HomeMy WebLinkAbout1993-005626 - kit/garage addn PEI�MIT
CITY OF ORONO � � PEl�MIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: �=;;=;j;;;;�;.=.�.v�
Orono, Minnesota 55356-0815 Date Issued: � q � '
(612) 473-7357 f j r� t C_1;3`-i:::
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR. �� i-tF'{-`-�. 7=:r��. — OWNER: {� Y
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APPLICANT/PERMITEE SiGNATURE ISSUED BY:SIGNATURE
CHECK OFF ZIST FOR ISSII.ANCE OF PF�ZMITS
FOR OFFICE USE ONLY
P.DDRESS OR I,EGAL: /7C7U �OI�li�l3 Po��vT /ceA+O PID_
DESCRIPTION OF WORK: �i,�IO/ T1UNS 7� (�O</S� /�'0 ��'�'�C -
------------------------_---------- ------
------------------ c -
---------- DAZ'E APPROV� ( � ��`' 7 3 -
ZONING .REVIEW BY:_�
_ , .. . _
3IIII.DING REVIEW BY- DATB APPROVED: (d"�`'l"5 ?J" -.
-------------------- --
�,�5 � gg ��- Misc. Fees Ca�culated By: " _ .
PERMIT Yes�No � -
PLAN REVIEW Yes �//.No SEWER CONNECTION
STATE SIIRCHARGE Yes r/ No WATER CONNECTION "
INVESTIGATION FEE Yes No�' PARR FEE
SAC � Yes No � SITE INSPECTION
Number of SAC IInits OTHER (specify)
----------------------------
----------------------------
ZONING CHECR LIST Zoning District: La(/j
Fire Department•�dc.7,�►-rY� Post Office:i�A.�,� School District: p/1�rv0 �
- �.*.�.�—
� Width: �,SO't �i✓� Depth: �S�'�-t ��/C
Lot Area:�;� � . ���
Survey Submitted: Yes�_ No Date of Survey: $=!�'-g3
q r�0�n eN �A��.' A-,o.GZA7o�•�
Proposed Setbacks : G '�
Front (Lake) : �. ( Right Side:SS' �/�A
Rear (Street) : 3Z�f SS��-� Left Side: y{ Zd � '�' �
� Adjacent Structures : �4-%�9�tt--� Wetland: /(� �/�
. �
-; Buil.ding Height: Def . Hgt. Fj./C Peak Hgt.
1
; r,vg. Setback: /l1 j/•�
Lot Coverage: /Z•S�`�
Existing Proposed
Hardcover: 0-75 '
� 75-250 � .s � 32.j" �
250-500 '
500-1000 '
Hardcover Variance Required: Yes� No Date of Council Approval: 7-l2-S�
� Grading: Staff Approval Date: Council. Approval Date:
Septic: Staff Approval. Date: BY=
� Zoning File- ���� Resolution � : � �y� Resolution Date: 7-�2"f3
REMA�2.RS (in honse) : ..
:UILDING REVIEW CHE�K LIST � �- -. .
TBC: ��3 CONSTRIICTION �YPE: VN - _ �
Sq Footage $ Per Sq Ftg . �
_sement . x = . .
:t Floor x = _ .. .
:3 Floor x =
�rage x =
x =
'GTAL _ - .
- Bstimated Construction Valne: $ Z 2,pC90�� .
�nspections Reqnired: Work Reqniring Separate Pe=mits: . .
Site -� �0 Plumbing Grading/Fil.ling
�Footing �_Mechanical Fire .
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
�Wall Board (Masonry) Lawn Irrigation
�Final (Mf g.) Other
Other Well (State Permit)
�— _�Electrical (State Permit)
-----------------------------------------------------------------------------
:F.MARK$ (IN HOIISE) : •
�VIEW BY OTHL�2S: DATE:
Access: Existing ' New
Access Approval: Date By=
�-----------------------------------------------------------------------------�
F�tARKS (TO BE NOT.�D ON PERMIT) :
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CITY OF ORONO - BUILD�NG P�RMIT APPLICATION
Total Fee• $ � ' � � � � Date Received: /�1���'�3
. �
Date Approved:
Entered By: ^
Permit#: ��'�'`�
ALL INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PLAN REVIEW WILI, B$ STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRESS: j 7�� ���ir�5 �! i�� f l�, 1 ZIP:
(� rC �� L�
(work)
NAME OF OWNER: R �>b � w f C_'-' [,�J c- l� 5 PHONE: (home)
MAILING ADDR.ESS: / �c� �+ !� � liflc� �_��� f��r� CITY: c^ rc .� 2 ZIP:
CONTRACTOR: �� ���" 5� � � S C�y, i : ��i' PHONE: l�/J�� _3 ��c' ��'
MAILING ADDRESS: �-�, r t� . .� '� _ CITY: ����/<, i,` ZIP: �$,3� �-'
STATE I,ICENSE: � (� DO / ,� � �
ARCHITECT/ENGINEER: �� r',� � ��Gt 1� : •� �c c` ►'' PHONE: ���� - �3 �� >'��'
MAILING ADDRESS: �, i��>(�; �.�-� (�G, ��i�� n �ku�FITY: �) /)�., ZIP: .j���/l.
