HomeMy WebLinkAbout1996-007755 - wall particians - _ _ _
P�RMIT
CITY�F ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �;��j�[;�'���
Crystal Bay, Minnesota 55323 Permit Number: {�����.��
(612) 473-7357 Date Issued: �^#:.`�,��f���
SITE ADDRESS:
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DESCRIPTION:
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�,ui ldin�� F'�3�n��it. Tv���. �.:��t�l—€�l�i�.•'�'�tfi;I:rL-`L
F:u� ?�i.r�� ����t��:: TyF�M �;�.�`�#+:��r'�`TE"�;�t��=}CyEL
t 1�;r�: f:lr�i�n:�tiZc y �_
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REMARKS:
:.;EF'�'�F�HTE� ���T�TF �'��ih'[t T tiEC..?i 1 T�'�3 7 F��ati �LF�":1�I t:.��;L_
FEE SUMMARY:
Vfai_t;���'j f i�1( �:?, �wti rt:,
F.�s� �wN ��`�7 . ':'4
F'l�:�r� Rw�vi�w ���, . �f
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CONTRACTOR: _ ��,�,� ; �,�,-��.. _ OWNER:
td�����`f 1l:_Y�i-? +��ii�l'��T 1�.'i�1 i s:}_� C:�i�:Hi; L i��i
7i;�� �T��:�� N i��Ni_A4�C7 L� �3?�=31 °�:�-'�::��i�L.I�?E ��3�;
L_+��Nt� I�Al�::E �1td ��:��.��, M��}������a�_� r�{�.a ��:����1
t;i=�1:�:':; �.f�—i. �c��:�; �t?i —�=:�=;�`'F,
i�-ik: s�!�l����r�'=;I!7tti��� �-i�:_��E�Y €=�i��x=k 1�:°�;��'=� 4='�:Ri 1 I':�:�;I?�t�i i�~i tir��t::�_ ..l�����.� '�:°��:�:�:_ ��r;x='�;;-��}Ef°?i:;-��;°:::
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APPLICANT ITEE SIGNATURE ISSUED BY SIGNATURE
:I'otal I'ee: � ��7'S� DateReceived:
Date Approved: _
Entered By: /� Permit#: � �
CITY OF ORONO - BUILDI'�i tG PERNIIT APPLICATION
ALL INFORMATION l��iJST BE SUBMITTED�T FULL BEF�RE PLAN REVIEW WII,L
BE STARTED
------ ---------�------(--------- )
THE APPLIC�v'T IS. circle one OWNER U� ONTRACTO
�1/'a .--c
JOB SrrE �DnxESS: 3 70/ s�o...�/,�, P c-(,-- ZIP: .Ss3?/
N��OF OWNER: �t � a C r�a ,�- PHONE: (home) el `7/� 93 ��
(work) �t`�/ ^ 9� �-C
MAII.ING ADDRESS: ��ke --��4 CITY: /`7�'`�� ��a�LZIP:
CONTRACTOR: G/�-, ��d� P-'� T`��,—' PHONE: Ll 73-//o.3
MOBILE PHO�TE/PAGER:
MAII�INGADDRESS: 7'v 9 �i`Gr« hiq k /aK �ITY: L�.., q L�l.�ZIP: S'1'1���
STATE LICENSE: # o o � 7S6,�
ARCHITECT/ENGINEER: PHO�IE:
MAILTivG ADDRESS: CITY� Z�'
r N��: REGISTRATION #
TYPE OF WORK: New Addizion Accessory Structure
Move Remodel/Alteration �. Land Alteration
PROPOSED WORK(describe indetail): C o�r7'r�4� � �� � �---�'`�ic,u..,r
� � �
� � �s�`!r
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROONIS: GARAGE STALLS: ATT. DET.
ESTIMAT'ED CONSTRUCTION VAI.UATION(escludingland): � �� o-�
I hereby apply for a bu:lding permit and I acknowled�e 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: ��^- � t-'`�'`Y.�� DATE: `Z- /
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.
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` ' .:�. �., Posc office sox 66
`�``�,� �i:•'�l .+ -_ �:� �'�' Crystal Bay,�linnesota��2.3-0066
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DATA PRIVACY ADVISORY
In accordance �;�ith �i.S. 13.0�, Subdor licensetfroms thee CiryTotatO:ono or�an io e o
i n fo r m y o u t h a t y o u r r e q u e s t r o r a p�r m
departments may require ��ou co furnish cercain priva�e or co�dential information.
You are notified that:
1. The information you furnish «�ill be used to determine your qualification for the
permit or license requested.
?. You may refuse to suopl}� �'ata, but refusal may require that the City deny the
pernit or license.
3. The information may be shared ��ith other local, state or federal a�encies to t?�.e
extent necessary to pro��ss �ilz perr��t or license.
4. If your requested permit or license requires Council action to approve, some
information may becam� public.
�, You ha��e cer:ain ri�hts under M.S. li.04 (see fo?]o�z�ina pa�e) to review private
data on yourself.
(. Your full name is required to process this application or permit.
PLEASE PRL�T'T
/� �r � c�cY c+/ -PrM ti' 2 v—
First �iiad:e Last
�-o� �y.�., o.. � c. �ak d
Address
��, S-�'.3 r �l-7S`� r�o�
°�` `� Zip Phone
C iry S tace
I understand my rishts as sta�ed above.
0
, �
Si�nature
��orrE-a��s�• Fax-a�-osio
----- —-- �
-t.y- r .
�.04 RIGHTS OF SIIBJECTS OF DATA � �
Subdivision L Z`ype cf data- The rights of individuels on whom the data is
stored or to be stored shell be es set forth in this section.
