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Home My WebLink About1995 - 006910 - remodel PERMIT CITY OF ORONO PERMIT TYPE: 27'51 Kelley Parkway- P.O. Box 66 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: (612) 473-7357 SITE ADDRESS: DESCRIPTION: 7 : v • REMARKS: • 7 77 .7 7 FEE SUMMARY: _ . CONTRACTOR: OWNER: -- • • IFL':77. UNICE THTiNED HEREE!Y RE(0ES TS PERM I I THE MPROVI:±*:NT3 '.4.'ECIFIED AND Ae;REES TO Da ALL WiDRK IN STRICT c:OMPLIANCE WITH ALL CITY IJF ORONO ORDINNCES ANO STTE OF MINNESOTA BUILDING CODE REOUIREMENTS APPLICANT PERMIT SIGNATURE dOlv ISSUED BY:SIGNATURE CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ Date Received: Date Approved: Entered By: `- Permit#: ( /0 ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) THE APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: 31-0 (ie%,51- Lake- >7.OY�r/ ZIP: .55_35-4 (work) /,/ NAME OF OWNER: Chr(( ( (0 VZ PHONE: (home) Ti 936(4 MAILING ADDRESS: f/aA t-tk. St. CITY:L.0yd ileP, ZIP: . 5 2)3-6 CONTRACTOR: Cl'1,CAv 5 ) at baa PHONE: q75'`7 5 42`f' MAILING ADDRESS: 34/ GCITY:/_._9 £ c?/� ZIP: 5S.5", STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration $. Renovate Land Alteration PROPOSED WORK (describe in detail) : Rem oce *vcr rrj f 6eolv'oon"i STORIES: 2 SQ. FEET OF EACH FLOOR: ap/reX• Dc-10 - �� d NO. OF BEDROOMS: 2- GARAGE STALLS: ATT. DET. 2— ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ JVD- 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: (X2!i? .1 DATE: ill-/T J l C CITY of ORONO CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices OF .ORONOOn 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. charis flit);I1 661(3aa.KA First Middle Last 34f (LJe Address Loh, Lake. 6c3% City State Zip qi Phone I understand my rights as stated above. 4e;i__Z54J Signature BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS -473-7359 ASSESSING S13.D4 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 Subd. 2. Information required to be given individual. supply private or confidential data concerning himself shall be informed of: (a) the and intended use of the requested a whether within the che ollecting esoates g gds purpose ( from h political subdivision, or statewide system; known consequence arising required to supply the requested data; (c) any or refusing to supply private or confidential data;w to and de the data.identity off supplying state or federal other persons or entities authorized by 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. Thunde commissioner of revenue may place the re notice i required under insteadrthis subdivision in the individual income tax or property taxon those orms. Subd.an Access to data by individual Upon request to a responsible authority, an individual shall be informed whether he privateis subject of or confidential.ed data on Upon his aut y, data on individuals, and whether it is classified as � charge is the subject of to him and, ifo he desires, shall further request, an individual how dudata without any tored private or individuals shall be shown theof that data. After an individual has been �e informed of the content and meaning the data need not be disclosed to shown the moantedata ereafinformed e��ess°a its oractionpursuant to this section is him for six m e request by din or additional data on the individual has been collected or created. The pendresponsibleing provide copies of the private or public data upon the eindividual subject shall The responsible authority and require e the the of the data• certifying,requesting person to pay the actual costs of making, yi g, copies. immediately, if possible, with any request The responsible authority ion,shacomply hifive days of the date of the eis qu not made pursuant to this subdivision, excluding Saturdays, Sundays and legal holidays, if immediate comp he individual, possible. If he cannot comply with the request within that time, he shall so informtthe individual, and may have an additional five legalo lidayss tun which to comply request, excluding Saturdays, Sundays and to or complete. An individual may Subd. 4. Procedure when data is not accurate contest the accuracy or completeness of public or private data concerning himself. To ht an individual shall notify in writing the responsible authority describingexe cithis right, late and attempt to the nature of the disagreement. The etironsiobCen authority shall within 30 days either: (a) correct the data found to be inaccurate data, including recipients named by notify past recipients of inaccurate or incomplete the individual; or (b) notify the individual indiv'dual'sbelieves statemen tof disagreement it. s Data in dispute shall be disclosed only if the pursuant to the • included with the disclosed data. be appealed p • The determination of the responsible authority to contested cases• provisions of the administrative procedure act relating CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3,41 W EF-sr LAKE ST PID: DESCRIPTION OF WORK: aE'rwo01=Z-- ZONING REVIEW BY: (V / DATE APPROVED: BUILDING REVIEW BY: ..17 &4-4,1,44."- DATE APPROVED: `.1- /y-`)< FEES TO BE CHARGED: / Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes No t- SEWER CONNECTION STATE SURCHARGE Yes-C/-No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No L/ SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIS Zoning District: Fire Department. Post Offic: : Sc ool District: Lot Area: Wid•h: Depth Survey Submitt: . : Yes N• Da e of Survey: Proposed Setba s: Front (L. : ) : R' ght Side: Rear (St e=t) : -ft Side: Adjacen • Structures Wetland: Building Hei.ht: Def. “gt. Peak Hgt. Avg. Setbac : Jot Coverage: Ex sting Proposed Hardcover: 0-75 ' 5-250 ' 2 0-500 ' 5r' 0-1000 ' Hardcov=r Variance Required Yes No Date o Council Approval: Grading. Staff App oval Dat- : By: Co ncil Approval Date: Septic Staff Appro al Date: By: Zoning File: # Re olution # : esolution Date: REMARKS (in house) : / 1 BUILDING REVIEW CHECK LIST UBC: it % L,3 CONSTRUCTION TYPE: ' N.9- ' 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: SitePlumbing Grading/Filling Footing Mechanical Fire Framing Septic Water Connection Insulation Fireplace Sewer Connection Wall Board (Masonry) Lawn Irrigation QLFinal (Mfg.) Other Other Well (State Permit) Electrical (State Permit) REMARKS (IN HOUSE) : REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT) :