HomeMy WebLinkAbout1993-005418 - finish room/bath PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway ` P.O. Box 815t_1 I LD I NU
Orono, Minnesota 55356-0815 Permit Number: �{X5418
(612) 473-7357 Date Issued: 08 1 E./9 3
SITE ADDRESS:
3415 WATERT+AWN RD
CH
P. I . N . =32-11 ED-23-44-001 1
DESCRIPTION:
FINISH ROOM/BATH
Building Permit. Type SF-ADD/REMODEL
Building 'Work: Type RENOVATE/REMODEL
UBC Occupancy _. R-_;
Construction Type VN
REMARKS: ; —
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FEE SUMMARY: I-
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p,
VALUATIONi _ l.:t:L': r-
1\L7.rL27�� 7tlTlT!l 7L:V
Base Fee $2-'5 . 00 oil L'!
Surcharge -------- -I-�-K
Total Fee $ 5. 50
CONTRACTOR: OWNER: - Applicant -
FERRELL WARD
3415 WATERTOWN RD
ORONi� MN 55356
T tRG� ' � � �. P �4 � IMM �= REAL
I=I�. AND K� I , N TR T Wit. ANC Ifi
CfRI)
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATUREi
t
CITY OF ORONO - BUILDING PE LMIT APPLICATION
Total Fee: $ Date Received:
Date A_nvroved
Entered By: 1
Permit a
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
-------------------------------------------------------------
_,HE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: �'�1� 1�Y i` l� i� ?� ZIP:
J� (work) /7
TAME OF OWNER: dA&, < �G� PHONE: (home)
AILING ADDRESS: CITY: C — ZIP:
:ONTRACTOR: 7 /' PHONE:
_'.AILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
-IRCHITECT/ENGINEER: ���1� PHONE:
'AILING ADDRESS: CITY: ZIP:
,.T REGISTRATION Or
."YPE OF WORK: New Addition Accessory Structure Move
Demo Remode Alteration Renovate Land Alteration
'ROPOSED WORK (describe in detail) : FIN%,Sx CLOO^1- A4v6
'TORIES: SQ. FEET OF EACH FLOOR:
30. OF BEDROOMS: GARAGE STALLS: ATT. DET.
'STIMATED CONSTRUCTION VALUATION (excluding land) : $
hereby apply for a building permit and I acknowledge that the information
.hove is complete and accurate; that the work will be in conformance with the
:rdinances and codes of the City and with the State Building Code; that I
.nderstand this is not a permit and work is not to start without a permit; and
hat the work will be in accordance with the approved plan.
?PLICANT'S SIGNATURE: DATE:
' CITY Of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•MuniciPal Offices
•
a _ • On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects mit or
data" , we would like to inform you that your request for a permit
license from the City of Orono or any of its departments may req
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 to review privale
data on yourself.
6. Your full name is required to process this application or
permit.
Middle
Last
First
AdLlz�
�.
Address
2,d .�r
city, State Zip
Phone
I understand my rights as stated above.
Si.gnatu e
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS—473-7 35 9
ASSESSING
i
513.04 RIGHTS OF SIIBJF.CTS OF DATA
whom the data is
Subdivision L Type
of data. The rights of individuals on e
stored or to be stored shall be as set forth in this section.
Sbd. 2. information required
to be given individuaL An.individual asked to
supplyprivate or confidential data concerning him ithin the colleself shall be cting state agency,
re
purpose and intended use of the requested data from his
(b) whether he may refuse or is legally
political subdivision, or statewide system; known consequence arising
required to supply the requested data; (c) any and (d) the identity of
supplying or refusing to supply private or confidential data;
asked to supply investigative data,
other arsons or entities authorized by state or Federal law to receive the data. This.
P 1 when an individual
requirement shall not appy to a law enforcement officer.
pursuant to section 13.82, subdivision 5,
The commissioner of revenuis
e may place the repand instructionsuired uinsteadder hof
subdivision in the individual income tax or orooert
on those forills. - --
Upon request to a responsible
Subd. 3.
Access to data by individnal-
authority, an individual shall be informed whether he
vatteeor�confident confidential.
Upon his
individuals; and whether it is classified as pt P public data on
charge to him and, if he desires, shall
further request, an individual who is the subject of stored private or�du� has been
individuals shall be shown the data wit g of that data. After an indi
Se informed of the content and meaning the �� need not be disclosed to
shown the private data and informed of its uta action Pursuant to this section is
him for six months thereafter unless a �P n request by
pending or additional data on the individual has ate or public dataupon
req The
Pe g shall provide copies of the p require the
responsible authority responsible authority may
the individual subject of the data. The resp yi gcertif n and compiling the
requesting person to pay the actual costs of making, ,
copies. 1 immediately, if possible, with any request
The responsible authority shall comp y of the date of the request,
made pursuant to this subdivision, or within five days
Sundays and legal holidays, if immediate compliance is not
excluding Saturdays, with the request within that time, he shall so inform the
possible. If he cannot comply days within which to comply with the
individual, and may have an additio sin five
legal v holidays.
request, excluding Saturdays, Sundays
to or complete. An individual may
Subd. 4. Procedure when data is public pot up private data concerning himself. To
contest the accuracy or completeness of Pnotify in writing the responsible authority
exercise this right, an individual Bement. The responsible authority shall within 30
describing the nature of the disagreement.
to
da either: (a) correct the data found to be ince urate incomplete
�e pients named by
Ys
notify past recipients of inaccurate. or income
the individual; or (b) notify the in dividuabl's statement data
disagreement is
if the in
Data in dispute shall be disclosed only i Baled pursuant to the
• included with the disclosed data. may be app
The determination of the responsible authority e act relating to contested cases.
provisions of the administrative procedur
-- CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USEONLY
ADDRESS OR LEGAL: �s L��IZ �`�^s (� PID:
DESCRIPTION OF WORK: i W t s N yk71P!Q X774 lei
-------------------------------------
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED: 5-
-----------------------^---
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yesy/No
PLAN REVIEW Yes No 77' SEWER CONNECTION
STATE SURCHARGE Yes No / WATER CONNECTION
INVESTIGATION FEE Yes No PARR FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------
ZONING CHECK LIST Zoning District:
r 1
Fire Departme Po t Office: Sc ool istrict:
Lot Area: Wid h: Dep
Survey Submit a Yes No Date of Survey:
Proposed Setb ck 1.
Front (L ke) : Right ide:
Rear (St eet Left ide:
Adjacent Stru tures: We and:
Building Heig t: ef. Hgt eak Hgt.
Avg. Setback: Lot Co erage:
Existi g Pro osed
Hardcover: 0-751
75-2 0 '
250-5 0 '
500-10 0 '
Hardcover Va 'ance Re uire : Ye N ' Date of Council Approval:
Grading: Sta f Approva Date: By: Council Ap roval Date:
Septic: Staf Approval Da By:
Zoning Filer Resolution : Resolutio Date:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC: !�� CONSTRUCTION TYPE: . -
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x -
x =
TOTAL
ov
Estimated Construction value: $ !�OcDc)
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
Footing Mechanical Fire
Framing Septic Water Connection
a Insulation Fireplace Sewer Connection
_g_wall Board (Masonry) Lawn Irrigation
Final (Mfg.) Other
OtherWel l (State Permit)
e
Elctrical (State Permit)
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REMARKS (IN HOUSE) :
----------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
---------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
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