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Home My WebLink About1998-010720 - land alteration . PERMIT CITY OF ORONO PERMIT TYPE: �-�� -. 2750 Kelley Parkway- P.O. Box 66 `-`�-`L-�`'_.�"=`� '��`-'` Crystal Bay, Minnesota 55323 Permit Number: _�i i�t i::�i� (612) 473-7357 Date Issued: ;;�=;;;;;;�:_:;; SITE ADDRESS: t;.��_ ��;�'{�°_;i��,` �{} .4:-s f`e�_ T'Y , :ySL�i � I�Y_,�_`�'Z 1f i_..s. DESCRIPTION: ;i•�;,-.}� �-`W�}�r�,i : I y�� ..�,�'',:�i ft�._ ! e:.i;'�=s�3'#_;�.E REMARKS: FEE SUMMARY: r�� #=�� ___.____ ��_`-' ='�'b�f 1',_,t..�l (=�� f;i �,_ti�i CONTRACTOR: OWNER: - �=:=��_�= =�=�}�;= �` i��;vi�:=�:;��1 .�I�� i�i�_� F.�=;`v'_;T!��=, h:!i 3 I;z';y�;{:_; i"��! =C_��'� —_..G� --� - ��4::��;_::'` C.��."[i i;-'-,"(' ;-`iv�i=- -:T E_3{:f i f_! �`!`-�`;,` -i�"S�= �.j''i� �E'?+'�`i-'�``'��'-�`:'; � 3_� v1. I' �'.��.' 1 i.�'�''..�$� . ..__. .._..f� �_ !-» . �'_ -{ .. _ f � .. i k { 3 � i i_.� 3 :F-., Z_{';', �.,.'.�, : . . t � I J �:L .... « _. �t't„� f-;�.fti t-lj±i'i__�= � �..f _ _. ?"!...?_ ',i't-{'.. . _. . .. . ... , _ • "__ .. .__, _. _ '. _ ._ . . _ . 1-4`�`i�Si`s— 1 f'�`�j�C, .,� :—., _ �f� E1! ' . _ 3_4S" �''��3`�i`,1!�_ _` � ;`� `.��_��!��`v.� _;;��i` �'i'.t-tt 1_E-�;�_?•'€_!"•i'!.`W . L _ _ � v:a:u+_`=_� t-l.�f� �� i r-�i ?:� _ J APPLICA PER TEE SIGNATURE ISSUED BY:SIGNATURE - Total Fee: $ �� J Date Received: Entered By: C1 Permit#: ?t� ��; ;,� ; CITY OF ORONO - BUILDING PERNIIT APPLICATION � All information must be submitted in full before plan review will be started. (please print all information) ---- ----------------------------------------------------- --- ----------------------------------------------------- THE APPLICANT IS: (circle one) OWN�OR CONTRACTOR JOB SITE ADDRESS: ��2-- � ��✓�� ZIP: �-�—S _�S NAME OF OWNER: ��V� �'1��(��-p-� PHONE: (home) ��2=-�Z�-? (work) MAILING ADDRESS: �A n'1 C CITY: ZIP: CONTRACTOR: (�� `�C�s PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: v+-��J rv�(� PHONE: MAILING ADDRESS: CITY: ZIP: '� NAME; REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �T �2 �� `i(�1'�G'f P`►�K-e_ ��i�- 7 `�' �'�, �.�1�� 1 STORIES: Z___ .SQ. FEET OF EACH FLOOR: � �>� NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 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 pernut and work is not to start without a permit; and that the work will be in accordance with e approved plan. APPLICANT'S SIGNATURE: DAT'E: �-� �� I � NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGH'TS OF SUBJECTS OF D�TA Subd. 1. Type of data. The righa of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency,political subdivision,or statewide system; (b)whether he may refuse oY is legally required ro supply the requested data;(c)any Irnown consequence arising from his supplying or refusing ro supply private or confidendal data;and(d)the idenriry of o[her penons or enrides authorized by state or federal law to receive the data. This requirement shall not appfy when an individual is asked to suppty invesdgauve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement off"icer. The commissioner of re�enue mav place the nodce reouired under this subdivision in the individual income tax or propertv taz refund instructions 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 whe[her it is classified as public, private or confidential. Upon his furthec request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content and meaning of chat data. After an individuai has been shown the private data and informed of iu meaaing,che data need not be disclosed to him for six months thereafter unless a dispute or acaon pursuan[to [his secrion is pending or addiaonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making, cerafying, and compiling the copies. The responsible au[horiry shall comply immediately, if possible, wi[h 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 reques[ within that time,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 dara conceming himself. To exercise this right,an individual shall nodfy in wridng the responsibie authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempc to noafy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual thac 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 de[erminanon of the responsible authority may be appealed pursuant to the provisions of the administradve 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 pemut or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to deternune 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 other local, state or federal agencies to the extent necessary to process the pemut or license. 