HomeMy WebLinkAbout1994-005555 - part bldg-spklr tank PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: BUILDING
Orono, Minnesota 55356-0815
Date Issued:
(612) 473-7357 /0S ;4
SITE ADDRESS:
,s_' WAY7ATA E VO
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F . I . N . . :,_}- II._ _._.-44-;r_ :t.
DESCRIPTION:
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PART Bi �•lig-�:F`�-::i_`''. TAN '.
Building Permit_ Type In°_;T-ADD/R MODEL
Building Work Type INSTITUTIONAL
Construction Type V N
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i i_ !;TATE PERM IT RFOUIRFnFOR ELECTRICAL . 04/08/94
FEE SUMMARY:
VAi_UA !ON - _. 1 500
I"'IEi[ Review -40 , (j_•,
Surcharge
Total i-ee
CONTRACTOR: c: i s;; i-lt. _' _ i__I OWNER:
CUSTOM!'! 1..1I i'iEa'iS•f! i s OF MN i:SE,5E2l^1.-, t=l ':'_:' ':ATA F`RO='ER''•.-I`-
NORLING AF 3S6 DEXTER DR
t;'o :..r'_,.T(- Mi" 55'221 LOW=
MN SC3s1;
(612) ._.``f.:-•-5: S=) (612)476-2125
i f
THE ihi_:SI -�: E_ HEREBY REQUESTS PERMISSION Ti MAKE THF REAL IMPROVEMENTS
_
SPECIFIED AN[ z"aE�'cLE_; TO DO All WO ::: . I N STRICT COMPLIANCE WITH ALL CITY O
ORONO ORDINANCES AND STATE OF MI NNESO rt BUILDING CODE. REQUIREMENTS .
(C-615)
APPLI ANT/PERMITEE SIGNATURE �`_' ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
';,ta1 ree $ 5 ' Date Received: (f' fix)
Date Ao roved:
._ t
. ered By: • jg2� - - ��5 S
Permit
INFORMATION MUST BE SUBMITh.D IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
APPLICANT IS: (circle one) OWNER o _CONTRACTOR
OB SITE ADDRESS: 15O L/, y-./A! 1_, 7i4 /3L v/ ZIP: J 5
(work)
AME OF OWNER: ,4Yi4?A 010, PHONE: (home) y -.LJ2S
:AILING ADDRESS: 3 < V. xrF g f) g , CITY: 6: ZIP: ccI
( 5.7- f''( Q///Ij/C,�3 O t /v14 PHONE: Z qb - 1
;OtiTR.ACTOR: � .-
:AILING ADDRESS: J 0 2 9 't /L/O/.L/./o _414 CITY: e 0 k -4ra ZIP: 575-3�, /
'ATE LICENSE: # 0 c') <2
/'f A/+3/EL//'k ,-
.,-2CHITECT/ENGINEER: ' . i ..4,./AL A'u, QM %G FmPHONE: i./ - ` /,_/
y0 c-
ILING ADDRESS: % 7 2 I /14 ER CITY: ./`7(l jJ�✓.y) ZIP: Ks-/?‘
.AE: REGISTRATION
PE OF WORE: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
?OPOSED WORK (describe in detail) : FA, r4'l f- /` ✓ �'`� '� n`
0A 0L ,vG -m.4/ • , -Q/ � / ti < AA
.RIES: SQ. FEET OF EACH FLOOR:
OF BEDROOMS: GARAGE STALLS: ATT. DET.
"^IMA'i .) CONSTRUCTION VALUATION (excluding land) : $ 3 5-0 0 , 30
:Hereby apply for a building permit and I acknowledge that the information
ove is complete and accurate; that the work will be in conformance with the
:'finances and codes of the City and with the State Building Code; that I
.ierstand this is not a permit and work is not to start without a permit; and
at the work will be in accordance with the approved plan.
DATE: 9
=CANT'S SIGNATURE: _.„44-4 �, '
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','.::...• -,.:'..! :',,',-..`.;:: CITY of ORONO
~"Y• F rrw. .
; ., CITY' . Post Office Box 66•CrystaI Bay,Minnesota 55323•Municipal Offices
z,pRoNcF 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 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 to review private
data on yourself.
6. Your full name is required to process this application or
permit.
,Zi fri ccrAy if ( ,t/ Q,
First
Middle Last
X02 , � � Ale.
oA �. 6 -
Address
City State Zip
1-
Phone
I understand my rights as stated above.
