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Home My WebLink About1995-007063 - land alteration , PERMIT Ci•TY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 - -;_ Crystal Bay, Minnesota 55323 Permit Number: _ ; (612) 473-7357 Date Issued: - _ ` - SITE ADDRESS: DESCRIPTION: ;;:;�r �;� �1��t�d� -�rt.{�rr•c r�t r�•r i 1 tni �.� w � .t t,.L 9?i'i't;�%t�i �i iJ1JJ V :;� i rr�r �� n v �., .; , a ui��', T"��q.p� �t,ta.j L� i�ii.��ifli"T'e IWe�lFtiq i,ir+i! r�i.'�,i�l%�rir ��v.� a�iTi !{r!u%s:� r : _ ir�a�}i�i,.�rf vJ REMARKS: FEE SUMMARY: , CONTRACTOR: OWNER: -� - _ -:�• - . . ___... . _ _, .�� ;� --.. : - f_. �_. "�j=i �.:fi=. . ._ _ � .. . � _ `� . _, . _ , ; ,_ � E z _ : . f= � � • r . : :_._ _ •: � _. . ._.. _. �._.... . . .�.____ . .,w _:_ ___. . _ .... .. . . _ _. .. _ . .� . ,. .. ... . . .._ . .... . _ _ .. . . .. . _�. .... . _ :z _ . - - .. . , _ � - �. : :- -- � i F t t. � . . ;- . , t :i � .^ " IA f� I . r� � _:�.._. . . ... . .__. ._ _ . . .._ __. .� .::__: .. . .. .� - — _. _. .._ _ _ .. _ ..... . _, ._, . . . . ._ . � / � ' 1 � � � � APP�ICANT;PERMITEE SIGNATURE ISSUED BY:SIGNATURE � CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ Date Received: Date Approved: Entered By: Permittt: AT•T• INFORMATION MIIST BS S�M he�offFList$En�Cl�ose� �vl� �� BE STARTED -------------------- � --------------------------------------- THE APPLICANT ZS: ( circle one) O�dNER r CONTRACTOR JOB SITE ADDRBSS: Z �0� ��tS�o �� ZIP: S S 3 / � CJ�2,�work) �4� ` � / 'Z / NAME OF OWNER� D ..JQ-1 I PHONE: (hame) �7 I � � � 7 � MATI,ING ADDRESS: Z $V� C-ctSw �'� � CITY: W 0. � ZIP: SJr 3 /� ( 7 CONTRACTOR: �O � l l S�S PHONE: • MAIIrING ADDRESS: CITY: ZIP: STATE LICENSE: � ARCHITECT/ENGINEER: pH�� MAILING ADDRESS: CITYt ZIPs NAME: REGISTRATION n TYPE OF WORR: New Addition Accessory Structure Niove Demo Remodel/Alteration Renovate Land Alteration_� ►^� a.�'I�-e-H o--�-� lo w ea S d�� PROPOSED WORR (describe in detail) : �" � �ad� �. � �� ro x 4 U d s -�-o `�-a.Q �e - sac� . STORIES: SQ. FEET OF EACH FLOORs NO. OF BEDROOMS: GAR.AGE STALLS: ATT. DET. ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the wor}c will be in conformance W1thathe ordinances and codes of the City and with the State Building Code; 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 SIGNATDRE: �' , DATE: �o �� I `S K µ4 A,.- i��-�" r�•: -�. �";� ..uy �;�.� � �i��Y O� ��N� r� � '' �''� ` �'�"f� �.,�5.��'z4 T,i::F`�;.. :=E•i -� . Minnesota 55323•Municipal Offices Post Office Box 66 Crystal Bay, � � _ o � On the North Shore of Lake Minnetonka DATA PRIVACY A�VISORY In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of data" , we would Iike to inform you that your request for a permit or Iicense from the City of Orono r conf dent al e nf rmationmay equire you to furnish certain private o You are notified that: l. The information you furnish will be used to determine your qualification for the permit or Iicense requested. 2. You may refuse to suppl.y data, but refusal may require that the City deny the permit or license. 3. The information he extenthnecessaryhtotprocesscthe permit °r federal agencies to t license. 