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HomeMy WebLinkAbout1996-008066 - pool PERM� � CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Permit Number: �;�_I 1 �_f;3 t,�4� Crystal Bay, Minnesota 55323 _ (612) 473-7357 Date Issued: �_�;:;;�;r ii=,r, t i:—'f''�:'=�i— SITE ADDRESS: �a.�.;�� �,�Y°_,T� E ; i� .T�= DESCRIPTION: � �;i:i.+'?1� t-��`!_!l t��) i-`i_li"!I_ �+�..,1i .t�:��t?'7 F`�'t'f:=i�� Tyr�!� '—=�•—(-jl..:(� �:T�;;(_;�;—:Ti l;;f� ��{,a l i s�Z F i�� 'ja,���i�`�:; ����+t� ��I_,E#i�... ���=11.t'"—�t.�i5 r:�_���� _ ����`����...�J�.7 ����1�:j�..�� . REMARKS: FEE SUMMARY: �i�1L_t)�,j T�=3�r( �.�,; [�)i�i7 �'.�_� t=,�.� �1 Z'.� . z� �],c:!•:,-� �;H=1�'1 t,�f1 �?_' , `�F. ....- `�t.,l l'C�fc!i''-��' _i�=;_f_it j -------- j:��#..-�� �r+r-* '�1�_''� . .�.i CONTRACTOR: OWNER: — — — �-:�����, i r t{��t. — i=t°`,,s"�L,�'�_�::: ALLH�� :.L;�-.�. �:�'�'T'=��13F Fi�T I�E;�'!�!i'�ll_[ ��� !�s�_:�`Wi [:�f_`•_._�-�F-,�_`�_: --- -- —� ?�ii;- I_t� ;_ -;T i i� �. .. i.i? � . - �' .r'� _ , __�.i i ..�t,.��� <:.{_�_,', 7 k,i;:_;��,-#: �.�.•I`:;,- i:lii_�'_ �.�:��=.D i�-i��.:�����f' F;�'.: J;�:.=,�i°� �';���?�.=;."_; � i��;�� i t ��"i.•::�= . . .__ € �'=�i__ _. . . ... �r,•�;_.�.; _ ^:�'SY '���!,�i) �',. i i!i� '��:-: ; [� i 7E_I i�:i (,,,, _E . +� - -r�,i r ` — _;.' _; ��:ii.. i.i a :',�'( �: I j�`� 1.6�- '_. 4.._. _. . �;. 'C. t ��, i.����k` r r•� ! < <::. _::f f-f i�_.7 F..��..i-� �:�f=-� ;. _. . L I^tt�i i��;��! !i?Z'�'�1`af-ii`�'•:C��_� f��'��J �_����� �f�" ����'?��I°i.".:—:!„�.?�;'=3,_ I—�_ �_;;j i�y�.j !_-i_1l�:�� ,�#,�-t•?i_��(�;�s"Ii=��#`: . � _ f � APPLIC PEFiMITEE SIGNATU I ISSUED BY'SIGNATURE '�'`'��L... Total Fee: $ /�=�� .,� ' DateReceived: �- /�- `I G� Date Approved: Entered By: � '�' Permit#: q,���.� �, CITY OF ORONO - BLTILDING P RNIIT APPLICATION ALL INFORMATION MUST BE SUBMITTED IN L BEFORE PLAI�t REVIEW WILL BESTARTED ---------------------------------------------------------- -- ------------------------------------------------- THE APPLICAI�tT IS: (circle one) OV�JN� R CONTRACTO J , w�a,�le, �4 � v� , Yv��n . JOB SITE ADDRESS: �� S .r-� a S � e. � Z�: � 5 <3 S 9 N�iE OF OWNER: ��Ica * ;�.� �e e PHONE: (home) 5 L/D ' 3� �� (work) ^ MAILINGADDRESS: � b o U CITY: ZIP: CONTRACTOR: a e s' PHONE: �I MOB PHONE/PAGER: MAILINGADDRESS: ��-/-�-��' �� CITY: �ZIP.__ ._�7 STATE LICENSE: # I����� ARC NGINEER: �� iVIAILI�iG ADDRE : ('T�`'� ZIP: ����. �ION # � ��r �� TYPE OF WORK: N� L �c' � �;-�� sory Structure Move \ Lar�d Alteration — ,, , � PROPOSED WORK(desc � „�� j ��° 1 1 �� '� i STORIES: � NO. OF BED OMS: '� U -�� DET. � ��� � ' � �' 3 5 ESTIMATED CONSTRUCTIC � I hereby apply for a building perr, I� _��nation above is complete and accurate; that the work will b� ., �rdinances and codes of the Ciry and with the State Building Code; ti j s is not a permit and work is not to start without a permit; and that the work , �n accor ance with the approved plan. APPLICANT'S SIGNATURE: ,7`au.R�� o��. DAT'E: �D ' 91' NOTE! Parade of Homes events require separate p rnzit approval by Police Department and City Council 60 days prior to the event. Non perm tted events will not be allowed. 9 "'�� � � � i _ _O ,�. ' �' O 0 CI Y of ORONO ,� `: ' =z�� � �z„►���►otr� ': ;-"s �, c� Post Offx�e Box 66 �� ��'�� "- . �'.�r �'~ CC�'StBI BHV��'11IlIlfSOt3�J3Z3�6 i , ... ��kESH�4� DATA PRIVACY VISORY In accordance with M.S. li.04, Subd. 2, "Ria ts of subjects of data", we would like to inform you that your request for a permit or licens from the Ciry of Orono or any of its departments may require you to furnish certain priva or confidential information. You are notified that: 1. The information you furnish will be us d to determine your qualification for the permit or license requested. 2. You may refuse to supply data, b�pt re sal may require that the City deny the pernit or license. 