HomeMy WebLinkAbout1999-011466 - sport court PERMIT
� L�ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 =�> ;;� [��;=wt;
Permit Number: ° • �-• '_
- Crystal Bay, Minnesota 55323 `�:_� s.��_`��;:
(612) 473-7357 Date Issued: ! _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — ��_��� �i'����=� — OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ,.G�
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` Total Fee: $ 3S 7. ,Z,/ Date Received: __`> 4;. /",�;
Entered By: � Permit#: /� lo�i
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: f��;� e���'� /�C ZIP: •�'`-�� �
NAME OF OWNER: :T:,���rg.�,�,.;�„c�� PHONE: (home) 7�5�-U;��
(work) �--T/.�"C7 J/ _ E��, ti�= �r�/
MAII.ING ADDRESS: `�•,�..� CITY: ZIP:
CONTRACTOR �,,)�or�C�� �'�' PHONE: (�5/ �!5�/G �/�E,
CONTACT PERSON: �` ;��2 <<, .�'� .�r"5 MOBILE/PAGER �.(;�.��;_;��-��'C�
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MAILING ADDRESS: �;C� �; �L��/J�r�h CITY: ��f,�;.-� ZIP: ,�`z�''/�-��
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New x Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�:( �,.���-r c.;<:� �x;X 3�� (f;�,,.-c��i���✓��3�31r-�.i'�i
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ I �CC�' C�i�X
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 accord nce ith the approved plan.
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APPLICANT'S SIGNATURE: �� DATE:�.`� � �C
NOTE! Parade o Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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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 individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requesred data within 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 known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identity of odier persons or enaries 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�lace the notice reauired under this subdivision in the individual income tax or nrooertv tax refund
instructions instead 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 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 acaon pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,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 additional five days within which to comply with the request,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy
past recipienu of inaccurate or incomplete data,including recipienu named by the individual;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 determinadon of the respo�sible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
ro 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.
C1�Clc"� ��t" c�." � —J � ••!�
First � Middle , / Last
'S��� S � Z�� ��7t���, /f C � /
Address
�-<<•n .-� /��L` ��/:���, GJ/ 'Y���''¢��
Ci�y State Zip Phone
r
I un d my rights' state above.
�___ �
Signature �
6
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` CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z$5� �Q a,,...�.� ��
PID:
DFSCRIPTION OF WORK: �l1o,rA� (.��.•c� -
ZONING REVIEW BY: DATE APPROVED: S���5
BUII.DING REVIEW BY: DATE APPROVED: g-�t�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes v No SEWER CONNEC'ITON
STATE SURCHARGE Yes � No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
-----__�-----------------------------------------------«---------------------------------- - - -
ZONING CHECK LIST zoning District: �Q 2-
Fire Department: Post Office: (� School District: ��l.cr-,.J
Lot Area: Sq.ft.�c��Acres Width Depth
Survey Submitted: Yes� No Date of Survey: 0� � �"P
Proposed Setbacks: f �
Front(�ej: �� `� Right Side: ��'
/ l
Rear�j: Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By. C un il Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolu ion: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Eusting Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Vaziance Required: es No Date of Council Approval:
REMARKS(in house):
7
� � .
BUILDING REVIEW CHECK LIST
UBC: � CONSTRUCTION TYPE:
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gazage x =
R =
TOTAL
a�
Fstimated Construction Value: $ / �/, 0C7b
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
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARI�S (TO BE NOTED ON PERMII�:
�.
8
Sport Court: 35' x 7`
shown, compact all f
Modified Proctor De
Future Gazebo/Caba.
k
Ne
MY OF 0110HO
SITE PLAN GRADINI
❑ APPROVED TH AEYISIQN
PR®V
❑ DGAPP
BY
DAT
Ex
me
eqi
alli
Existing septic PVC fog
Verify depth so as to re
excess cover above.
Future swimming poc
18'x 36'w/ concrete
deck to be designed
Construct 3-18" high
corner of house under
yin jn nniit and 4rgiii;
shown.
Future stairs from up]
of deck to new conc i
sets of 6" risers
1139 sf 3
(ave) 400
air expos
aggregate
concrete
hand too]
3' oc
Existing woods: ren
Pr,
Bituminous Drivew,
1. Verify layout wi,
Landscape Architec
Layout points will b
Landscape Architec
2. Reshape existing
new base as require
minimum.
3. Construct 306 if
deep exposed aggre,
with hand tooled jot
Concrete to be 4000 psi mix w/5% air
entrainment
4. Construct 2923 sf 3" (compacted
depth) MnDOT # 2341 paver laid
bituminous paving.
LL 111.7[IA i1t� %/Lia ♦ vi v
James Robin, Landscape Architect
23420 Park Street, Excelsior, Minnesota 55331 612 / 474-3946