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N�g: REGISTRATION #
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration� Renovate Land Alteration .�
PROPOSED WORR (describe in detail) : �( �� �i �� � f� � t 5�i h 4 � cr. ✓`� y �`
j .� c> .s -t:
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: G�GE STALLS: ATT. DET.
ESTIMATED CONSTRDCTION VALIIATION (ezcluding land) : $ ;�::,� / �`l' • � �
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 SIGNATIIRE:�� �'�_ ,t �=���� �� DATE: G- , - ��l �_
�
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�y ' � � �� C ITY of ORONO
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�`�{����� � Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
� �
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k�"`� ""� �'`�'" `` On the North Shore of Lake Minnetonka
� �. ' �x,
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04 , Subd. 2, "Rights of subjects of
data", we would 3ike 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:
1. The information you furnish wi31 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 Iicense.
3. The information may be shared with other local , s�ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii act�or.
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to rev;ew private
data on yourself.
6. Your full name is required to process this application or
permit.
���:( (� ij � f� � r s i L� -
First Middle Last
�> c Zc 1�: .3 3
Address
� �' 1a �i �� ►�r1 /1�� � 53 �-� --
City State Zip
��--1 ?f - 3 �l �� � -
Phone
I understand my rights as stated above.
��� � .��
Sig a ure .
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
�.0.4 RIGHTS OF SIIB.7BCTS OF DATA
Subdivision L T�ipe of data- The rights of individuels 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 in�ivi�usl- An.individuel asked to
� supply private or confidentiel c3ata �uest d d tam i hin the collecti g state agency,
purpose and intended use of the req
political subdivision, or statewide system; (b) whether he may refuse or is legally
required to supply the requested date; (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 rec investi at ve data,
requirement shall n�t apply when an individusl is asked to supply g
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenu�o� rolertv tax re�und instructeons insteadho5
subdivision in the individual income t
on those orms. -_-_ -
Subd. 3. Access to data bY in���' UQon request to a responsible �
authority, an individuel shall be infof eddas h ublic, privateeor confident alre Upon his
individuals, and whether it is class P ublic data on
further request, an individual who is the subjecc�gQ to himrlande if he desires, shall
individuals shall be shown the dats without any
�e informed of the content and meaning of that �tthe data needinotVbe disclosed to
shown the private date and informed of its meaning,
him for six months thereafter unless a ,�a�e n� b en collected or areatedtioT�Q
� pending or additional data on the indivi
responsible authority shall provide eopies The hresponsibler a tho i Yt maY� requ re tthe
the individual subjeet of the data.
requesting person to pay the actusl costs of making, certifying, and compiling the
copies. ssible with any request
The responsible authority shall comply immediately, if po �
made pursuant to this subdivision, oe �th lideys,�f Simmediategt ompliance e��,su ns�t�
excluding Saturdays, Sundays and 1 g
possible. If he cannot comply with the request withi�ithintw ch toh omplynwi h the
individual, and may have en additional five days
request, excluding Saturdays, Sunda3'S and legal holidays.
Subd. 4. Proced�e when data is not accurate or eomplete. An individual may
contest the accuracy or comQleteness of public or private dat�he°resp nslb e au hor ty
exercise this right: an individuel shall notify in writing
describing the nature of the disagreem to beTnaccurate or incomQlete and att pt to
days either: (a) correct the data f ound
notify past recipients of inaccurate or incamP�t heg believesdthe datalto be correct
the individuel; or (b) notify the individu
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the disclosed data. e�e� �uant to the
' The determination of the responsible authority may be aPP p
provisions of the administrative procedure act relating to contested cases.
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Q OS FINAL 13 METER SETITURN ON 17 SITE INSPECTION
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Call for the next inspection 24 hours in advance.47�73�J7
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� DATE TIM
CITY OF ORONO CALLED IN � " �� � `-����
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Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
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DATE G TIME
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Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac r on 'te:
Inspector.
Whit Copyllnspector's File Canary CopylSite Notice
DATE ,/ TIME
CITY OF ORONO CALLED IN �"�y" ��T
INSPECTION NOTICE SCHEDULED a - �S` !o; 3��
PERMIT NO. ��%'�� COMPLETED � '�
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OwnerlContr o n 't
Inspector. *
White Copy/lnspector's File Canary CopylSite Notice