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HomeMy WebLinkAbout1996-008034 (accessory struct) � PERMIT ` CITY,OF ORC3NO PERMIT TYPE: ?750 Kelley Parkway - P.O. Box 66 ��s='�.�'s��`!�: Permit Number: i_it i;=;ij:���.� Crystal Bay, Minnesota 55323 Date Issued: {;;�,,�� i/�=�F,� � ��12) 473-7357 _ _.. _ . . _. _. SITE ADDRESS: ��7�=;+:x E;f�Y'=�I C�� €'�;�� .��; f=' I . h�! . , t��5—f �--;�:�:—�'1—i fi ri tF, DESCRIPTION: :^ii��!l�.(� '.-;f-l��7 F,��i 1�:11 Yl�� F'�_rrr�i t. ��.r-�Y '_�!=—At=+�: `=,1'r;t ii=i i.!I=�� ��L�f 7. �.�::t 1 i��a ��::+1"E:: i ;���� r;t:i_:�,:_:°_;l�IFi`t =�C-�l f4:1 ��(��f_ f Il..[l,lr,.�[��C;i =�7t—� i l.��tj jti�.5'i.�li t.'E�_�j'Y ��"�:._�* �Y1� [:�'ll=�..�35 i_��i 7F� _,..� �_�'Ty�I'� ;���i�)f"�°L°�� . REMARKS: FEE SUMMARY: `'��lt._t 1#-;�1.���i�l �L�t")(3 ��.�,;� F,_:= �:.Y`#. . i�+::� �'�ctl# �{t�'�!1 e:?W �3,�i�_�, t-.�; ��a,,l;�r_i-tctl''�t�� ----___ �! . .ri?�; �f�I 7.:i�, �1=+3r ���T._i.'l J,."_t CONTRACTOR: OWNER: — �=rF�l. ?c���f�� —� �,�I t:��::Li 1t�1!} G�=iH?s� _°i:�,{�r �;�'1 v':;I Cy+-: �i�.} 1_i�';f_�r�t_� �'i�� �!�s:��ii�� .�,.(i'J�,.--(J;'=;F. Ti-i� :���li,=��i:M�1 i�tu�;� �=i=�°�;���Y` ��i:�:��.!�_°_;r°�= F���+.�•1.i�;'=�i���?� Ti+ t°i;�a��::� i�-!�: �;�€��- ���"`�`'�'j��'?`���- _..-.r r. • . -- ,- r••-- h C: �.E .�3.�. _ . . _ __._. _ _ '•_�`�t'.�:�.�" i:�„'} :iiv�,: ��i-il�'.�".'�C..'•,-; !I_! I�)1 J t-tL,�._ �x�l I�`;�; ��`w •W���?��.: I i;�_t�'f�'[,_�{�•,l��!=:� 4,:T !� E�_...?. ;:.i , c 1_!!- i��;�:�-�i�(��� E� 4 i i���,t��=:�'_: ��i�ii:? =�Tr�T�= i��= t i I i����t�'=�i�iTta �;t;i Lu�t�i:� ���=l��� �:�i:�;_!i f:��i>�;�r,;T°=� . I_ — � � APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE � I • e - �. ��S DateReceived: �` - ;,Z �- ��(,, Total Fee: S ) Date:�pproved: L � �l�-. Entered B�-: i Permit#: ,�'C, �� � . � CITY OF ORONO - BUII.DING PER1tiIIT APPLIC�TION :�LL ��FOR�I�TION`1t:ST BE SLB��ITTTED�1 FULL BEFORE PL��1 REVIE`V WII.L BE ST�RTED -------_--_------------------------------- THE :�PPLIC��T IS: lcircle one) O�VNER OR CONTRACTOR % � I'> -� ZIP: �� c =:�`. �� JOB SITE �DDRESS: _�-`� `; , t ' t � _� , � 1 � � � ' i �' ,'� L.� �� > ' �t�tilE OF O`iniER: ^c<< c d ��f � c .'� . PHOr�: (home) , , � (work) 7 ; �' ' �"' (�_ � � , " - .� �- -,-�;, , , ZIP: �j`�C __� �I�ILL�G:�DDRESS: �' ��-;� ! �� <r� � c_ CITY: ��-� � � ` , '.�- ' �-..L. - l -- ' PH01VE: ��—l "'' CONTR�iCTOR -=--.� `�+`" � ' - v10BILE PHOVEIPAGER: �1AILINGADDRESS: -- — �� ,,=a=,` CITY: ZIP: � ST�TE LICENSE: # �RCHITECT/ENGINEER: PHO�1E: �IAILPIG�DDRESS: CITY: Z�': ����: REGIST'RATION �# TYPE OF WORK: New Addition Accessory Structure � vlove Remodel/Alteration Larxl Alteration PROPOSED�VORK(describe indetail): � :� �� t �, `r �' � ; � STORIES: SQ. FEET OF EACH FLOOR: ��-' � � 1�� -;��� � `, �10. UF BEDROOMS: G�R�GE STAI.LS: ATT. DET. �' � �� �i,�t ;�; -�� ESTL�I�TEDCONSTRUCTIONVAI.UATION(eYcludingland): � �� � ' ` `��' ` I hereb�- appl�� for a buildin� permit and I acknowledQe that the information above is complete and accurate; �hat the work will be in conformance with the ordinances and codes of the Citv and with the State Building Code; thac I understand this is not a permit and work is not to start without a permit; and that �he work wil� be in a��az'dance with the approved plan. r- , :��1T'S SIG�i�TURE• � � << C r_��� l�� DATE: `� - �`i - ��� - �PPLIC _ 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. .. . . � , � Sec.13.04 RIGH'TS OF SUBJECTS OF D�T� Subd. l. Type of data. "Ihe righcs of individual on whom[he data is srored or ro be stored shall be as set for[h in[his secdon. Subd.2. Information required to be gioen individual. An individual asked to supply private or confidendal data concerning himcelf sha11 be informed of: (a)[he purpose and