HomeMy WebLinkAbout1994-006545 (building-shed) � PERMIT
CITY OF ORONO � � �
2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: -.
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Permit Number: ;;:��_:,,
Crystal Bay, Minnesota 55323 ;'�`; _..
(612) 473-7357 Date Issued: ;..,;,:�:.._,,-;;����;�,
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CONTRACTOR: O_W N��` �R: "" � � �- �� '-'�=�'"- y"
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APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
CITY OF ORONO - BUI.T��DING PERMIT APPLICATION
Total Fee: $ ������ Date Received:
Date Approved:
Entered By:��l� u. (���5`�
Permit tt.
AT•T• INgpRMATION MUST BE SIIBMITTED IN FIILL BEFORE PLAN RE�7IEW WILZ B$ STARTED
(See Check-off List Enclosed)
---------------------------------
TgE APPLICANT ISc (circle one) ��`..�.'�` or CONTRACTOR
JOB SITE ADDRSSS: -3� � C�I-S � l� V� ZIP'
(work) ��t� ,���' �
NAME OF OWNER: ���F3�111 �'� ��� PHONE: (home) `�1� ���C�'�
MATLZNc �nx�ss: �75�.� �.�a�t��. ,� �� cz�: ��� --� Z��1��`�� zzP: 5>�>`I/
CONTRACTOR: '��; ��, PHONE:
1KAILING ADDRESS: CITY: ZIP:
STATE I,ICENSE: #
ARCHITECT/ENGINEER: P$���
MAILING ADDRESS: CITY: ZIP:
N�: REGISTRATION tt
f�Y, .� ��y�.t..� �
TYPE OF WORR: New� Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : �'������� � �� ' ��C' � K ' � �` � � z r t�
STORIES: SQ. FEET OF EACH FLOOR=
NO. OF BEDROOMS: GARAGE STAI�LS: ATT. DET.
,.
C �_
ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ � L L •
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 wil.l be in accordance with the approved plan. �
� /�_ .
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APPLICANT'S SIGNATORE: '� � ��� i'� ���-'''-� __. DATEs ({,' I����"�
Y �
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-�;�. CITY of ORON�
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� . � � 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:
l. 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 ot=OCe scthe permit or
federal agencies to the extent necessary to p
Iicense.
4. If your requested permit or Iicense requires Councii ac�ior.
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 proc�ss this application or
permit.
First
Middle Last
Address
City
State Zip
Phone
I understand my rights as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS—473-7359
ASSESSING
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOK OFFICE USE ONLY
ADDRESS OR LEGAI,: �-5� G��� �'� PID'
DESCRIPTION OF WORR: -�-� -�
--------------------- ----------------------
ZONING REVIEW BY: DATE APPROVED: /O - �°!� �y
BIIILDING REVIEW BY- DATE APPROVED: !U-l�l- �1�
----------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes�� No SEWER CONNECTION
STATE SURCHARGE Yes-� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER ( specify)
--------------------------------
------------------.----� iL
ZONING CHECR LIST Zoning District L
Fire Department: P st Offi c o strict:
�
Lot Area: ' th: ep h
Survey Submitted: Yes No�. Date of Survey:
v::�/� �.X�rt��-v
Proposed Setbacks:
Front (Lake) : Right Side:
Rear ( Street) : S� Left Side: � 0 '
Adjacent Structures: 2jU� + Wetland: /��►�
Bui�ding Height: Def . Hgt. � , � _ Peak Hgt.
Avg. Setback: �/1��� Lot Coverage:
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 ' � ' ��
Hardcover Variance Required : Yes No� Date of Counci� Approval:
Grading: Staff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: y;x
Zoning Fil.e: # Res 1 tio # : Resolution Date :
REMARRS (in house) :
BUILDING REVIEW CHECR LIST �► .
IIgC- � �jl/( — � CONSTRIICTION TYPE: `�1'`�
Sq Footage $ Per Sq Ftg
Basement X -
lst Floor X -
2nd Floor x -
Garage X -
x =
TOTAL
�
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Bstimated Construction Va�ue: $ ��`�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/FiJ.�ing
Footing Mechanical Fire
Framing Septic Water Connection
Insulation Firepl.ace Sewer Connection
WaJ�� Board (Masonry) Lawn Irrigation
�Final (Mfg.) Other
Other Wel 1 (State Permit)
E�ectrical (State Permit)
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REMARRS (IN HOIISE) :
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
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REMARRS (TO BE NOTED ON PERMIT) :
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