HomeMy WebLinkAbout1996-008020 - remodel PERMIT T
CITY OF ORONO PERMIT TYPE:
750 Kelley Parkway- P.O. Box 66 BUILDING
CryPermit Number:stal Bay, Minnesota 55323 inti;020
(612)473-7357 Date Issued:
051z9/9rw,
SITE ADDRESS:
1530 TANGLEWOOD RD
JB
P. I .N. 26.-118-23-:32-i�i 711
DESCRIPTION:
REMODEL
Building Permit. Type SF-ADD/REMODEL
Building Work Type RENOVATE/REMODEL
Construction Type VN
Census Code 4:34 ALT. RESIDENTIAL
REMARKS:
SEPARATE PERMITS REx;J I RED FOR PL6G, MECH 391 'NATE ELECTRICAL
FEE SUMMARY:
VALUATION $85,000
Base Fee $793 .50
Plan Review $515. 78
Surcharge --------142-55
Total Fee $1 ,351 . 78
CONTRACTOR: - Applicant - ST . LIC OWNER:
ANDERSON-L I NDQU I ST 1472 7'24 5665 CEC I N ANTONIO
6115 SUNSET DR 15=0 TANGLEWOOD RD
MOUND MN 55364 ORONO MN 55:356
x:6121 472-2724 475-0495
THE UNDERS�I6NED HEREBY REQUESTS PERMISSION O ' S
SPECIFIED AND AGREES TO DO ALL WORK IN TRI f =L.ILL fT J!,,YI* ;'
ORONO DRI"?I NA S AND STATE.°OF` MINNESOTA I LD I NG ,CSE r£ N
APPLICANT/PERMITEE ISSUED BY:SIGNATURE
j CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY,
ADDRESS OR LEGAL: /]� 3 0 7XIV d c-�W
PID:
DESCRIPTION OF WORK: i` -7?".0 re L—
ZONING REVIEW BY: N/04 DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED: 5--2-0A&
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No —�� SEWER CONNECTION
STATE SURCHARGE Yes f No WATER CONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
---------------------------
ZONING CHECK LIST Zoning District: Shorel d District
Fire Department: Post Office: School D' trict:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Sury
Proposed Setbacks:
Front (Lak R ght Side:
Rear (Sire t): ft Side:
Adjacent tructure : etland:
Building Height: Def. Hgt. eak Hgt.
i
Avg. Setback: Bluff etback: Lot Coverage:
Ezis g
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover V 'ance Require Ye N Date of Council Approval:
Grading: St Approval at : y: Council Approval Date:
Septic: S Approval Date: By:
Zoning File: # Resolution: # Resolution Date.
1,
REMARKS (in house):
BUILDING REVIEW CHECK LIST
UBC: iZ ,3 CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value:
Inspections Required: Work Requiring Separate Permits:
Site X' Plumbing Fire
Hardcover Removal — Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
_jor- Wall Board (Mfg.) Well (State Permit)
_ — Final Grading/Filling oL Electrical (State Permit)
Other
REMARKS (IN HOUSE):
-------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY:
REMARKS(TO BE NOTED ON PERMIT):
27
1
-Total Fee: S DateReceived:
Date Approved:
Entered By: Permit#:
CITY OF ORONO - BUT-LDL-;G PER?vIIT APPLICATION
ALL INFORMATION.-MUST BE SUBMITTED IN FULL BEFORE PLAIN REVIEW WILL
BESTARTED
---_____------------------------------------------------------__--__-_ .-------------------------------
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: f�, �_-r 06'� cdoo U R ZIP: 3�
NAME OF OWNER: N I a Ni� C-ec I PHONE: (home) .S �0
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: - Z 1 T PHONE: 2-Z 72
MOBILE PHONE/PAGER: - -7
MAILING ADDRESS: `�tiSE 1 , CITY: ZIP:���
STATE LICENSE: # _
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION 7
TYPE OF WORK: New Addition Accessory Structure
Nlove Remodel/Alteration 1� Land Alteration
PROPOSED WORK(describe indetail):A L. 4L#j-j= 'F-�t0
E l �6
OF I<QTc E
F ►°tom ' tAkS TjM'U3 iALLS (�� -t f) �E
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
00
ESTLNIATED 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 w k ill be mi ccor ance with the approved plan.
APPLICANT'S SIGNATURE: DATE: 2q
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.
i
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the dam 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 requested data within the collecting Mate agency,political subdivision,or statewide system:
(b)whether he may refuse or is legally required to supply the requested dam;(c)any known consequence arising from his supplying or refusing to supply
private or confidential dam;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative dam,pursuant to section 13.82,subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income mx or property rax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored dam 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 dam 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 dam. After an individual has been shown the private dam and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the dam. The responsible authority
may require the requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authority 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
dam concerting 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 dam found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Dam
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dam.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 famish certain private or
confidential information.
You are notified that:
1. The information you famish 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.
j. 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 Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature