HomeMy WebLinkAbout1996-008526 (garage addition) � PERMIT
CITY OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 �;;_;� ;, ;;���i=_;
Crystal Bay, Minnesota 55323
Permit Number: ,.�,._;�,,.�.�,;^,' �-
(612) 473-7357 Date Issued: - . �. -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: -� :;�:.�.�, i.��;.�;�:. --
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APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ ����� E���� Date Received: l�� '-� `! '� l��
Entered By: ;1�- Permit#: �:; ��
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle on OWNER R CONTRACTOR
JOB SITE ADDRESS: �LZ � C��SC� C l �C-C._��� ZIP: � S .3��I
7►9�io � Tc-:Nn�� F�2
NAME OF OWNER: �j�L/��C��1-� PHONE: (home) " �� g��Z
(work)
MAILING ADDRESS: 3�Z2 j C�SC,�� CITY: ��c�, �.c� ��� ZIP: - ✓ � `)
CONTRACTOR: � PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: 2E`�` ��+c.���.,_.l�k PHONE: `�},��l" � ��f1
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition V Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: C�C� ��' x �-� �L '�X S 1 S [�i✓�� '
- c�.rc:�^
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �'.�C��
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:�.._� � - —'– DAT'E: \l� Z`� �1.�
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
� 1
Sec.13.04 RIGH'I'S OF SLJB.TECTS 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 forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal data conceming himself shall
be informed of: (a)the purpose and intended use of che requesced data wichin the collecting'state agency, polidcal subdivision,or stacewide system;
(b)whether he may refuse or is le¢ally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
privace or co�denrial data;and(d)the identiry of other penons or entiries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked[o supply invesrigadve data, punuant to secrion 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,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 subjecc
of stored private or public data on individuals shall be shown the data without any charge to hun 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, che data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this secaon is pending or addidonal data on the individual has been collected or creaced.
The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual cosu of making, certifying, and compiling the copies.
The responsible authority shall comply immediacely, 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[ime,he shall so inform the individual,and may have an addidonal 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 concerrung himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shafl within 30 days either. (a)correc[the data found to be inaccura[e or incomptete and attempt to nodfy past recipien[s of
inaccurate or incomplete data, including 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 disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 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 pemut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have cenain 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.
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First Middle Las[
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C��, Stare Zip Phone
I understand my rights as stated above.
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Signa[ure
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR QFFICE USF� QNLY
ADDRESS OR LEGAL: �°; � >-',:'� % '��'._`,�� �_.. C--
PID:
DESCRIPTION OF WORK: �� �-���f���-�-�, �-/,�� ��:� �� ��<<���
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ZONING REVIEV�J BY: •� � ri �,,, DAT'E APPROVED: �`�� t � - '7�
BUILDING REVILW BY: b v� DATE APPROVED: c c� -�� -`��
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 � SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: �.,2 -I L
Fire Department: r`i�Cv��•'� Post Offce: v.;rqi�Zq�T`�! School District: wc�s7Z�K=¢
Lot Area: Sq.ft. IL`c9 �_E�l�r��f'Acres -- Width - - Depth —
.
Survey Submitted: Yes � No Date of Survey: 7 -2� `�S
Proposed Setbacks:
€�'ront (Lake): ?Z � � �' Right Side: / 2-? � �
-�ar (Street): 3v + Left Side: �1 �-� �
Adjacent Structures: i{V` Wetland: /t1 /f}
Building Height: Def. Hgt. �_>, �� Peak Hgt. 0 (�
Lot Coverage: /�; �,/1-
Grading: Staff Approval Date: /� ( ,/� By: - Council Approval Date: —
Septic: Staff Approval Date: �t; (� By: -
Zoning File: # � ��O Resolution: # �, 7�J� Resolution Date:
Shoreland District: 7��;
Avg. Setback: N t r� Bluff Setback: a.� 1/}
Existing Proposed
Hardcover: 0-75'
75-250' �
250-500'
5�-1000'
Hardcover Variance Reouired: Yes No oC Date of Council Approval:
REMARKS (in house):
10
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BUII.DING REVIEW CI3ECK LIST
UBC: ()—l CONSTRUCT'ION TYPE: V�L�
Sq Foota�e S Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
.,�.�
Estimated Construction Value: $ 7��%�% ��
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hardcover Removal Mechanical Water Connection
,X Footing Septic Sewer Connection
,�C Framing Fireplace Lawn Imgation
Insulation (Masonry) Other
Wall Board (Mfg.) We11 (State Pemut)
,�-Final Gradin�/Filling i�Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REVIARKS (TO BE NOTED ON PERi'�IIT):
\
27 �
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All that part of Lot 28 , Spring Park , lying westerly of a line described
as follows : Commencing at a point on the northerly line of said Lot 28 , •
_____ distant. �+ 5 - 5 feet seuthwesterly, measured alor.g said northe:•ly line from
the northeasterly corner of said Lot 28 which corner is marked by a
�udicial landmark ; thence southerly along a straight line to the shore of
Lake Minnetonka, said straight line passing through a point , marked by a
�judicial landmark , which is 9 feet westerly , measured at right angles ,
with the easterly line of said Lot 28 , from a point in said easterly line
of said Lot 28 , distant 262 . 5 feet southerly from the northeasterly cor-
ner of said Lot 28 ; also all of Lots 29 arid 30, together with and includ-
ing that part of Lake Shore Avenue , vacated , lying in said Lots 29 and 30
and in that part of said Lot 28 hereinbefore described , all in Spring
Park , ,according to the plat thereof on file and of record in the office
of the Register of Deeds in and for Hennepin County, Minnesota , and the
Northwesterly corner of Lot 30 having been marked with a judicial land
• mark, and a further ,judicial land mark having been located on the west-
erly line of Lot 30 at a point which is 249 . 2 feet southerly from the
northwesterly corner thereof .
I hereby certffy that thls plan, survey or report was JOB# ��v�.
SCH�BQRQ prepared by me or under my direct supervisfon and that i am �,SLS-G
N D SU RVEYI NG a duly Registered Land Surveyor under the laws of the State
'NC of Minnesot . Bqok - Pag� ��jrZ��/���"�
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R'•'�BO120° Date: �cc. L y 2f� /9� Registration No. 14700 � �!3Q �
9�2-�221 Dsl�no.MN 55329