HomeMy WebLinkAbout1995-007178 - sign above windows PF,�MIT
C1�Y OF ORONO � � ` - �•
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: -
Crystal Bay, Minnesota 55323 . . .- -
(612)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: "- -�� ° � - - �
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APPLIC T/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
, . � CHECR OFF LIST FOR ISSIIANCE OF PERMITS
� FOR Or�F.T.CE iJSE ONLY
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ADDRESS OR LEGAL: .'�``I,�.S S i-}-�;il-�=��{ �.-�`� i .�,�_- PID:
DESCRIPTION OF WORR: ���=_�-'
------------
------- --- . ---- "-------------------- /_"( 2� "
ZONING REVIEW BY•�'' � i DATE APPROVED: cT 3^
BIIILDING REVIEW BY: !ti l� DAT$ APPROVED:
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FEES TO BE CHARGED• Misnc,�. Fees Calculated By:
• �_ S C 6 N �"�Lc-(-
PERMIT Yes � No
PLAN REVIEW Yes� No 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)
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ZONING CHECR LIST Zoning District: [S'�
Fire Department• Post Offi'ce: � S�hool. District:
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Lot Area: Width: j Depth:
/ �
Survey Submitted es No Date of Sturvey;
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Proposed Setbac s: `
Front (Lak¢) : Right Side: ;
Rear (Str�et) : Left Side: ,�
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AdjacentjStructures: Wetland:
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Building Heig�t: Def . Hgt. / ! Peak Hgt.
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Avg. Setback� r'� ��Lc�t Coverage: �
' �xisti�g ;� Proposed
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Hardcover: i0-75 ' , � � ��
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7�5-250 ' � �
2�0-500 ' � � �
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50i0-1000 '
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ired: Ye ' No Date ofil�Council Approval:_
Hardcove,� Variance R�q�i �_..._ i
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Gradings Staff Approvajl Date: By: Co�ncil Approval. Date:
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Septi c:i S taf f Approvai�. Date: � _ BY=
Zoning File•# � Resolut�:ion # : Resol.ution Date:
REMARRS (in house) :
��_r��5 S t�, v� ,�'!c:�--'�c,��-�"s Gt-}-�'v��' v �r b�-c�-T o s ( 6 �
— �V� 5l?�e- �.�.* ��`�1 t�'u �(��� f�3L�� L� vv��T-5
BIII NG REVIEW CHECK I�IST _ , �-` .
LDI
IIgC. �/1/�j/1- CONSTRIICTION TYPE: p��/Q.
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X
2nd Floor X
Garage X
x -
TOTAL
Estimated Construction Value: $ ���� `' 2�
Inspections Required: Work Requiring Separate Permi.ts:
Site PJ�umbing Grading/FilJ�ing
Footing Mechanical Fire
Framing Septic Water Connection
Insulation FirepJ.ace Sewer Connection
Wal.l Board (Masonry) Lawn Irrigation
�—�ina 1 (Mf g.) Other
Other Wel 1 (State Permit)
,�E�ectrical (State Permit)
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RFMARKS (IN HOIISE) :
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REVIEW BY OTHF�RS: DATE:
Access : Existing New
Access Approval: Date BY=
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REMARRS (TO BE NOTED ON PERMIT) :
" '� CITY OF ORONO :- B�:I,DING PERMIT APPLICATION
/ �
Total Fee• $ ,�Jr, �� • Date Received: '7���( '�
Date Approved:
Entered By: �� � permit�: �1� 7 �
AT•T• INgpRMATION MIIST B$ SIIBMITTED IN FULL BEFORE PLAN REVIEW WI� B$ STARTED
(See Check-off List Enclosed)
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TgE APPLICANT IS: (circle one) O�dNER Qr CONTR.ACTOR
Jos sz� An�x$ss: =��-)�I � �+�-�-�l�-c� �-!,1�� �J I� � 1i �-
ZIP: �� � % ��
^ (work) ���� �"/���/��
NAME OF OWNER: � � � `#`�. �-��Z� S S \� PHONE: (home) l�r//-�'���o�.
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MAILING ADDRESS:• ����� � ���� �- ���L� �'��� CITY: �i�,'-'�"��/��_.��� Z IP: ��� � �
CONTRACTOR: (� � C � C� k' �..�-t�j�. L C° S PHorrE:
MATI�ING ADDRESS:
cz�: v��-U�4-���— zzP:
STATE LICENSE: #
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
CITY: ZIP:
N��' R.EGISTRATION �
TYPE OF WORR: New
Addition Accessory Structure Move�,
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : '7 l� � �� h���� � � �
> I C� L; /�--$`� �l i� ( u �; ; ��� ( , �t ; � �%Li' � k' �, ,��'%
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STORIES:� S4• FEET OF EACH FZ�OOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (excluding land) : $
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 wi�ha�hl
ordinances and codes of the City and with the State Building Code;
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.
_ _, `� � . �/ ���
� DATE:
APPI�ICANT'S SIGNATURE
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�:�. ��-��� O� ORONO
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� �I�Y
� Post Office Box 66•Crystal Bay,Minnesota 55323•141nniciPal Offi�es
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� _ � � On the North Shore of Lake Minnetanka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2, "Rights of subjects of
data", we would 3ike 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 wil3. 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 Ioca1 , s�ate or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Councii. ac��or.
to aporove, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to proc�ss this application or
permit.
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First Middle Last '
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Address
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I understand my_ rights as stated above.
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Signature � �
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BUILDiNG&ZONING-473-7357
• ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS -473-7359
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