4. If your requested pemut or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required ro process this application or permit. First Middle Last Address C�ty State Zip Phone I understand my rights ated above. Signamr • � r' '` � � � . �. �� -:� � �� ap#� � 5 �g��s1 �� I ,,� , �. � � _ �-� �.. - � - �� _,�._.�___ .__. �� : �:,�_::..__ _ �._.�3� �-_ _-`r a 33----- _� � �� C �4 5 i� ��1�� ... !�3 =- �. I G�� u��l `�� . Z �- - �» t c, �� y:� _ _E--,_ _ � 2'' �c.'� t��SiZ-i� =�� . ��- �2 _ ; � ... � _ �,_ � � -� - � �` ��' d u� �'a `�� _ _ -�-_. ri;� i ' � r � `�" � : (J 'Z�, �� --- j�7�'� U ;l-� �� ! �) --._ SZ, � ``n�` �'�� L. "`� t� Z�O �''V:` oF �;��J� i � ` I io�� ,�� '�;`' — �� •V``� Y.} ��i�tR,\_ }��`( _ : � J . Y'� i '•{� uV � 7�{ . / � + „J�_ , jJ l�'�i� o t ;�-_.,:, - � �� .. . ��- 2��_ - _�__ .��_� : --- , '- � .% � � ��j; .t,� f`�`` :j�,� -' �� , ,; ` ��`, . . '` � � f;;��"_. � .� � U� � ?.' i`��.� ,, = � i(7 � • �� f� ..; -� � ,_- � E� _ ° � , � . ,� � L` .. �� `� [ VV'�r�',,�;�',r� O�+-r�t�� - I tJ� E � 1" , , 5��.J � M �N �v ., '' ,, � L77"r/=.i�r ,�'fia�_ (�t�1�� ,=� t- � , (=f l�''�r�t,� /�^. � ' _ !� n� � t �� YY1 ��V�.,.��"�� j / , i i la��`` _.,.,E � L� � - L��j � �,� t� ; ..�. v � G!TY 0� �� t �I /� + � ' � � '- � �^� �y �� F �I�-- �1 u ?1�11�1�A �1.1�� - � /�/� � b� S� . � P�n'� j � ! r 6�� ,�._^ — r�C�-� � 5V('`J (�"�<< , � �?v;,UE�J ��. ;, ,,,�:,�•ri��} �i,�;j�S t�� '!�S Ydi�' �� .l �;��-,J'� �'- - - - - __ ❑ D1S�� 'hi��;'� ' BY � � � �'';`� D�+TE ' � _ % _ `�`� Sz„e w�c r�vc�'� w�.t�`ST � � II e� � �� ;� Vi= S-�� L -t-v4,^J<< �-c s�-� . • CHECK OFF LIST FOR ISSUANCE OF PER�I2ITS ' FOR OFFICE USE ONLY ADDRESS OR LEGAI,: �I7 2 S �A�/s�at 20�-/� . . PID: - �l7 r � .� �z a ��:� �. DESCRIPTION OF WORK: /�"' � ��G < 5 v �„1�� ZOY�YG REVIEti�BI': � 1 � Y DATE APPROVED: S' 3 - S� ~ BUII.,DING REVIEVV BY: � /V��- . . . DAZ'E APPROVED: . . ' FEES TO BE CHAR . Pe^..ti cy=-'----`--------____-------- . -- GED: �Rr�.p,,� Misc. Fees Calculated By: PERMIT Yes oL No ' PL� �� YeS No SEW�COYNECTiON STATE SUR`H1�I�Gr, Yes No WATER CO�NECTION INVESTIGAZTON-�'EE Yes No pARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST zoning Districc: w� c�.-��{�� N � � � Fire Departmenr. Post O e: School District: � Lot Area: Sq.fr. Acres tiVidth Depth Survey Submitted: Yes Date of Survey: Proposed Setbacks: Froat (La.tie): . - Ri ht Side: . Rear(Street): - Le Side: Adjacent S[ructures: �Vetland: Building Height: Def. Hgt• Peak Hgt. Lot Coverage: Gradin�: Staff Approval Date: - By: Council Approval Date: Septic: Staff Approval Date: gy; • � . Zoaing File: # Resolution: # Resolution Date: • Shoreland Dis�ict: � � Avg. Setback: Bluff S back: Lot Covenge: � � ' E�� Proposed Hardcover: 0-75' 75-250' . � - 250-500' . . 500-1000' Hardcover Variance Required: Yes N Date of Council Approval: . � RE11�ZA.RKS ('in house): � z - � ' � : �,� .. 26 . �Z�. . . � ' . BUZI.DING REVIEti� CHECK LIST � � : . trsc: _ � �✓/�- covs�trcriov�E: : �i� . Sq Footage $ Per Sq Ft� Basement x . - . � . lst Floor . � . X . . — . . 2nd Floor � � . .z .. _ . .. � �' Gara�e _ X . - � - . . x TOTAL Esti.mated Construction Value: �_ �� • — Tnspections Required: • Work Requiring Separate Permits: � Site Plumbing � Hazdcover Removal Fire . _ . _ Mechanical Water Connection Footin� Se tic . • Framino P Sewer Connection ' Insulation Fueplace Lawn Irrioation Wall Board - ��O�Y) Ocher � : . _� F�� . (l�If�.) Well (State Permit) � � Other Gradin�/Fi11in� Electrical (State Permit) . REiI�ARhS (lN HOUSE): ---------�` ------ -------------------------DATE ------ ----- VIEtiY BY OTHERS: �---�------ Access: Eziscin� New - • Access Approval: Date BY: � ---------------------- -_._—_________ RE�I�I.ARb'S (TO BE IV•OTED ON PER1tiLIT): � � �� . . . . . t . . ...,..._ � 2� , _ - . ._ _ ,�_. _ . : : -- - --- _ _ ._._ ____ . _ � - -- - ._� . . ----- . . ___ _._-- . ._... . .. . . � �. � - -- . :._:_ ._:_ __. ._...- , . � -.. . � . •� . _�_