intended use of the requested dara within the collecring'state agency, polidcal subdivision,or sratewide rystem; (b)whecher he may refuse or is legally required to supply the requested dara;(c)any�o�coasequence arising from his supplying or refusing to suppty pnva[e or confidenoal data;and(d)che idendry of o[her persons or enrides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesngarive da[a, pursuant to secdon 13.82, subdivision�, to a law eaforcement o�cer. The commissioner oi revenue mav lace che noace re uired under this subdivision in the individual income tax or orooem tax refund instrucnons ins�ead ot on those forms. Subd. 3. �.ccess to data by individual. Upon requesc to a responsible auchoriry,an individual shall be informed whether he is che subject of stored data on individuals, and whe[her it is c(assified as public, pnva[e or confidenaal. Upon his futther request, an individual who is the subject ot stored private or public data on individuals shall be shown the data wi[hout any charge to hun and, if he desires, shall be informed oT the conten[ and meaning of�ha[data. .4fter an individual has been shown the pnva�e data and informed of i[s meaning, �he data need not be disclosed co him for six months thereafter unless a dispute or action pursuant[o [his secdon is pending or addiaonal data on the individual has been collected or created. The responsible auchoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible au[horiry may require the requesting person to pay the actual costs of makine, certifying, and compiling the copies. The responsible au[honty shall comply immediarely, if possible, wi[h any request made pursuant to this subdivision, or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is noc possible. If he cannoc comply wi[h[he request within[hac time,he shall so inform[he individual,and may have an addiuonal five days within which to comply wi[h the request,excluding Sa[urdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or privace data conceming himself. To exercise[his nght,an individua!shall notify in wricing che responsible au[horiry describing[he nature of the disa¢reemen[. The responsible authonry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempc to nodfy past recipienrs of inaccura�e or incomplece data, including recipients named by the individual; or(b) nodfy the individual tha[he be(ieves the data to be correct. Dara in dispute shall be disclosed orily if the individual's statement of disagreement is included wi[h the disclosed data. The determinadon of[he responsible au�honry may be appealed pursuant ro the provisions of the administrarive procedure ac[ reladng to contested cases. DATA PRIVACY ADVISORY In accordance wi[h M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request for a pernut 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 deternune your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that �he City deny che permit or license. ;, The information may be shared with other local, state or federal agencies to[he extent necessary co process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. �. You have cercain ri�hts under M.S. 13.04 (available upon request) to review private daca on yourself. (. Your fu11 name is required to process this application or permit. , j � _� r� c.: <.i ,� - ,���c� �� ��'�/ �E�. ;`_._. First �� vtiddle �� Las[ �.� � �/ ��i ;��c �i � �L �— .�ddre�s ��� ) � � � _, "�� ✓ � � �" �� ;"' �;��-��r� ���. ,✓�� ��;I-' -� - `� � Ciry State Zip Phone I understand my rights as stated�above. �� / _ , .