HomeMy WebLinkAbout2003-P06916 - detached garage i
PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po6916
Crystal Bay, Minnesota 55323 Permit Type: a��esso�-y snu��ures
(952) 249-4600 Date Issued: io�2�i2oo3
SITE ADDRESS: 450 Big Island
Excel si or,MN 55 331
PID: 23-117-23-32-0070
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 438
Permit Type: Accessory Shuctures Permit Sub-type(s): Garage-Detached
DETAILS:
Approved per resolution#:
Separate pernuts required: Eiec;iricai�siaiej
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 167.25 Valuation: $ 8,500.00
Plan Review Fee: $ 108.68
State Surcharge Fee: $ 4.75
TOTAL FEE: $ 280.68
APPLICANT: owner/Self OWNER: Gabriel Jabbour
� 985 Tonkawa Rd
Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE 4 SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Avnlicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
Total Fee: $ Date Received: �� � �
Entered By: Permit#: ' j ,, `
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR�ONTRACTOR
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JOB SITE ADDRESS: � _. -, ��;� `'_{, , � ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes Q No If yes, a special event permit is required with Police Department and City
' Council approva160 days prior to the event. Non permitted events will not
be allowed.
�
NAME OF OWNER � ' '4 � ,l���:�I '(� � ,, _. i_.�i i,��; 1PHONE: (home) �;�- � � �`� ; ,';
(work)
MAILI\G ADDRESS ''l Y���:� �i��?_�����_ k -� �� CITY: ;' ;;.i�)�, L�; ;%:� ZIP: ` >'; ,� ;.� �
CONTR�CTOR: � i �' , � '� ;� �� � � � �, � � ���i i� PHONE:
CONTaCT PERSON: 1 MOBILE/PAGER:
MAILI\G ADDRESS: CITY: ZIP:
STATE LICENSE: #
i
ARCHITECT/ENGINEER: � ��� ����a"�i,�- I - �C,�,)����.� r' PHONE:
MAILI\G ADDRESS: � � CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure �
Addition N1ove
RemodeVAlteration Land Alteration
, , �
PROPOSED WORK(describe in detar�: ; � ' `,, ; :� 1 ` ' �
STORIES: _�'�.. SQ. FEET OF EACH FLOOR: �
NO. OF BEDROOMS: GAR-�GE STALLS: ATT. DET.
s� ��c`;� -�
� � C.�
ESTI�LaTED CONSTRUCTION VALi��TION (excluding land): $ � - - . _ _
I hereby apply for a building pernut and I aclmoa-ledge that the information above is complete and accurate;that the
work will be in conformance with the ordinar_ces 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 pernut; and that the work will be in accordance with
the appro��ed plan.
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APPLICANT'S SIGNATURE: l. � . ; % DATE: I � . I '
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Sec.13.04 RICHTS OF SUBJECTS OF DATA
Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential 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 or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement otficer.
The commissioner of revenue mav olace the notice reQuired under this subdivision in the individual income taz or oropertv tax 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 whether it is classified as public,private or confidential. Upon his further 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 that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority 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,certifying,and compiling the copies.
The responsible authority shall comply immediately,i(possible,with any request made pursuant to this subdivision,or within�ve 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 time,he shall so inform the individual,and may have an additional 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
concerning himselL To exercise this right,an individual shall notity in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with bI.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 notitied 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 permit or license.
3. The information may be shared with other local,state or federal agencies to the estent necessary to process
the permit or license.
4. If your requested permit 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 to process this application or permit.
�., ; � �
� � �:� � ; � � � ��.��. a � � ; �-
First Nliddle - Last
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Address ,
,
i,;"v�'�G; �° (' � y ) � l �� -> j��, �� �� � ,"-�- / �- �/.� �7-
C�tY State Zip Phone
I understand my rights as stated above. �
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: tis v 63�c� ,�S c�4r�'/J
PID:
DESCRIPTION OF WORK: ���L(�
ZO�"1�1G REVIEW BY: DATE APPROVED: /v�z y—63
BUII.DI�i 1G REV�W BY: DATE APPROVED; /o- L �i , ��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLA1�T REVIEW Yes v' No SEWER CONNEC"ITON
STATE SURCHARGE Yes � No WATERCONNEC"ITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: .
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_� No Date of Survey: 3-Z�•03
Proposed Setbacks:
Front (Lake): !y 3� fi Right Side: /t-f�� -`--
Rear (Street): 3"7� �= Left Side: �� � �=
Adjacent Structures: Zi' i Wetland: --
Building Hei;ht: Def. Hgt. �. � Peal:Hgt. —
Lot Coverage: /� !�
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: -- By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: U�5
Avg. Setback: iv�/�J- Bluff Setback: L.otCoverage: —
Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500' �'�C
500-1000'
Hardcover Variance Required: Yes No_� Date of Council Approval:
REMARKS (in house):
7
BUII.,DL�TG REVIE�y CHECK LIST
�C� R ' 3 CONSTRUCTTON TYPE: V N
_ Sq Footage $Per Sq Ftg
Basement x _
lst Floor z _
2nd Floor x _
Gazage x =
z =
TOTAL
Estimated Construction Value: $_ Q f�Q Q °�
Inspections Required: `Vork Requiring Separate Permits:
S ite Plumbing Fire
Hard;,over Removal Mechanical Water Connection
.. —�FO°�g � Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
—�F� Grading/Filling �, _Electrical (State Permit)
Other
REMAR�S(PT HOUSE):
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REVIE`i� BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY:
--------------------------------------------------- ----
REMARPLS (TO BE NOTED ON PERivII�:
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