HomeMy WebLinkAbout1993-005683 - finish basement PERMIT
CITY OF ORONO � � PE�iMIT TYPE: ;;�
2750 Kelley Parkway • P.O. Box 815 t;t i�:_[��,�ii;
Orono, Minnesota 55356-0815 Permit Number: ;�t!�!_ar_;_;
(612) 473-7357 Date Issued:
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SITE ADDRESS:
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CONTRACTOR: _ ��r.,�,3 ; �.�,�.�. ..._ ._;; � ��; .OWNER:
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APPLICA T E IGNAT�RE ISSUED BY:SIGNATURE�� ,
' CITY OF ORONO - $IIILDING PERMIT APPLICATION
Total Fee: $�� S� Date Received:
_ Date Approved:
Entered By:�. permit#:_`j��
AT•T• INFORMATION MDST BB SIIBMITTED IN FDLL BEFORE PLAN REVIEW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDR$SS: � � � ZIP: �
�
(work)
NAME OF OWNER: � �p� PHONE: (hom
MAILZNG ADDRBSS:�� � c :l1� CITY: ZIP:
CONTRACTOR: � � PHONE:
MAILING ADDRESS: � CITY: ZIP:
STATE LICENSE: # L����!
ARCHITECT/ENGINEER:���(1l1 I � PHONE:
Tr�=-
MAILING ADDR$SS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) :���L1�.1.�' �,�,�L� � ► 7'� F-�t 1 v 1 /
�. � 1�'� ��?��� �
�TORIES: I SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS:� GARAGE STALLS: ATT.� DET.
BSTIMATED CONSTRUCTION VALIIATION (eacludinq land) : $___����(- iC/
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 permi and work is not to start without a permit; and
that the work will be in c nce wi the approved plan.
APPLICANT'S SIGNATORE: DAT13: /
� � 1
�
- C ITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minnetonka
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 wi3.1 be used to determine your
gualification 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, s�ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Council action
to approve, 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 process this application or
permit.
l,� +
First Middle Last
Address _...�
� � ��
City a e Zip
������/1 � _
Phone
I under ta y ri s as stated above.
Si a
BUILDING&ZONING-473-7357 • ADMINISTRATION 8c FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
f � �. .
�.p,� RIGHTS OF SIIBJEC'TS OF DATA �
Subdivision L Type of deta- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information � to � ��� ����'1' An.individuel esked to
� ' su ply private or confidentiel data concerning hims�n� collect g stat agency,
P
purpose and intended use �f the req tem;d (b) whether he may refuse or is legally
political subdivision, or statewide sys �own consequence arising from his
required to supply the requested date; (c) any
supplying or refusing to suQply private or confidentiel data; and (d) the identity of
other persons or entities authorized by state or federal law to rece��eethe�ve da a
requirement shall not apply when an individual is esked to supply ' g
pursue�t to section 13.82, subdivision 5, to e law enforcement officer.
The commissioner of revenue or rolert tax re�und instructio insteadhos
subdivision in the individuel income tax
on those orms. . _ . ___ _ -. -- -
Subd. 3. Access to data bY in�vidual• UP°n request to a responsible '
authority, an individusl shall be informed whether h��gteepr confident el.e Pon �
individusls, and whether it is classified as public, p ublie data on
further request, an individual who is the subjecc�g� to himrlande if he desires, shall
individuels shall be shown the data witho of�hat data. After an individuel has been
�e informed of the content and meaning t� �� need not be disclosed to
shov+m the private date and informed of its u���8ction pursuant to this section is
him for six months thereafter unless e �SP
� � pending or additional data on the indi�d� h�8teeor Qublie dataruponarequest by
responsible authority shall provide copies P
the individual subject of the data. The respensibl Cert f �nity and c mPiling the
requesting person to pay t he a e t u s l costs of making, 311 g�
copies. ' immediately, if pessible, with any request
The responsible authority shall comply � of the date of the request,
made pursuant to this subdivisi�nd le al tholideys,dif immediate compliance is not
excluding Saturdays, Sundays g
possible. If he cannot comply with the request within�i�n w�ch toh mply wi h the
individual, and may heve an additional five days
request, excluding Saturdays, Sur►da3's and legal holidays.
Subd. 4. Pmced�e when data is not acc�ate or complete. An individual maY
himself. To
contest the accuracy or comQleteness�of pnblic or private da the�respor�sible authority
exercise this right, an individual shell notify in writing
describing the nature of the disagreem�o be ����e or in omplete and att pt to
days either: (a) correct the data found
notify past recipients of inaccurate or au�P�t he tbelie es�the datalto be correcty
the individue13 or (b) notify the indivi
Data in dispute shall be disclosed only if the individuel's statement of disagreement is
• included with the disclosed data• � a eeled pursuant to the
' The determination of the responsible authority may PP
provisions of the administrative procedure act relating to contested cases.
. • CHECR OFF -LIST�FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR I,EGAL: Z(I Z �U�r4-�"Z w�o cX_S PID:
DESCRIPTION OF WORR: �=i cti�S (�f- -(�o-4-5-�(���..�.,-�-� -- j=f�.�'4-v���.•. c:� �i�v L�-f
-----------------------(�--------------------
4 / ------------------- ------------
ZONING REVIEW BY: /v DATE APPROVED:
BIIII,DING REVIEW BY: ^�� ��1i��__ DATE APPROVED: t� - ?.`i� � S
----------------------r ---------------------------------------------------------
FEBS TO BE CHARGED: Misc. Fees CaJ�culated By:
PERMIT Yes ✓� No
PLAN REVIEW Yes r/ 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)
--------------------------------------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: Post Office: � SchooJ. District:
Lot Area: Width: ' Depth:
Survey Submit e�d: Yes No Date of Sur��ey:
j
Proposed Setb cks:
Front ( ak�) : Right Side:
� �
Rear (S�ree�) : Left Sid�:
Adjacer�t St�uctures: Wetland':
Bui�ding Hefi�ght: ', Def. Hgt. Peak Hgt.
Avg. Setba�k: Lot Coverage:
Existing Proposed
HardcoverJ 0-75 ' � j
i � !
�15-250 '
50-500 ' '
5 0-1000 '
�
r
Hardcove�r VarianceiRequired: Yes Nq Date of Council Approval:
Grading: Staff App�ova7. Date: By: Council Approval Date:
Septi c:,� Staf f Approval Date: By:
Zoning Fi�e:# Resoluti�n �#: Reso�ution Date:
REMARKS (in house) :
BDILDING REVIEW CHECR LIST _ ,
. .
IIBC: � �(, � CONSTRIICTION TYPE: �(v�� _
Sq Footage $ Per Sq Ftg
Basement x � _
lst F�oor x =
2nd Floor x =
Garage x =
x =
TOTAL
$stimated Construction Value: $ �Uo• U J
Inspections Required: Work Requiring Separate Permits:
Site Pl.umbing Grading/Fi�ling
Footing Mechanical Fire
�Framing Septic Water Connection
�Insulation Fireplace Sewer Connection
/ Wal]. Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Wel 1 (State Permit}
E�ectrica� (State Permit)
--------------------------------------------------------------------------------
REMARRS (IN HOIISE) :
---------------------------- -�z-----------------------------------------------
,;-
REVIEW BY OTHERS: DATE:
�
Access: Existing New
Access Approval: Date By:
--------------------------------------------------------------------------------
REI�lARRS (TO BE NOT$D ON PSRMIT) :
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