HomeMy WebLinkAbout1991-004109 - remodel basement/gar PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O �:��< <7E: Permit Number: �'�'.;��'t�`'u`�
Crystal Bay, Minnesota 5532� ; � `'�`�`+1�_'�:
(612) 473-7357 Date Issued: -,:, - .
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: ----� �=;�:��:.1 i ��,a�t. -- OWNER: r�; rL�r �f� ��
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE �t'�v�r'
CITY OF ORONd - BDIZDING PERMIT APPLICATION
I`otal �'ee : ��/^. j� Date Keceived: / � -/ (����- ��
r ' ,.-�- a- -�
LJdI.0 HUULUVCCI:
Entered By: .��v �
Permit#: �/(��
AT•T• INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN REVIgW WILL B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLIGANT IS: (circle one) OWNER or CONTRACTOR
JOB SIT$ ADDRESS: � �g' �I �dS«� �i�`� � �d ZIP:
(work)
NAMl? OF OWNER: �� (,��' � PHONE: (h ome) `/7%-�1?'z�?
MAILING ADDRESS: Z��i G4.S'Gc� �;n7` � CITY: �j�"L�/ji� ZIP:
CONTRACTOR: C��r�I�rlC��v' /���/�r ����s'��+•�c�lo'�� PHONE: `��d '-�%S `/S�
i�IAILING ADDRESS : ��j � S /--�cIY'�jj%�r� CITY: S�tC/�c' c�t.�4.��eE ZIP: `�5�.]�
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration
� N
PROPOSED WORR (describe in detail) �1,L��1,��,it�rrc�'rc�� �z-��.� �c�r�.��Y-ctl ,, .a�. i
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..�a ��e�i �y�e� .�.�.e�C�i,c'� a.;�..�� ;���� �d� �ccz�`�rY� �:,.� �,c�.h.�.t�t�
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STORIES: � SQ. FEET OF EACH FLOOR: /�f)K-} _
1�I0. OF BEDROOMS:�� GARAGE STAI.LS: ATT. DET.
ESTIMATED CONSTRUCTION VALIIATION (egcluding land) : $ �� �, �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 acco�dance wi the approved plan.
APPLICANT'S SIGNATURE: �z{."`. DATE: J°�6�I�
r.rrr��+v nDa T TCT pnD TCCTTA1�7f`7.� I'l1� DT?AYyTC
<,.IIb\.i� Vl 1' L1J1 1 Vi� ivvv�u��a.' vt
FOR OFFICE USE ONLY
,
ADDRESS OR LEGAL: � I� �l �uSco ��� l<<� • PID: �G -//"�J � � 3 3/ - oa ;"�
n�crvrvm�nu n� WQR�� /[�rl u�-��
�,..,.......«
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ZONING REVIEW BY: ►�I�/� DATE APPROVED:
BQILDING REVIEW BY: �yJ� � DATE APPROVED: �2- I �-�t(
FEES TO BE CHARGSD: 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)
------------------------------------------------------------------------------
ZONING CHECR LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: idth: Dept
Survey Submitted: Yes No Date f S rvey:
Proposed Setbacks :
Front (Lake ) : Rig S de:
�
Rear ( Street) : Le ' de:
�
Adjacent Struc ures : ��7eiland
�
Building Height: ef. Hg . Peak gt.
Avg. Setback: Lo Coverage:
Exist 'ng Proposed
;°
Hardcover: 0-75:�
J
75-2 0 '
;
250- 00 ' �
j � /
500�000 ' f
1
Hardcover bariance Requ ' ed: �� Yes� No Dat of Council Approval:
Grading: Staff Approva Dat�: By: Council Approval Date:
Septic: /Staff Approval Dat�: By:
,� I
Zoning File: # ,�tesolution # : Resolution Date:
;
�
REMARKS (in house) : �
$�]�T_1�TNC_ RFVTFW _ T�.F.� T.T�T
I7B�: S£� (�-3 CON�TRII�TIOI� �'XPE 3 Y�
Sq Footage $ Per Sq Ftg
'�accmcn� Y =
1 g+r F 1�pr X =
2nd Floor x =
Garage X -
x =
TOTAL
Estimated Construction Value: $ I�,Oo�°—`'
Inspections Required: Work Requiring Separate Permits:
Site p( Plumbing Grading/Filling
X Footing pCMechanical Fire
X Framing Septic Water Connection
_�Insulation Fireplace Sewer Connection
_�Wall Board (Masonry) Other
_�( Final (Mfg. ) Well State Permit
Other �Electrical (State Permit)
R$MARRS (IN HOOSE) :
-------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approvai: Date By�
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R$MARRS (TO B$ NOTSD ON PERMIT) :
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���-����� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
���
�w� g � . _,
'� � ���ll� ��� 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
Iicense 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 Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or 3icense.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Council. action
to approve, some inf ormation may become public.