4, If your requested permit or I.icense requires Councis a��'-or to aporove, 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. ScM � `� �� I � �� Middl.e Last First ,� � � C 7 �-s �� 1 � �� - - Address � _ C�� ct �1. � � ,� � ^ State Zip City � 7 �- � 77 � Phone I understand my ,rights as stated above. / � � ; �z_ � �%��. � Signat e � i BUILDING&ZONING—4�3-�357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC�'ORKS —473-7359 ASSESSIY G CHECR OFF LIST FOR ISSUANCE OF PERMITS . � FOR OFFICE USE ONLY ADDRESS OR LEGAL: �-�"�, 1 ��.�t-�' r �' 1'�'�^ PID: D$SCRIPTION OF WORR: y� ��"�Tr-'��- �" �'`�j ----------- ----------- ,-- _ .-- ZONING REVIEW BY: �-� �ia��•�-- _ DAT`E APPROVED: �.. ..��_._��.�- ' ' DATS APPROVED: ' 'a BIIILDING REVIEW BY: /L' � � _ _ _ ----------- ---------------------- ---------------- FEES TO BE CHARGE�' Misc. Fees Calculated By: � _ �u4rvr:% Y�-�,_t"`'g�rT2-,;..> PERMIT Yes �'- ` No PLAN REVIEW Yes No SEWER CONNECTION No WATER CONNECTION STATE SURCHARGE `�eS No pp,RK FEE INVESTIGATION FEE Yes SITE INSPECTION SAC Yes No OTHER ( specify) Number of SAC Units __�--------------------- -------------- --------------------- � ZONING CHECR LIST Zoning ;District: I Fire Department: Post Office• ' Schoo�. District: I � Lot Area: Width: Depth: i ' Survey Submit � ed: Yes No Date o� Survey: ; r Proposed Set ack : Right;' Side: Front ( ake)��: � 1 j� ' '� Left/� Side: Rear (S�treet� : ' I ; Adjace t Str�ctures: r Wetland: � , � Peak Hg�. ': Building He;ight: �ef . Hgt. �' � Lot '��overage: Avg. Setba�k: � proposed , Existing i ,' I , Hardcover:' 0-75 ' I '` ! �� ; �5-250 ' 1 2�0-500 ' t 4 50�-1000 ' ' � ' Date of Counc�.l Approval : Hardcover� Variance Re`quired: Y�s No 1 � �� Council A�prova� Date : Grading: 'Staff Approval Date : � BY= Septi c: S!taf f Approval Date: By� Zoning File: � _ Resolution # • Resolution Date:_�_ gEMARRS (in house) : BIIILDING REVIEW CHECR LIST � '�, i . i' , • IIBC: %' CONSTRIICTION TYPE: Sq Foo�a�e $ Per Sq Ftg _ ' � _ ; Basement �_ _ � _. � _ . _x =; , � j . : - Ist Floor ; T— x � --� . . f __ -_ _ _ .__ _ - --: - 2nd Floor � x - .- ^ . . _ _. :_.-. Garage X = - - �- _ _.. � - .. - -- - -._ , _ ,� � . x - -------- � ; __.--.._. _ - f __� � �-�-- i � TOTAI, �' % � ; Ssti_mat�d Construction Value: $` Inspections Required: Work Requiring Separate Permits: Site Plumbing Grading/FiZJ.ing Footing Mechanica� Fire Framing Septic Water Connection Insulation Fireplace Sewer Connection Wa�l Board (Masonry) Lawn Irrigation �Final (Mfg.) Other Other Well (State Permit) Electrical (State Permit) ------------------------------------------------------------------------------ REMARRS (IN HOIISE) : ------------------------------------------------------------------------------ REVIEW BY OTHEF2S: DATE: Access: Existing New Access Approva�: Date By: ------------------------------------------------------------------------------ RFMARKS (TO BE NOTED ON PERMIT) : � 'S Gv �.�.. ... -i .. 20.0 � / 0 n o pE � K o f C!T OR4N0 5p,� � � oC SITE PLi;��E _o�___ r t=.hD!NG PLAN ' Q �, � � 1S� � APPROVED o ,� � � � 1 n APPR�JVED WITH Nc:'�i;� . � � � �` A � �$ , 't)ISA�P GVED �,� � '� � � � �`� � �� ___� --- �. ^' N � ° � o Q N D�J '� S � ---- �� 5 -� s ,------ t �� Q � �O� �� i � u� 1`�. N � y � �� /��° �° � w��'k�' � , � � � � m1 0 ` fi ; '` O � ��°�4, Z g 9 A ` � n; � \. � � r" ?a � Q v . �_—_�---�--__ I �'i�e I ��e _ \ Z •� � � � • - �� "- b . _ U � J � �'j •0 . ` �`-1--�. 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