3. The information may be shared with o er local, state or federal a�encies to the extent necessary t� process the permit r license. =�. If your requested permit or license r quires Council action to approve, some information may become public. �. You have certain ri�hts under M.S. 13 04 (see followina paQe) to review private data on vourseli. (,. Your full name is required to process is application or permit. PLE?,SE PRP�'T Sh �'wl M �eha. ��� First Nliddle Last IS' s +� s•� � �. Address j 1e. ' �� `� - �5 � - o � Ciry State Zip Phone I understand my riahts as stated above. I � Sianature v TELEPHO!VE-473-7357• F. t-a73-0510 10 • �' Sec.13.04 RIGHTS OF SLBJECTS OF DAT� Subdivision 1. Type of data. The rights of individual 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 shall be informed of: (a) the purpose and intended use of the requested data within the collecting state agency, 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 other persons or entities authorized by state or federal law to receive the data. This 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. The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or pro�erty tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the subject of stored data on individuals, and whether it is classified as public, private or confidential. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning, the data need not be disclosed to hun for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making, certifying, and compiling the 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, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, excluding Saturdays, 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 private data concerning himself. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a) correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data, including recipients named by the individual; or (b) notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is 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. 11 . A CHECK OFF LIST FOR ISSU 'CE OF PERI�IITS � FOR OFFICE USE NLY �DDRESS OR LEG�L: �//�'S� t1n • � � PID: C�(� -��7 ' �3 1� � c� �Z DESCRIPTION OF �VORK: �-�-� — C"-G ------------------------- Z0�1ING REVIE`V BY: ;, . �%�..�.,-� DATE APPROVED: � -i y `t� BUILDING REVIE�V BY: �,,L_.� DATE APPROVED: � - r K -G c. --------------------------- FEES TO BE CHARGED: Mi c. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes ✓ No SEWER CONNECTION STATE SURCHARGE Yes .�� No WATER CONNECITON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITE INSPECTION Number of SAC Units OTHER (specify) -------------------------------------------------------------------- ------------------------------------------- ZONI'i�1G CHECK LIST Zoning District: r�`-i� Shoreland District : �i�5 /Fire Department: Post Office: School District: �� < t.� \�\Lot Area: Sq.ft. Acres Wid Depth Survev Submitted: Yes v� No Dat of Survey: oN c"� �. Proposed Setbacks: �ent (Lake): �-{c;K�� ;' Right Side: ( I U � � -�eat (Street): �1�� , i" Left Side: 1 `10 Adjacent Structures: �U � '}' Wetland: I-� �� Building Height: Def. Hgt. Peak Hgt. Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' �00-1000' n' ��L , 1" i�' � Hardcover Variance Required: Yes No Da[ of Council Approval: �� B Council A roval Date: � Grading: Staff Approval Date: Y� PP ISeptic: Staff Approval Date: BY� � Zoning File: # Resolution: �# Resolution Date: \. REMARKS (in house): 26 . � BLILDLtiG REVIE�`' CHECK LIST �TgC; �/`� ��" CONSTRUCTION TYPE: lrL�I� Sq Footage � Per Sq Ftg Basement X = lst Floor x — 2nd Floor X — Garage x — x = TOTAL � Estimated Construction Value: $ /o �W Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection p�Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) a'�Final Grading/Fiiling 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 A handsome, yet rugged, design ca��able of turning a y b<<cI���ard into an overnightsuccess. Treat your family and friends t� . . . I I �,t � : -t: . � a , ,��r � ,�,�. �r,'3. k'^�"�,,. 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' r � i�c�''� " l(�'� -+ � ;Iti�6� �V �r 7 at'�., S,�' �d �,�p f, �; ,a 5 {1 t� �-'x i .� �,�y � r � �4 (� ��.w � i `����t��u�'�t,��.l:'��L$.�:,'�iLY�"�R�(�.!���Cs't�s?�if�,aa..��s�b't�l,.*.rit ..;"l.:r���'�da>"�. :.', '� ��,'.�!„��o-+.1.!'l�ei�r3't _ - o�, "the original po�table pool" c t°�o"d �4�N�°�o Y,j��`A j� � �'F P{o4 a�h� � � � � V � � � �i