HomeMy WebLinkAbout1999-011584 - above ground pool/deck PERMIT
CRY OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 R! IT i ?�%;
Crystal Bay, Minnesota 55323 Permit Number: 6
Date Issued: � �'5'-`"�
(612) 473-7357
SITE ADDRESS:
%,tNf'.: WA2 RIC,-
CH ,-{_H
F% . T 1 '_t i—2 —4 1—iii
DESCRIPTION:
ABLDVE GRN
L-'ui .l.+_in,g {'`i.=``=.'mi t T pe _, i-)E-t_ 'ST t=`!it_T 417z;�
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REMARKS:
FEE SUMMARY:
VALUATION $41 s%iH_%
Base Fee $87 . 25
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L.f"rfi•Erg e
CONTRACTOR: OWNER: - Applicant. -
FIR*1 T,! DAVID
Tt-ttv'`AWA RLD
_Ri;lit I MN .5 _:.'ir_.
THE UNDERSIGNED HERESY REQUESTS PERM I SS I��N TO MAKE THE REAL I MI*'ROVMES `"
SPECIFIED AND AGREES TO Dt_► ,ALL WORK IN STRICT COMPLIANCE VITH' ALL CITY W
L_ ORONO ORDINANCES AND S TAI E O MINNESOTA BUILDING CODE REQ:U IR ENiTS.`y.
A LICANTiPERMITEE SIGNATUR ISSUED BY:SIGNATURE ,
Total Fee: Date Received:
Entered By: Permit#: //
CITY OF ORONO - BUILDING PERART 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: 73 D h K o cam)a, /1 b Q s ZIEP: 65 3 S 6
NAME OF OWNER: VZ1 t p/tNM5 PHONE: (home)��/7� Dy/6
(work)
MAILING ADDRESS: CITY: ZIP: ,5,5-,09"
k)6 "�o b�, ohe �� OW.?er .
CONTRACTOR: PHONE:-
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
A �+
ARCHITECT/ENGINEER: N4 PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure�(
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): A)e, fu
h I o4 e, Am c
,jYD44 n, t e p dol •
STORIES: SQ.FEET 'i�Sp2 c c
NO. OF BED OOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ yD 0 p
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 accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: 6 /
NOTE! Parade g f 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.
5
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 requested 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 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 data,pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue may place the notice reauired under this subdivision in the individual income tax or property tax 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 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 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 data.
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 data concerning 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 ttte data found to be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,inchtding recipients 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 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 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.
D, z4 Gt /,s Frl L
First M' die last
Ad ss
ke AA7-60
City State Zip Phone
I understand my rights as stated above.
Ll",�44 Z , E4g�
Signature
6
v CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSOR LEGAL: 44-73 -To r,'1:A A R,o avO
PID:
DESCRIPTION OF WORK: o CL- A3o rt.e,..� + -
ZONING REVIEW BY: DATE APPROVED: 6, -2,z s 5
BUILDING REVIEW BY- D- DATE APPROVED:
__-------------- ------ ---------- --------------=----------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
—----------------------------------------------------------
ZONING CHECK LIST Zoning District: "- /#4
Fire Department: (,aN 64:;" Post Office: Zap!t� (i+Pu% School District: O�
Lot Area: Sq.ft. No cN+tr -Acres — Width — Depth
Survey Submitted: Yes�_ No Date of Survey: S-31.11
Proposed Setbacks:
Front(lee): `t Right Side: T o'
Rear(Street): ZSO f Left Side: ast
Adjacent Structures: 101 } Wetland: #J (A
Building Height: Def. Hgt. r4 /A Peak Hgt.
Lot Coverage:
Grading: Staff A oval Date: By: C uncil Approval Date:
Septic: Staff App v D.
By:
Zoning File: # Re lution: # Reso ution Da e:
Shoreland District:
Avg. Setb k: Bluff S tback: Lot Coverage:
Exist oposed
Hardcover 0-7 '
75- 0'
250- '
500-1 '
Hardcover ariance Requ a Yes No Date of Cour it Approval:
REMARKS(in house):
7
BUILDING REVIEW CHECK LIST
UBC: /?,'3 CONSTRUCTION TYPE: V/-J
Sq Footage $Per Sq Ftg
Basement x —
1 st Floor x =
2nd Floor x -
Garage x =
X =
TOTAL
Estimated Construction Value: $ 4/,U
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical. Water Connection
_-p4-Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
Final Grading/Filling Electrical(State Permit)
Other
REMARKS ON HOUSE): . .V ti
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMM:
8
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ORONO
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❑ APPROVED WITH V1S10NSo-_
❑ DISAP ROVED '
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Cartif ic-atr, c7;• j : F'
t}::,t tl,i:; i, /1 tru'� :Il'rl Corr +, r�::.rn.^unf,-ltion c�
k s1111vtb;{ Of the of Lots 3, 4,
Sn r:it Park, mi-3 t►v: location of alL eri:-l.inj buiiiint;s tlte-:roan, and
the prolx;sr'.: lorrit_::r of a proposed a:iditior.. it cine:: 1:ot purport to
show other iillprov_!.!.erts or eneroachr.-.ent�.
Scale: 1" 44' Gordon n. i�Gk"4
Date : 5-31-77 Lard suzve;or and Planner
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