The URL can be used to link to this page

Home My WebLink About1997-009720 - stormwater pond PERMIT CITY � ORONO PERMIT TYPE: - 275�Kelley Parkway- P.O. Box 66 � - - Crystal Bay, Minnesota 55323 Permit Number: ° . `�:�:��:+ (612)473-7357 Date Issued: � SITE ADDRESS: , � ;-. _ DESCRIPTION: .� , .. .. .... . . __. . � ;-�;.; < :--�-• ;::•,�•;';;j j T. !`{;^-��;_,' ':__'~a''�'.��' �-��-- ' " i � .. : -1' . .. , _. .. _ ._ REMARKS: . ,. __ .. _ _ _ ; :� : _ FEE SUMMARY: CONTRACTOFi: OWNER: ` � � ; , .:: . : . :..:. . .. - : . : , ;� �.:_ . ._. .; . - . - - . . , _ . ':'��'`'� �. .. .. _ f _ . . _ _. � , I-i __ �..=1"•�#�f�,�`.��f�;� ��:�sr_w'� ` ,t — �, ,,. ,,. .. , � _r ,, y � ; {��_ , i�. =�'�::�� I�:.� �;�v�"r f��'�:�:=' �'3�� 3i fi .�E,.�,.T t�t f� � �.. �` , ;.. � �,; f'�; ,�. � -�� :. �, .. _� . �. � . . .� . x ..__; _ .. a . � �,:��;.;�� =iU�Z#��'�� ai�li� :��`fl�'� �3��= �i��,�,�€�..:�w _ �� ._ . . . � ... .. ��..�_ .. .: . . , . � ...., _ . . _ , L �� _ �� G�� l.�cl�� APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE CITY OF ORONO � 6124730510 11/20/97 12:36 �1 :02/03 N0:881 . � '�'otal Fee: $ Date Received: Entered $y: Permit#: CITY OF ORONO - BUIIIDING PERNIIT APPLICATION 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: �'�gS SJX'T� �Y�. /tJ• ZIP: Ss3SCp '�r�� NAME OF 9�R: M �� PHONE: (home) �' (work) y7/- DS�Q �.nvG a.Dnx�.ss: 2�v s�+�ywar� crrY: �ce. , z�: 5533/- 9s�S CONTRACTOR: X Cr: L: CC-•r rn a-�--r;�v�,�, �ti��G. PHONE: X 5�7�- %S�j CONTACTPERSON: �C C[./FF ,C'.�-z-f� MOBILE/PAGER:x MAILING ADDRESS:x �3�a !�,'i�..�ow ��.'� CI'TY: x f'1'JE.�iiv� ZIP: X j S3�fo STATE LICENSE: # ARCHITECT/ENGINEE�R: C/��C� �SSO�. PHONE: X ��9 �Z ��1 MAII.ING ADDRESS: k/�ao �iQN��L �.ec�'it Ci7',CI'f'Y: �r��+F+�.� ��+�N ZIP: +c s-s 3s`1 NAME: X G'L�c N .4_ -SA�uv��t,� REGTSTR.ATION# -- TYPE OF WORK: New Addition Accessory Struciure Move _ Remodel/Alteration Land Alteration __�___ PROPOSED WORK{describe in detai�: S 7"�l2/�L e�vi4'f�-'� j°ON.� CON S G?�70 STORIES: SQ. FEET OF EACH FI.00R: 1�t0. OF BEDROOMS; GARAGE STALLS: ATT. DET. ESTiMAT'ED CONSTR.IICTION VALUATION (excluding land): $� I he�eby apply for a building peruut 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 Ciry and with the State Building Code; that I understand this is not a permit and work is not to start without a pernut; and that the work will be in accordance with the approved plan. APPLICANT"S SIGNATURE: �C �,.- l�i� �'�%DATE: �C /�.�/�/r7 NOTE! Para �Ham�s events require separate permit approval by Police Department and City Counc�l 60 days priar to the event. Non permftted events will not be allvwed. 5 CITY OF ORONO � 6124730510 11l20/97 12:36 [� :03/03 N0:881 . � Sec.13.04 RIGHTS OF SLJB,IECTS OF DATA Subd. 1. Type ot data. 3'he righu of individual on whom the data is stored or to be stored shall be as ut forth in this section. Subd.2. Intotmation required to be�rea lndlvidual. M individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose ud'uuerded use of the requesud data within the collecting state ageney,political subdivision,or ststewidc system;(b)whether he a�y refuse or it le�ally requised w svpply the requested data:(c)any known consequence arising from his supplying or refusing to supply private or confidenti�l dau;and(d}the idendry of other persons or enpties authorizcd by state or federzt law to receive the data. This rEquirement shali not app►y when an individual is asked to supply invesdgative data, pursuant to secaon 13.82, subdivision S. to a law tnforcament officer. T►,�r�,,,micc�onsr of revenue vL?v olace Che notice rea�ire�under�hie«bdivision in�he individual income Lx or orocerN tnx te_f�nd instrucdons instead of on those forms. Subd. 3. Accesa to deta by tndividuai. Upon request to a responsible autfiority, an individual shall be informed whether he is the aubject of arored dara on individuats,a�d whether it is classified as public,privam or confidential. Upon his further rcquest,an individual who is the aubjecs of stored private or public da�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 thut dati. ARrr an individual has been shown the private data and informed of its meaning,the data need not be disclosed tn him far siz rtwnths thtceatocr uniess a dispute or acaon pursuu►t Oo this secaon is pending or addi�ional.deta on the individua)has been collxmd or creatod. 'ilx roaponsible authoriry shall providc coQics of the priva0e or public data upon request by thc individual subject of the data. '17ie responsible authority may requir:tha requesting person ta pay the actual costs of making,cerrifying,and compiling the copies. The responsible authority shail comply immediately,if possibie,with any request made pursuara to this subdivision,or wi[hin five days of the date oE the request,ezcluding Samrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the eequest wirhin thae time,he shall so inform the individual,end may have an addibonal five days within which to comply with the request, excluding Saturdays,Sundays aod legaJ halidays. S�bd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this righe,an individual shall notify in writing ths responsible authoriry describing the nature uf the disagreement. The responsible authonry shall within 30 day9 either: (a)correct the dara found to be inaccucau or incompiete and atumpt ro notify past recipienLs of inaccurate or incomF•lete data,including recipients named by the individual;or(b)notify the i�ividual that h�believes the data to be corrcet. Dau in dispute shall be d'uciosed only if the individual's statement of Qisagreement is included with the disclosed data. The determination of the responsible suthority may be appealed pursuam to the provisions of the administrative proceduro act relapng 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. Yon are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refus�to supply data, but refusal may require that the Ciry deny the pernut or license. 3. The informat'1on may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requeste3 permit or license requires Council action to approve, some information may become public� 5. You have certain rig3its under M.S. 13.04 (available upon request)to review private data on yourself. 6. Your full name is required to process this applicaiion or permit. k G L�N �L,L�,V' �S'��c=R,S First � Middle Lasc X j��'G /'/GNc_�7L C2c-ZTK CC=Nr'�T'� Address x �I�-t�t� �'��v /�"Iti� �s—sj�s`y ��% ��i � c�ri r-- s�u z►� Pnone I uaderstand my rights as stated above. �C � � - C��,Gl�� signaaere ' 6 CITY OF ORONO � 6124730510 11/20/97 12:36 � :01/03 N0:881 C�TY of a��NO TELECOPY COVER LETTER Please deliver the following paqe (s} to: Name: �t.�'NN S�/Vpe,X-S From: INt �rr� G��eo� Total number of pages � including this cover letter. Date: l�-Zj -�7 IF YOD DO NOT RSCBIVE ALL THE PAGSS, PLEASS CALL DS �S SOON AS POSSIBLE. Phone: (fi12) 473-�358 and ask for: /�I�(,X(G�' . Our telecopy number is: (612) 473-OSIO A�ditional Message: .r �L,.�'A2� f/L L l N 'T1�'f'L� /7�:N1.g ' X � l�eR.r��T � f s ��b� � - CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: l�/8� S!x➢'�/ AV�NLL� Na.Q�'ff PID: �!'o -/IB Z3 '�3 002� DESCRIPTION OF WORK: 57D�DU�2 �pN L� --- --____----------- ----------------------_____------------------------------------- ZONING REVIEW BY: DATE APPROVED: - � BUILDING REVIEW BY: --�— DATE APPROVED: FEES TO B CHAR ED: Misc. Fees Calculated By: PERMIT ��p, Yes ✓ No PLAN RE W Yes No ✓ SEWER COrfNECTTON � STATE SUR��iARGE Yes No ✓ WATERCONNECTTON — INVESTIGAT'ION FEE Yes No � PARK FEE — SAC Y;;s No � SITEINSPECTION -- Number of SAC Units -- OTHER (specify) -- __ ---_---- ----------------------------------------------------------- ZONING CHECK LIST zoning District: �./�'�� Fire Department: � Post O�ce: �L School District: �/LO/�� Lot Area: Sq.ft. -� Acres -- Width '— Depth '-' Survey Submitted: Yes� No Date of Survey: �/U /L�' Proposed Setbacks: Front (Lake): _ � Right Side: "' Rear(Street): Left Side: "�'- Adjacent Structures: ! Wetland: //� Building Height: Def. Hgt. � Peak Hgt. "' Lot Coverage: Grading: Staff Approval Date: � By:�-- Council Approval Date: �`�� Septic: Staff Approval Date: -� By: '- Zoning File: # C�� Resolution: #3 ro7 Resolution Date: '�� -/� Shoreland Dist ict: ✓ Avg. Setback: � Bluff Setback: — L.ot Coverage: -- � Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Vaziance Required: Yes No� Date of Council Approval: REMARKS(in house): � 26 ..r—� M BUII.DING REVIEW CHECB LIST �U � UBC: CONSTRUCTION TYPE� • Sq Footage $ Per Sq Ftg Basement x = lst FToor x = 2nd Floor x = Gazage x = R = TOTAL Estunated Construction Value: $ Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Boazd (Mfg.) Well (State Permit) Final Grading/Filling Electrical (State Permit) Other REMARI�S (IN HOUSE): REVIEW BY OTHERS: DATE: ----.._ _._._._.__.._____---______.___. Access:,,Exist�---"._..�__.._. N`�ew � Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): � ,4�.! �Nne� � B� c�N� P�2 �ot�rr��s o� ``� ��u,cx-��.5 �- �� ,�' . ,__` 27