HomeMy WebLinkAbout1995- 007555 - shed PERMIT
CttY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS:
DESCRIPTION:
: -
REMARKS:
FEE SUMMARY:
CONTRACTOR: OWNER:
,• • _
iiiL
WiTk f'iLL 1-..1F
(NO SUILUTM-1 COX7-
APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
t •
;
Total Fee: SDateReceived: 1/` ! 9 6
Date Approved:
Entered By: Ct Permit#: 7 5S-
CITY OF ORONO - BUILD11G PERII/IT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED _._.
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SUE ADDRESS: c72/6 G(Ji4y ,54/1
NAME OF OWNER: PHONE: (home) —. /C) 3f)
(wor ) ,`/ 73
MAILING ADDRESS: ✓J, 5 4 f CITY: ZIP: "7s 3
CONTRACTOR: Sift- /)1 -G-
PHONE: "/ 7
MOBTI.F, PHONE/PAGER:
MAILING ADDRESS: ./17CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure X
Move Remodel/Alteration i and Alteration
PROPOSED WORK(describe indetail): �''j//.� r 12 ,):14,c' b /
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED 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 work will be in accordance with the approved plan.
' SIGNATURE:�� e- / DATE: // // A S
APPLICANT'S
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.
c 0
CITY of ORONO
�., Municipal Ota
', ;:" ,1$' 'il Post Office Box 66
� ,` _ •
Crystal Bay,Minnesota 55323-0066
kESSOVv.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04. Subd "Rights
fromsubjects
the Cityrof ta". we Orono oranylike to
inform you that your request for a permitor license
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.
. 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 (see following page) to review private
data on yourself.
6. Your full name is required to process this application or peiiilit.
PLEASE PRLNT
b��fi_iA Middle Last
First
Address
4 D MC MN
Phone
City State Zip
I understand my rights as stated above.
Signature
TELEPHONE-473-7357 • FAX-473-0510
S13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision 1. 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.
Subd. 2. Information required
to be given individual• An.individual asked to
•
supply private or confidential data concerning himself
the be
informedrstate agency,
PP
purpose and intended use of the requested (b) whether he may refuse or is legally
political subdivision, or statewide system;
the requested data; (c) any known consequence arising from his
required to supply private or confidential data; and (d) the identity of
supplying or refusing to supply ral
other persons or entities authorized by state yfseeskedlto supplyi nvest gative data,
requirement shall not apply when an individual
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma •lace the notice re•uired under this
subdivision in the individual income tax or pro•erty tax re and instructions instead o
on those orms.
Subd. 3. Access to data by individual Upon request to a responsible
authority, an individual shall be informed whetherbhpr�prthisubject of vate confidential.e Upon his
individuals, and whether it is classified as p public data is
e to him and, ifo he desires, shall
further request, an individual who is the subject of stored private or
n
individuals shall be shown the data without any charge
After an individual has been
Be informed of the content and meaning the data need disclosed to
shown the private data and informed of its meaning, neednot beeis section is
him for six months thereafter unless a dispute or action pursuant
pending or additional data on the individual
has been
or public datorupreare created.
bye
rP sif require the
the individualble authority subject shall provide copies The the
responsible authority may din the
the of the data. P certifying, and comp g
requesting person to pay the actual costs of making,
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,
ys legal holidays, if immediate compliance is not
possible.e
osuding Satucaays, Sundays withdte request wiin that time, he shall so informvtthe
he
If he cannot complyys within which to comply
individual, and may have an additionalazid legal five dholidays.
request, excluding Saturdays, Sundays
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of public or private data
theoresponsib a authority
himself. To
exercise this right, an individual shall notify in writing
describing the nature of the disagreement. The responsible authority shall within 3to
0
days either: (a) correct the data found tobe
inaccuratTete data�includingror ec pients named
by
notify past recipients of inaccurate or incomplete
the individual; or (b) notify the individual th ividu believes
statement the
data disagreement be a correct.
is
Data in dispute shall be disclosed only if the
• 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.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2.‘6.0 w r4yLA-'rA- 13tAJO
PID: _ Z� 0 /40 F ve[ /24 )4 a'? "I'
DESCRIPTION OF WORK: s«�
ZONING REVIEW BY: cam"."...__ DATE APPROVED: ii-2I-mss
BUILDING REVIEW BY: ��Qy,.,,,._. DATE APPROVED: 11-
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes No i/ SEWER CONNECTION
STA 1'h SURCHARGE Yes '" No WATER CONNEUFION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No Sta. INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: 6-1 Shoreland District :
Fire Department: 1.•L • Post Office: G•L_ School District: 0 a o N O
Lot Area: Sq.ft. /Vd GK�� Acres
Width Depth
Survey Submitted: Yes No DG Date of Survey:
Proposed Setbacks:
Front (1=k-e): /V//- Right Side: 630�
Rear ( et : 3 Left Side: /00 ` ±
Adjacent Structures: p..). 3� Wetland: /U leg
Building Height: Def. Hgt. O• - Peak Hgt.
Avg. Setback: i Bluff -tback: •t Coverage:
Exist'•g P oposed
Hardcover: 1-7 '
5-2 0'
250-9e'
e'
500-1•Is'
Hardcover V. 'mace Req ired: Yes o Date of Co Approval:
Grading: St. Approval aate: By: Co 'cil •pproval Date:
Septic: Staf Approval Dat : By:
Zoning File # Resolutio : # Resolu ion Date:
• DI • ' (in house):
BUILDING REVIEW CHECK LIST
UBC: u— t CONSTRUCTION TYPE: V KJ
Sq Footage S Per Sq Ftg
Basement x
1st Floor x =
2nd Floor x =
Garage x —
C -
TOTAL
VV_
Estimated Construction Value: $
I, U00
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
;k Final Grading/Filling 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 •
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