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HomeMy WebLinkAbout1994 - 006436 - remodel PERMIT • CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: (612) 473-7357 SITE ADDRESS: 200 lAiOODHILL RD 014 DESCRIPTION: RE:MOPE-1_ Building Permit Type i7i-fm-An/pFmcing Buildinci Work 1YPe CON7Pc:IAL Construction Type VN 77. IT 31.00 Fr i• -. lJJ s IT REMARKS: FEE SUMMARY: VALUATION V7, 600 CO PLEin Review $S2. 6S Sur char e R() Total FP'7' $136 . 45 CONTRACTOR: OWNER: - Applicnt - n rill t L I C:11 t iNTRy 2 00 WOODHILL RD CRON() MN S-=',391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROW.---.MENT SPECIFIED AND AGREES TO DO ALL WORK IN sTRICT COMPLIANC:E WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA SUILDIN,7i CODE REQUIRFMENTS . L_ f. , „44 APPLICANT/PE MITEE SIGNATURE ISSUED BY:SIGNATURE •• CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ / _ (1-5 Date Received: / '7- Date Approved: Entered By: 'yA Permit#: ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) THE APPLICANT IS: (circleone)11 (OWNER or CONTRACTOR p. I JOB SITE ADDRESS: c;\ © O rr W 0 0 0 k i I �?�� ZIP: S-5 3 l l (work) (-/ 73 -5 67// NAME OF OWNER: LOO (DVV\\\ CC)U "A rt c i IA D PHONE: (home) Y 7 S'-/ 7.5`1 ADDRESS: a a C7 CO . h.; 11 I2 CITY: U../ 2 o A ( I C ZIP: ss.3 9 MAILING Q / CONTRACTOR: C �G-�I U 'e 9U I I DE'2 S PHONE: (173- 3 6 .r 3 MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition V Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : ni c 103.e �`� GJe R 6 e ioC4J _ - ,vN1 i! ? 31 - j C 11 STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. • / oci ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 6T, b d O 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: 9\ 7 9 Y -s s -lam CITY of ORONO CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices OF ORONO 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. �c.) R LA) e 0 e /c '`first Middle Last 9\ 00 uJood( Lill Qo&cQ Address W yZoAct, j7ffrJ , 9City State Zip y 23-- 5-8// Phone I understand my rights as stated above. Signature BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING • 513.04 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- Anindividual asked to supply private or confidential data concerningriiw thin tself he collecting state agency, be informed of: (a) the purpose and intended use of the requested data political subdivision, or statewide system; (b) whether he may refuse or is legally required to supply the requested data; (c) any known consequence arising from his supplying or refusing to supply private or confidential data; and (d) the identity of Pstate or the data. This. other persons or entities authorized by iseaskedlto supplyi nvest gat ve 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 required under this subdivision in the individual income tax or •ro•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 informd�whe pr vetis e or confidential.subject of ed data on Upon individuals, and whether it is classifiedpublic, data his further request, an individual who is the subject of a toe private him and, ifo he desires, shall n individuals shall be shown the data withoutof that data. 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, neednotto beets section iso him for six months thereafter unless a dispute or action pursuant pending or additional data on the individual has ateen nr pule c datocted rupre request hThe the responsibley eauthority subject shall provide copies The responsible authority may requireithe the individual of the data• certifying, and compiling requesting person to pay the actual costs of making, copies. The responsible authority shall comply immediately, if possible, with any request e made pursuant to this subdivision, or withinfive def si of he datee of th ce eisqueT1ot, excluding Saturdays, Sundays and legal holidays, ipossible. If he cannot comply with the request withinshall so i with the that time, toinform the individual, and may have an additional le al holidays. request, excluding Saturdays, Sundays g or complete. An individual may Subd. 4. Procedure when data is not accuratehimself.lTo contest the accuracy orcompleteness individual s ha l notify inpublic or rivate writing data theoresponsible authority exercise this right, an innauthority shall within 30 describing the nature of the disagreement. The orencomplet and attempt to days either: (a) correct the data found to be notify past recipients of inaccurate or incomplete data, including recipients to ies named by the individual; or (b) notify the individual thatbelieves is Data in dispute shall be disclosed only if the individual's statement of disagreement 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: -2-cc) W C9C.6/4/U, /rah PID: DESCRIPTION OF WORK: ee 7N.006 Z. — L.NJC-L4)$ cAma'\ Amac-c rani/yr 3 Cftc,ie"r3 ZONING REVIEW BY: N/4- DATE APPROVED: BUILDING REVIEW BY: 449 �,1/tGw-- DATE APPROVED: 9 - /S-C!`1 76 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes f No PLAN REVIEW Yes ✓ No SEWER CONNECTION STATE SURCHARGE Yes r/ No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITE INSPECTION Number of SAC Units OTHER ( specify) ZONING CHECK LIST Zoning District: A Fire Depart -nt: Post Of ice: :chtol District: Lot Area: Width: De•th: Survey Subm tt:d: Yes No pate o Survey: Proposed Se bac' s: Front (Lake) : Right Side: Rear (Stree •) : Left • ide: Adjac: nt Str ctures: W:tland: Building H -ight: oef. Hgt. Peak Hgt. Avg. Setb• k: Lot •overage: Existing Pr•posed Hardcover 0-75 ' 5-250 ' 11111 50-500 ' MI 5 ) 0-1000 ' 1111 Hardcover Variance Requi ed Yes to Date of Council Aoproval: Grading: Staff Approval 'at By: Council Appro al Date: Septic: Staff Approval Date By: Zoning ile: # R= .olution # : Resolution Date: REMARKS (in house) : 1 BUILDING REVIEW CHECK LIST DBC: CONSTRUCTION TYPE: Sq Footage $ Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ S,600 Inspections Required: Work Requiring Separate Permits: Site Plumbing Grading/Filling Footing Mechanical Fire laming Septic Water Connection Insulation Fireplace Sewer Connection W11 Board (Masonry) Lawn Irrigation inal (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) : Ccif:pi S64.7' ( iv'I' 'r42). - pi,j,i: ' (/ ii_i U M G• iminfom • ter,similmla as • 473-3653 3/j TR1:PTED PLy woof fr 0 111 't MLD1NG Mrr PLAN REW I Pt.:=ZM IT Nv). ......,._,.. 21(4 244 QC. - PEIR 4 y} - ''''IONS AS ( .�/ f' -- "CT & FSE`, ,rf 2X , LOWER ( � n & E PLATE i