�c� �� � �� L� � ���' `- Signacure � � CHECK OFF LLST FOR ISSU�iCE OF PERI`ZITS FOR OFFICE USE ONLY . �DDRESS OR LEGAL: x /' f� � ,< �� ; ',,/ PID: ,-�- ��- _ - , �,�,,�a� DESCRIP'I'ION OF WORK: � != ''� ZOiVI�i 1G REVIEW BY: DATE APPROVED: (o -3� �� BUII.D�tG REVIE`V BY: DATE APPROVED: � - 3 - g� ---------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERNIIT Yes No PL�� ��Ew YeS ��o SEWER CONNECTTON STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes No � PARK FEE SAC Yes No �� SITE I�i tSPECTION Number of SAC Units OTHER (specify) �N-___�___ _ --------------------------- ZOt�1I��G CHECK LIST Zoning District: L2 ' 1 A Shoreland District : V.�S Fire Department: Post Off . ch 1 Distr� Lot Area: Sq.ft. Acres �d `..� � Depth Survey Submitted: Yes pL No Date of Survey: �- ZZ- '°l5 Proposed Setbacks: � � ` Front (L.ake): � + Right Side: '�' Rear (Street): 3��� �" I.eft Side: �� � ?,djacent S[ruccures: �� � �- Wetland: �tl /A Buildin� Heieht: Def. Hgt. /��� Peak H�t. /�� Av�. Setback: Bluff S back: t Coverage: Existin Pro sed Hardcover: 0 75 7 -2 50-5 ' 00-1 Hardcover Vari e Requ ed: Yes ;�'o ate of Council pproval: Gradins: Staff pproval te: By Council A proval Date: Sepdc: Staff A proval Dace Y� Zonin; File: # Resolution: .' Resolution D e: RE�'�ZARKS (in house): � . - . , • � BU�II.D�tG REV�W CHECK LIST ' usc: U � � co�rsTxuc�o�v �rE: V� Sq Footage S Per Sq Ftg Basement x — lst Floor c — 2nd Floor R — Gara�e r — C = TOTAL oa Estimated Construction Value: � �Ov I Inspections Required: Work Requiring Separate Permits: Sice Plumbing Fire Hardcover Removal �Iechanical Water Connection ' Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (iVlasonry) Other Wall Board (Mfg.) Well (State Permit) � Final Grading/Filling Electrical (State Permit) O[her RE1VI�4RKS (IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date BY� REVI�iRKS(TO BE NOTED ON PERNIIT): 27 571 mr.�rarer.v�as ...rx�aaccc�:o�csm��suauc-� �:n�.snnxs.azc•aszc�s,e�anmr.anv�eau�ra�urs�ruwnv�rcr.,�..��enanmvuxau:s�nrn�wsnnra:. `f...� . ..�. � '��"�� . �.' cP.�.r Cer.tif.i.cate oF Sur ey � ���,�' tv • l Lor Dan 1�'arr Constru •tion ;-,= �� , . • oE L�ot 52 , 1luditor ' s Subdiv �ion No . 203 `t:.,;' •: ` ficnnc�in counr_y , Min� :sota �` � � ` � ��„ . .. .. N69°94 '/G"!v /99.oS � •�t+'" ~• I is".r�,. �$• il � ` � '���'R:Y 4� � ki� � � � �'� , y o � ��,�' •y . �;� . � . . ... . ������ ��� � ;�, � �,, �, � . � � � ; �� ,� � ,: � , . . . _ . ._ .. - .j;� °: � ^ �� �'� �� Q���Q �� � � D� SIT,; �'l_.�N __�_ GRADII�G PL.AN � �_ ... . � � a� �l\f'�����a���.►� �� _ — 979 — � , U ��i'F',"�''''y i:=.� �"�lTH f�E:VISIONS — ` ' — � � ❑ UI�•ra���� ..,,,�� , — � , � ' BY , � � J � � DATE �'-�—� '� , , t �^_, : - �-• , r- , 11'/ � � ;� , _ _. , � , :._.��. . �!�. .��v� .? � , ^ — _. � _ _ . � � 97G � �i � ,-� -- �� �- /^t ,"�' '� / \ J � � 1 l� a.� � . �1 �'(516.4� � � ,� ,� . � � .:.i /- . ,Y� i �: . O \ • -. . ... � �� f' � .' h _ � \ O `� `� ` .�J�; i � / ' — � � � /,^, I,' _- -`' ' n Y• / \ �\ � P � i' , _ .�. H � . °� CITY ,b���4 . , \ , ' � � , � � SITE P���V �ADING PI..AN � � o (� AE'�PfiUV�_u-� Sl�Et� �, : \ ..,. . � ❑ AP°�?UV�� �`Jl�f M REV)SIONS / o . ❑ DISANPi 0 � . � � BY DA'f E �- ��� � ' , 3s.9)., � � �• � • � Leq,�1 �escr_ intion ' \ ` � ,� � j L�ot 52 , 1luditor ' s Sul�divisi.on No . 2Q3 . ` � � �--rs3z�) ; � � � \ r� � E'� � 1 .' �o.,� t�.$) �� i� '�� �`�%�s�� \ � ' 'cnis :��i��vey Sn�w�� 1:1,�� loc��l.i�n or: a � 9����979.7), t; N i ��3J , A To� ,h�s �,� L r�r.o��osed l�ousc on the ahove �]c5cr�.bcd � � �qj e).' �r� � .° <v�'9� ��rc���c.�Yty .� T.t doc�� not C�urr�o�-t t.o show � , y ',.� a� � a� � �0,3- c'ltly othcr i.mprovements or �ncro��ch- i o y �o �e� �g• 'go` s.sc� $o m�n t s . ` 'o ��'v 4�_� �iQ4, \ C99/.Ph...�4• �5 PpS i p (t17.9) ''�' � ; � ��`;r.,� o � �3J��/ 0 4.�' I�,a� Pr J � \ � -� '� , --� \\ b �0 v 2'�xi9•� �)o p o� �) \, \ \ \ i � \� ^(991.�I \ �i8. 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