: _. .. _ _ _ �. :�:; �_F=��, , :;,� DESCRIPTION: ,ja — .. �:,:r � _ . _ _ - �i, ; .. �;�- ._r .. .._ . . ..._ r::: ,; ; i ti . � ,..:�.i i .:u - - 1 �ar, .. _a.c _ . . _ , ,sF° _,.j � +r . .._ ��.�.". ._ ... _._.. .�_: .. _ _ _,k:i:= _._._ . . '.li' i-iY'k. 3' ` . . .._ , a n _..� u ` ,. . . : . -. , _, . .. .«.. r_.r�. ::.� ._ ..,.t:�_ �. �.:...;.�:�,.' ..,'!�. .`�f._ � . �FS.._. _..:w�'��i _. �.._ REMARKS: _ . . _ _ ,:, . . . . . : . ; : . . . : , . . _..� .;�.:_►c ::� „ . K: , , , _ . _ __ . FEE SUMMARY: _ . � ._. _ s . _.�'�f � ., .. .. . __''a i� C':�.._ . ...�.. . w°ti _:f� 'i. ._.. '_i�„ �''i; ;1i: — —,.�__._...._._yr�.��_ ; i:'st.�-i. ;. t-','c:' w�F,._ . ,_..'. CONTRACTOR: OWNER: -- . : _ - — . — . _ _...r.� , ,,_ : . ��;�� , , . �>:�.,:�._t...:_.. � .:J f ! -�t-ii--��J� ��I,i�l r;;f 1 _ _ . - - . . �rr�» _ . _ �i;c ' . .��'a 1. . _ .._. _ 'r .. . . _ 7 - �ii}._ �t��1...��1��1 ..�1�+.:,::� ��._.�w.��4 �"t�==i�:�a:_e f W� a ._. .'` s _ �s _ a�� z��.._ � .., . . �_ 3�:? tt€"._��r._ _i��'.� ';:�`��":��T�t".,'€Y �'f�ii �.�'.�.�._`~� T't`3 �':!"i ��i..=_ �t_E�« �.�',� �.e�,..._�._m ..;�� -..�� '�..� �. �i'`� #t� L !�� , :, ` . �. :r_:� _ ;, � A 4 . .�,�'��t_.�':�#s:^� .._4_ ..�._.. _ �r _t_'1.....� 3'.s��.��_i- _ Yr ; � ' , � V APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE . 'G'� � � Total Fee: $ ��j..2�� Date Received: Entered By: l'� Permit#: �'-/3'7 / CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must 6e submitted in full before plan review will be started. (please print all information) -----------------------------------------------------------------=---------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��1 (�C� �h4�v t,�oo� (� n z�: _S53� / NAME OF OWNER: Sc v �-'j- Vc�C'LL PHONE: (home) y?/- /22 c/ (work) �f,2 4- �j.2 Cr(� MAILING ADDRESS: 21 G(o Srn4�v�-�at�� 2 n CITY: wA yzA rt/� ZIP: ss 3 5 / CONTRACTOR: �W N 2� PHONE: Y? l-12 2 S/ CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration PROPOSED WORK(describe in detai�: _a��I�,�c�co cA� �o �f{�e r,o�c pos � / Rep4 iK 5��o�F S�auc�V2� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. _ ESTIMATED CONSTRUCTION VALUATION (excluding land): $ .�� .11 Q 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 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: `l-y 9� 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 r 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 indiridual. An i�ividual asked to supply private or confidential data concerning himself shall be infortned of: (a)the purpose and intended use of the requested data withiit 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 lmown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or orocem tax refund instructions 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. After 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 cesponsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsib►e authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediate(y,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 addidonal five days within which to comply with the request, excluding Samrdays,Sundays and legal holidays. Subd.4. Prceedure 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 naNre of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data fourd to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the ic�ividual;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 pursuant to the provisions of the administrarive 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 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 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. ��'D 1-7- .OG,�i�L fj l'//,�/z'�L First Middle Last -2�G G �t�d/�/a� O� f2 �7 Address l,�r�-y2�T� �r� .S's.3 S / �/7'/��2Z�� C�iy Stace Zip Phone I understand my rights as s d above. Signature 6 . ' CHECK OFF LIST FOR ISSUANCE OF PERNIITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Zl 1•� �t+t�tq c�o c� PID: DFSCRIPTION OF WORB: _ tN�rt.�02 tZC vna r��z ZONING REV�W BY: /� DATE APPROVED: BUII�DING REVIEW BY: DATE APPROVED: 4-�t-5 7 F'EES TO BE CHARGED: Misc. Fees Calculated By: PERNIIT Yes _�' No PLAN REVIEW Yes No v SEWER CONNECITON STATE SUR:HA�CrE Yes � No WATERCONNECTION INVESTIGATION-FEE Yes . No PARK FEE � SAC Yes � No STTEINSPECTTON Number of SAC Units OTHER (specify) ZONIlVG CHECS LIST Zoaing District: Fire Deparcment: Post O�ce: School District: Lot Area: Sq.fc. Acres Width Depth _ Survey Submitted: Yes No Date of Survey: , Proposed Setbacks: Front (Lake): . Right Side: Reu(Street): Left Side: ��}.' Adjacent Structures: Wefland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: � Zoning File: # Resolution:# Resolution Date: ' Shoreland DisL-ict: Avg. Setback: Bluff Setback: Lot Covenge: • Existiag Proposed Hazdcover: 0-75' 75?SO' . . . zsasoo� - 500-1000' Hardcover Variaace Required: Yes No Date of Council Approval: _ REMA.RKS('m house): 26 , BUII.,DING REV�W CHECK LIST " : . �C: �- j COYSTRUCTTON TYPE: 1(/�I � ' Sq Footage $ Per Sq Ftg Baseuient x _ . lst Floor . . x . _ - . � � 2nd Floor x . _ . � _ . . Garage x _ : � x — TOTAL F.stimated Construction Value: $_ 2,�jo`� � - Inspections Required: • Work Requiring Separate Permits: � Site Plumbing Fire Hazdcover Removal Mechanical Water Connection - Footing Septic Sewer Coanection _�Fr�B Fireplace Lawn Irrigation Insulation (Masonry) Other . Wall Boazd (Mfg.) Well (State Permit) —�S F� Grading/Filling /r Electrical (State Permit) Other REI�ZARKS (IN HOUSE): � REVIrEW BY OTHERS: DATE: . �� Access: F.xisting New � Access�Approval: Date gy; � REMARKS(TO BE NOTED ON PERiI�IIT�: • . . . 27 _ _ .� _ _ -_ . :: ��?