HomeMy WebLinkAbout1996-007944 - attached garage PERMIT
CITY OF ORONO PERMIT TYPE:
2750 K��' ' vay- P.O. Box 66 �:�!T#�.i}j,}�.;;:
Permit Number:
Crystal '� �sota 55323 ���_�:'`�r%�-
Date Issued:
(612) 4�; t�i�i�,:�:;f';r=',
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- �.��.:r,� ���t,-�t. —
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
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Total Fee: � ���' ,�- DateReceived:
, Date Approved:
Entered By: �,L�if,l Permit#: •�9 4i[f
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
ALL INFORMATION viUST BE SUBv1ITTED IN FULL BEFORE PLAI�i REVIEW WII.L
BE STARTED
THE APPLICAi�1T IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: ��G' ,� ��ro-�crn, �d /�' Zg': �-�y'`��J�
NA�v1E OF OWNER:���c�c,�� ��e�� �1 r�L�-us�Z PHONE: (home) �`1(p —D S 7�
(work) �7� -� 7 3 S `7
v1AILING ADDRESS: �S' y�y� � CITY: ZIP:
CONTRACTOR: PHONE:
vIOBILE PHO�TE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PH0�1E:
MAII.Ti�1GADDRESS: CITY: ZIP:
N�y�; REGISTTtATION #
TYPE OF WORK: New Addition ✓ Accessory Structure
Move Remodel/Alteration Lar�Alterarion
PROPOSED WORK(describe indetail): �iC �� a � ���� ,�,��
i 2� -�� � �� / _ i� s5 O
STORIES: I SQ. FEET OF EACH FLOOR: � J�a.S �
NO. OF BEDROOVIS: GARAGE STALLS: ATT. � DET.
OU
ESTIMATED CONSTRUCTION VALUATION(escluding land): $ !1, ��D
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: � (X r � DATE: �� — 7 �" cl�
NOTE! Parade of Homes events uire separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGH'I'S OF SUBJECTS OF DATA
Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set fonh in this secrion.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecdng'stace agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to suppiy the requested data;(c)any Imown consequence arising from his supplying or refusing to supply
priva[e or co�denaal data;and(d)the identiry of other penons or entiries auchorized by state or federal law to receive the data. This requirement shall
not appty when an individual is asked to supply invesrigarive data, pursuant ro secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertv tax refund
insrrucrions 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 ic is classified as public, private or confidential. Upon his fur[her request,an individual who is the subjecc
of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he desires, shall be informed of the conrent
and meaning of that data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed[o him for
six months thereafter unless a dispute or action pursuant to this sec[ion is pending or addi[ional 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 che data. The responsible authoriry
may require the requesang person to pay the actual costs of making, cerrifying, and compiling the copies.
The responsible authoriry 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 no[possible. If he cannot comply with the reques[
within that tune,he shall so inform the individual,and may have an addiaonal five days wi[hin which to comply with the request,excluding Saturdays,
Sundays and(egal 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 individuai shall notify in wriang the responsible authoriry describing the nature of the disagreemen[.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienrs of
inaccurate or incomplete data, inciuding recipients named by the individual; or(b) nocify 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 disciosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to
contested cases.
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 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 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 pernut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pemut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
S. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
���n, a Y7` � ��j-u S �
First ,� p�iddle Last
��D GCl ,r� �n� I'L c� /�
Address
L,�T [�. ,�-e ss 3 - 7�-
C�h, State Z�p Phone
I understand my rights as stated above.
Signatur
CHECK OFF LIST FOR ISSUAi�iCE OF PERMITS
' ' FOR OFFICE USE ONLY
�iDDRESS OR LEGAL:
PID:
DESCRIPTION OF WORK:
-----------------------------
ZONING REVIEW BY: �� ?>� �>� DATE APPROVED: � —
BUII,DING REVIEW BY: DATE APPROVED: -�r"
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATIIt CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECI'ION
Number of SAC Units OTHER (specify)
----------------------------- — — -----------,-------
ZOivING CHECK LIST Zoning District: �—' Shoreland District :
Fire Department: �- ' (.t�f--�- Post Office: (.L�IG�' School District: �:� / ?�1�r''�
, / /
LotArea: Sq.ft. I�v ? F�Acres � Width r'�✓�", �`� Depth ;31�
Survey Submitted: Yes l� No Date of Survey: .�"v���1�
Proposed Setbacks: L�"'� � � /
Front-��):l ` !� Right Side:
.`�l;��'�'�; � �
Rear (� ��� Left Side: �
.� /
Adj acent Structures:,��ra�'�� � Wetland:
f .j �--- /
Building Height: Def. Hgt. 1� Peak Hgt. I,%
Av;. Setback:
����� Bluff Setback: �� " Lot Coverage: ���
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No d Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: # Resolution: �# Resolution Date:
�tF.MARKS (in house):
BUII.DING REVIEW CF�ECK LIST
UBC: r/� — q� CONSTRUCTION TYPE: ��
Sq Foota�e � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gara�e x =
x =
TOTAL �
Estimated Construction Value: $ ���
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_� Footing Septic Sewer Connection
_� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_� Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
RENIARKS(TO BE NOTED ON PERMIT):
27 �
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01-4
ORONO COPY
CITY OF ORONO
SITE PLAN _GRADING PLAN
❑APPROVED
❑ APPROVE WITH REVISIONS
❑ DIS R�
BY
DATE e
pvA%%4..lNk Foe
1LAk' { I,=% A" fcv or
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DRAWN BY
REVISED
MAWING NUMBER
PAG, lr' 1 cyp