HomeMy WebLinkAbout2002-P05842 - temp sign PERMIT
C I TY OF O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P05842
Crystal Bay, Minnesota 55323 Permit Type: Sign Permit
(952) 249-4600 Date Issued: iiiis�2oo2
SITE ADDRESS: 3380 Shoreline Dr
Wayzata,MN 55391
P I D: 17-117-23-44-0100
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pemut Type: Sign Pernut Pernut Sub-type(s): Sign-Temporary
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 35.00
Valuation: $ 0.00
TOTAL FEE: $ 35.00
APPLICANT: Owner/Self OWNER: Orono Liquor Inc.
MN P.O.BOX 36(Navarre 55392)
Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
AP I A RMITEE SIGNATURE IS D BY SIG A ���
Conies: 1-File(Si�nitures Repuired). 1-Aunlicant, 1-Monthlv Reuorts, 1-Assessin¢, 1-Finance Page 1
Total �ee: $ Date Received:
�ntered By: Permit#:
CITY OF ORONO - Bi,TII,.DING PERMIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
" (please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 33�o ��D/'�//r2� �f�`� ZIP: ���,�j�r
� 2
NAME OF OWNER:_ � yYl L� PHONE: (home) ���✓���
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: GL/'�'�� � 0 PHONE: �C'c � ,�
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: �
ARCHITECT/ENGINEER: PHOI�TE:
MAILING ADDRESS: CIT'Y: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: ���� � �l��
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (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 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 cordance wi e appr ed
APPLICANT'S SIGNATURE: DATE: ����d''�
NOTE! Parade of Homes e ts require separate permit approval by Police Department and
City Council 60 days prior t the event. Non permitted events will not be allowed.
Scc.13.04 RIGHTS OF S[1BJECTS OF Dl�TA
Subd. i. Type of data. 'Ihe rights of individual on whom the data u stored or to be stored shall be as set for[h in this section.
Subd.2. Information req�red to be givw individual. An iadividual asked w supply privau or confideatial data concerning himself shal(
be informed of: (a)�he purpose and intended use of the cequesud data within the collecdng§tate agency,polidcal subdivision,or statewide rystem;
(b)whether he may cefuse ot is legally required to supply the�equesud data;(c)any Imown consequeace arising from his supplying or refusing to supply
private or coafidendal data;and(d)the idenriry of other persoas or enriaes suthorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve dara,punuant to secdon 13.82,subdivision S,to a law enfoncement o�cer.
The commissioner of revenue mav place the noace rewired under this subdivision in the individual income tax or propertv tax refund
instrucdons inscead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of srored data on individuals,and wherher it is class�ed as public,private or co�denaal. Upon his further nquest,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[he content
and meaning of rhat data. Afur an individual has been shown the priva[e data and informed of its meaning,the data need not be disclosed to him for
siz months thereafur unless a dispuu or acdon pursuant to chis secdon is pending or addidonal data on the individual has been collecud or created.
The nsponsible authoriry shall provide copies of the private or public data upon request by the individual subject of che data. The responsible authoriry
may require the requesting person to pay the actuai costs of making,certifying,and compiling the copies.
The responsibie au[horiry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exciuding Satucdays.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 wirh the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An mdividuat may conust the accurdcy or completeness of public or private
data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authority describing rhe nature of the disagreement
The responsible authoriry shall within 30 days either. (a)correct rhe data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)noafy the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagre�ment is included with the disctosed data.
The determinarion of the responsible authoriry may be appealed punuant to the provisions of the administrarive procedure act relating W
contesud cases.
DATA PRIVACY ADVISORY
� In accordance with M.S. 13.04, Subd.2, "Rights of subjecu 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 aze 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 shazed 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.
First Middle I.ast
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signaaro
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
• FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 33�30 �f-kx��.�t-c� Q2
PID:
DESCRIPT'ION OF WORK: -7� ��� �- ��,2t� G��rf i
ZO�TI�i 1G REVIEW BY: DATE APPROVED: /�-/S-oZ
BUILDING REVIEW BY: DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
PLAN REVIEW � Yes No SEWER CONNECITON
STATE SURCHARGE Yes No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
_--- __---�_-------------------- - - - -
ZONING CH�CK LIST Zoning District: C� � �C
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetl
Building Height: Def. Hgt. Peak H t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # R solution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Eusting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hudcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUILDING REV�W CHECK LIST
�C� CONSTRUCTION TYPE:
Sq Footage $Per Sq Ftg
Basement x _
1st Floor x . _
2nd Floor x _
Garage x _
a —
TOTAL
Estimated Construction Value: $ / V (�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
F� Grading/Filiing Electrical(State Permit)
Other
REMARI�S(IN HOUSE): .
REV�W BY OTHERS• DATE: �-----------------------_--------------------
Access: Ezisting New
Access Approval: Date gy;
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RENIARKS (TO BE NOTED ON PERMI�:
8