HomeMy WebLinkAbout1994-006664 - interior firewall PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- PO. Box 66 1 T
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued:
SITE ADDRESS:
X Wil f",y 'A 1"11LIP-1
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DESCRIPTION:
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FEE SUMMARY:
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THE Ut-JIDERSIGNED HEREBY REQVE`,TS PERMI!-'-:.SION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO ORDINANCES AND STATE :OF MINNESOTA BUILDING CODE REQUIREMENTS-
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BIIILDING PERMIT APPLICATION
Total Fee: $ y aS� Date Received:
Date Approved:
Entered By: �iJ� Permit#: �P 7
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
-------------------
THE APPLICANT IS: (circle one) OWNER o CONTLT
RAO
JOB SITE ADDRESS: Z`-7Z.5 )A---1-A 1y�biy"p , �� ZIP:
►"� ��c 0 1 (work)
NAME OF OWNER: V I G 6a I lit e- PHONE: (home)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: EA:Ka4.WAt_-7V t-d11<L "77,,q/' PHONE: �5yD ,65i 73
MAILING ADDRESS: Z]OS W_ VA)jDg &al CITY: "Rup-,usw L W, ZIP:
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) : ICCWVC ��7 fix' YI�ot, fjZl4.fdn } U W#LL
sv S i WIN 4�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 4-0D
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: �l-
t
CITY of ORONO
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.
--VA
First I-liddle Last
-
Address
City State Zip
& I Z-
Phone 3
Phone
I un rstand my rights as stated above.
S gn RE u r e
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
513.04 RIGHTS OF SU&FJM 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.
Subd. 2. Information rid to be given individuaL An.individual asked to
1 private or confidential data concerning himself the collecting state agency,
be informed of: (a) the
suPP Y P
purpose and intended use of the req system;
whether he may refuse or is legally
political subdivision, or statewide sys , known consequence arising from his
required to supply the requested data, (c) �Y
supplying or refusing to supply private or confidential data; and (d) the identity is
state or federal law to receive the data. This_
other persons or entities authorized by is asked to supplyinvestigative data,
requirement shall not apply when an individual, toenforcement offier. g
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma lent tax re°und mstructionsnsteade 12, 11111ed under hos
3111
subdivision in the individual income tax or r�
on those orms. -—
Subd. 3.
Access to data by individuaL Upon request to a responsible
authority, an id data on
ndividual shall be informed whetherublic he
privateis subjectorconfiders ial.of e Upon his
individuals; and whether it is classified asp or public data on
further request, an individual who is the subject of ase toe him ande if he desires, shall
individuals shall be shown the data withouofanh t data. lifter an individual has been
Be informed of the content and meaning the data need not be disclosed to
shown the private data end informed of its uteoaction pursuant to this section is
him for six months thereafter unless aPUected
ending or additional data on the individual has been
or public datauponrequest by
ted. The
P require the
responsible authority shall provide copies The responsible authority may uin the
the individual subject of the da costs certif n , and compiling
requesting person to pay the actual costs of malting,
copies. if possible, with any request
The responsible authority shall comply immediately,
made pursuant to this subdivision, or within five days of the date of the request,
legal holidays, if immediate compliance is not
excluding Saturdays, Sundays and
possible. If he cannot comply with the request within that time, he shall so inform the
p within which to comply
individual, and may have an additional
i io and fivelegholidays.request, excluding Saturdays,
or complete. An individual may
Subd. 4. Procedure when data is not accuratehimself. To
contest the accuracy or completeness hof public in
the responsible authority
exercise this right, an individual shall notify
describing the nature of the disagreement. The responsible authority shall within 30
days either: (a) correct the data found to be inaccurate
or incomplete includnd named by
to
notify past recipients of inaccurate or incomplete , ta to be correct.
the individual; or (b) notify the individual that�dual'sleves the statem n of disagreement is
Data in dispute shall be disclosed only if the indi
• included with the disclosed data. be appealed pursuant to the
The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2Z ZS �JT7'� l3c-YD PID:
DESCRIPTION OF WORK: 1 'JlEal ok- F►2e w A.LC
------------------------------------------
ZONING REVIEW BY: A( DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED:
--------------- ------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes (/ No
PLAN REVIEW YesoW No v' SEWER CONNECTION
STATE SURCHARGE Yes p-* - No WATER CONNECTION
INVESTIGATION FEE Yes No 'PARK FEE
SACYes No SITE INSPECTION
Number of SAC Units OTHER (specify)
---------------------------
ZONING CHECK LIST Zoning Di trict:
Fire Department: Post Office: School D strict:
Lot Area: Width: Depth:
Survey Submitt Yes No D to of urvey:
Proposed Setba s: '
Front (La ) : Right S de:
Rear (Str a ) : Left S de:
Adjacent t uctures: Wetland:
Building Heig Def. Hgt. Peak gt.
Avg. Setback: Lot Coverag
Existing Proposed
Hardcover: 0- 5 '
75-2 0 '
250- 00 '
500-1 00 '
Hardcover V riance VR
d: Yes No Date of Council proval:
Grading: St ff Apprte: B Council Appr val Date:
Septic: St ff Approe: L By:
Zoning File:# esolu ion #: Resolution ate:
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC:
�' _Z CONSTRUCTION TYPE: —
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:
Site Plumbing Grading/Filling
Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
rinal
ll Board (Masonry) Lawn Irrigation
(Mf g.) Other
Other Well (State Permit)
Electrical (State Permit)
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REMARKS (IN HOUSE) :
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT) :
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