- to be given in�ivid�aL An.individuel esked to
gubd, 2, Informaticn required
� � supply private or confidentiel data concernin�tamWithin the collecting stat ag n Y�
purpose and intended use of the req em;d �b� �yhether he ma� refuse or is legally
political subdivision, or statewide sys �oy� consequence arising from his
required to supply the requested dats; (�) �Y �d (d) the identity of
supplying or refusing to supply private or confidentiel data;
other persons or entities authorized by state or�e�kedlto supplyeinvest gat ve da a
requirement shall not apply when en individusl
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue n►a lert t� re��d�tructionsuinsteadh�s
subdivision in the individual income tax or r•
on those orms. . - --- � � _
Subd. 3.
Access to data bY in�vi�u�1• �P°n request to a responsible
authority, an individual shall be informed�he bliC'hPr vate or confidentiaLe Upon his
individuals; and whether it is classified p ublic data on
further request, an inaividuel whe is the subject oi e t��mrl�v�gaeif he desires, shall
individuels shall be shown the date withou�f atn�t �t� �ter an individusl hes been
�e informed of the content and meaning t� �� n�d not be �isclosed to
shown the private data end informed of its ut��a��on pu��t to this section is
him for six months thereafter unless B d�SP
� ending or additional data on the individuh h�ate or p blie dataruPona equest by
' p require the
responsible authority shall provide copies The responsible authority may
the individual subject of the data- certif and compiling the
the actual costs of making, Y�g�
requesting person to pay -
copies. lmmedistely, it possible, with any request
The responsible authority shall comply '
made pursuant to this subdivision, or within aa e��ySimmediate8t ompliance e�ue.ns°t
excluding Saturdays, SundaYs and legel YS
ossible. If he cannet comply with the request within that time, he shall so inform the
p heve an additional five daYs Within which to comply with the
individuel, and m S t���� 5��� �d legal holidays.
request, exeluding
Subd. 4. Proced�u'e �►hen data is not accurate or complete. An individual may
himself. To
contest the accuracY or comQleteness of public oinri�� the�rcesponslble authority
exercise this right, an individual shall notify
describing the nature of the disagreemen b 'I?��c��e oren flmplet and att pt to
days either: (a) correct the data found to
notify past recipients of inaccurate or inc�mP�t he belie es the datalto be correct
the individusl; or (b) notify the individ
Data in dispute shall be disclosed on1Y if the individusl's statement of disagreement is
• included with the disclosed data. ealed purs�t to the
' The determination of the responsfble authority mo contested cases.
provisions of the administ�'ative procedure act relating
' �� ' CHECFi OFF LIST FOR ISSUANCE OF PERtiIITS
FOR OF�CE USE ONI-Y
�DDRESS OFc LEG:�i..: 3�0 l ���rtk.z,��► e —PID'
DESCRLPTIO\ OF ��'ORF�= t�t�''R'` � v`''
S
DATE APPROVID:
ZO\�G REti'IESV BY: � DATE A.PPROVED: 3- �-°t� .
BL-II.DL\G RE`�jv BZ'�
FEES TO BE CIi-�RGED: Vo
1�Iisc. Fees Calculated By:
PERti1IT Z'zS '� —
PL�N REVIEZV Yes �/ `to _ SEtiVER COIWi ECTION - .
�10 WATFR COi�Ni ECTION
STATE SliRCH.-�RGE YzS � — P qg� �E
INVESTIG:�TIO�+ FEE YzS �°� �'�—r.. s� INSpE�ON
SAC -'Zes — OTHER (sPecify)
Number of S�.0 Units _
ZO\�G CHECZi LiST Zonin�Disuicc:
Shoretand Disuict:
.Po� ��`: School Di 'ct:
Fire Departm c:
Lot Area: Sq. Acres
Wid[h Depch
Survey Sub ' ted
Yes No Dace of Survey:
Proposed Sec ac!cs: i�� Side:
F:o (Lake •
Re� (Streec): ft Side:
Adj cent Struc res:
We and:
Building He Qht: Def. H .
Pe H;t.
pvg. Se[bac :
Bluff S back: t Covezage:
Existi.n Proposed
I-�ardcovez: 0-75' ___
75-�0'
250-�00' —
500-1000'
Hardcover
'ancc Required: 1' Na D of Council Anproval: .
Grading: S App
roval Dace: By: Council ?.oproval Date:
Szocic: Staii ApP
roval Dace: B�'
� File: T
Reso uri a: : Resolutioa Daze:
Zonin_
�ti (in house):
. � 26
" i.
BL-II.DL`rG RE���Z' CHECI� LIST .
covsrxucTTov�E: �� ,
L�c: � — � �
Sq Foota�e 5 Per Sa FtQ _
Basement t =
lst Fioor t =
2nd Ftoor X =
Garage c = �
x
TOT�L
Estirnated Construction Value:
S 3 2��
tiVocic Requirin� Separate Permlts' .
Inspections Required: . p;umoing _ Fire
Sice �eCa��� _Water Conne=cion
Hardcover Removal SeDcic Sewer Conneccion
FoocinQ - L,awn Irrigacion
Fireplace —
—� Frami.ng (tiiasonry) _Other
Insulation �f� � Well (S[ace Permic)
�Wall Board �[ Eleccrical (State Pe:mit)
7C Final Gradia;lFilling —
—T Other _,�_
REyf.ARKS (� AOUSE�=
gEV�W BY OTHERS' DATE:
Access: Existin�
Ne•�v �—
Access Approv�: Date
By:
�1�i��gKS (TO BE NOTED ONPERtiII�:
27
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� .�. � '� ��`�; ��J
JAN-12-96 SAT 12;31 TOWLE REAL ESTATE FAX N0, 3479389 P, 02 � � � ��- �-0 � $��. r�.
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