--------- _
A At.
ignatureof
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS —473-7359
ASSESSING
L
513.04 RIGHTS OF SUBJECTS OF DATA -
Subdivision L Type
of data. The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section- An.individual asked to
to be given individual.•
2. Information requiredbe informed of: (a) the
• • supply private or confidential data concerning ila$mself within the collecting state agency,
purpose and intended use of the requestedwhether he may refuse or is legally
political subdivision, or statewide system; (b) }mown consequence from his
required to supply the requested data; (c) any and (d) the arising from ofs
• supplying or refusing to supply private state or federal lawential o receive the data. This.
other persons or entities authorized by investigative data,
requirement shall not apply when an individual is asked to supply
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
P � required under this
The commissioner of revenue may place the notice
ivision in the individual income tax or property tax refund instructions instead of
subd _ -
on those forms.
Subd., an. - Access
to data by individual Upon request to a responsible
it individual shall be informed whether
he
is
esubject of or confidential. d data on
Upon his
authority, classified as public, P public data on
individuals; end whether diis
the charge to and, if he desires, shall
individuals
request, n individual who
is
ay subject a stored himprand, diyeddes has been
individuals shall be shown theof that data. After an individual Se informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its meaning,
erection pursuant to this section is
him for six months lthereafter unlessthea disputepublic data uponcrrequest by
" or additional data on the individual has or p collected or created. The
pending provide copies of the privaterequire the
responsible authority shall e responsible authority may
the individualr subjectnof the actualhe •cosh of making, certifying, and compiling the
requesting person to pay - request
ifpossible, with any q
copies. comply immediately,
The responsible authority shallor within five days of the date of the request,
made pursuant to this subdivision,and legal holidays, if immediate compliance is not
excluding Saturdays,cnncSomply
If he cannot comply with the request within ithin which tothat time, he eall so comply with th the
possible. rm the
have an additional five days
individual, and may Sundays and legal holidays.
request, excluding Saturdays,
or complete. An individual may
Subd. 4. Procedure when data is not accuratehimself. To
or completene
contest the accuracy notify in completeness.of public or private data concerning writing the responsible authority
exercise this right, an individual shall authority shall within 30
the nature of the disagreement. The responsiblei and attempt to
describingrecipients named by
days either: (a) correct the data found to be atadata, including incomplete
notify past recipients of inaccurate or incomplete
the individual; or (b) notify the individual that he believes the data to be correct.
if the individual's statement of disagreement is
Data in dispute shall be disclosed only pursuant to the
• included with the disclosed data.responsible authority may be appealed
to contested cases.
' The determination of the
provisions of the administrative procedure act relating
• .. ,y
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
/ S - O 00ADDRESS OR LE : 50 (�� � & PID:��C
GLS(��
DESCRIPTION OF WORK: F / n) t61072.77 0/v ir- g6,D6 Fog. SPRCNK - .
ZONING REVIEW BY: DATE APPROVED: '-• Z7 ` 9
2
BUILDING REVIEW BY: DATE APPROVED: ( - Z.).- 3
4
------------------ -
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes ire No SEWER CONNECTION
STATE SURCHARGE Yes t " No WATER CONNECTION
INVESTIGATION FEE Yes No c/' PARR FEE
SAC Yes No 4/ SITE INSPECTION
Number of SAC Units OTHER (specify)
TONING CEECR LIST Zoning District:
Post Office:
Fire Department: / S h•ol District:
Lot Area: Wid,/h: � Dep h:
Survey Submitted: Yes Nor Date o Survey:
�, fi tis( 09-e 6v 0 c
Proposed Setba'ks:
Front (La - ) : ; Right Side:
1 FC) CT' OguJ(Ail
--
Rear (Etre=t) : Left /Side: /
Adjaceft St •uctures : Wet4and:
1 4eak Hgt.
3uilding Hel.ght: Def. Hg. .
Avg. Setbac : Lot Coierage:
, n Pro osed
:ardcover: 0-75 ' g
75-250 ' 111125 -500 ' 1111
500
1000 ' ill
� ou
Hardcover ariance Req i ed: Y�• o Date of Cncil Approval:s / i
B
Counc'l Approval Date:_____.__
Grading: S aff Approva Date: / y=
Septic: Stiff Approval 4te: / / By:
Zoning Fi4:# 1Resoliution J#: Res lution Date:
0
REMARKS (In house) :
i
1
BUILDING REVIEW CNRCK LIST
UBC: E - 3 CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
oo
Estimated Construction Value: $ 35-00
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
)( FootingMechanical Fire
FramingSeptic Water Connection
Insulation Fireplace - Sewer Connection
Wall Board (Masonry) - Lawn Irrigation
/.Final (Mfg.) - Other
Other Well (State Permit)
b( Electrical (State Permit)
REMARKS (IN HOUSE) :
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT) :
I
1