5. You have certain rights under M:S. 13.04 to review pri�a��
data on gourself.
6. Your full na:^.e is r�quired to process this apF.IicaLion or
permit.
r�.S r ��!' r� ��:� �
rirs� idu�e Last
�C 5�5 ��tr•d��<<ti ��� -
Address
�r/"��r'c�� �`'U C� f�?•� �S�,�/
City State Zip
�/,,;lU - o��-y�I
Phone
I understand my rights as stated above.
�
� `
Signatur
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
. �
t13,44 RIGHTS OF SIIB�`�t%"i� �r i�tsT'n
Subdivision L Type of dat�- The rights e ti di�iduels on whom the data is
stored or to be stored shell be as set forth in thLs S An.individu8l asked to
Subd. 2. Information required
to be given indivi�uaL
su 1 rivate or confidentisl data concernina �gm� t�n the collecti g state agen Y�
PP Y P uested
purpose and intended use of the re4 tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide syS known consequence arising from his
required to supply the requested dat8; (c) any
1 in or refusing to supply private or confidederal lawgto receive the data.1tThis_
supp Y g state or f investi ative data,
other persons or entities authorized by
requirement shall not apply when en individual is esked to supply g
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace the notice re uired under this
subdivision in the individu8l income tax or ro erty tax re und instructions instead o
on those orms. � -— � .
Subd. 3. Access
to data by in���- UPon request to a responsible
authorit , an individual shall be informed whe b�c h r vateeor confidential..e Upon his
y p i f i e d a s p � P u b l i c d a t a o n
individuals, and w he t h..r i t i s c l e s s
�ta without az�y charge to him and, if he desires, shall
further request, an individuh who is the subject of stored priva te a r
individuels shall be shown t of that data• After an individual hes been
�e informed of the content and meaning the data need not be �isclosed t�
shown the private data and informed of its meaning, uMuant to this section is
him for six months thereafter unless a dispute or action p
rivate or pubiic data upan request by
endin or additional data �n the individusl hes been collected or created. h�
� P g• rovide copies of the p require the
responsible authority shall p P o�ible authority may
the individual subje�t °�the actuel.cos h of making, certifying, and c�mpiling the
requesting person to pay -
copies. y if ssible, with any requesL
1i1z «sror,sible euthority shaIl comQly immediatel , Pa
made u.*suant to this subdivision, or within five days of the dat2 af thP request,
� SundaS� and legal holideys, if immediate compliance is not
excluding Saturdays, �,,�ith the request within that time, he shall s i in�or h the
possible. If he cannot comply within which to comp y
individuel, and may have an additio� le ��o��.
request, excluding Saturdays, SundaYS g
Subd. 4. Proced�e �►hen data is not accurate or complete. An individual may
ublic or private data concerning himself. To
contest the accuraey or completeness ef P in writing the responsible authority
exercise this right, an individuel shall notify
describing the nature of the disagreement.
The responsible authority shall within 30
da either: (a) correct the data found to be i ete datae including ree�Pi�� namedt by
�
notify pest recipients of inaccurate or incompl
the individual; or (b) notify the individual t�'v dual's�state entof disgg�'eementcis
if the m
Data in dispute shall be disclosed only �u�t to the
• included with the disclosed data• �ible authority may be aPPeeled p
� The determination of the respo to contested cases.
provisions of the administrative procedure act relating
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