HomeMy WebLinkAbout1998-010273 - entry monument curb cut PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: t���_'�4_�„f f ���i;
Crystal Bay, Minnesota 55323 `_'�`-`��'=�
(612) 473-7357 Date Issued: ;�_, :- -
.)�. .�r'����
SITE ADDRESS:
,�`L ���"i"'•�=�i�3;_ �_�'';�i��'�-. �`.!i
_�i�
�-`. 1 . �`�. . _. �_; f �__�::`_�—� �—i:�i if i=�
DESCRIPTION:
�,�a±�i�; t�it�it�Ei�;:';�:l:;;�c ::l�J.�
�:�}1 3.}�1 tl�'� t'`r?1'i3't i t. �Y#_`'' ���-—t-:ti:!_ _�=;=ti it_�!_s`f=~}�
�:i{j �E�j i i�:: Si1i�i'(�:_ : y'C�F= ��'V�ti�r;['.�(.� �Z'-it� �.`=�
��.f���=l�}'_ I.i if1'�'' .:i..�� i�i i��1�i�tiL{�.� 1 �{zit��t. f .
REMARKS:
FEE SUMMARY:
l' ~� ��r` � ��_�iV �i � i rl�J
!"."_-'-� - _
����h� �=;�:� �r;_,; �i:'•
�`�.c.S!l k i=''„1?.'4:f ��i'� . .. _
�,;
:_�.��'r��+j'�7� �i �r�
f�'tT.._'S-,�. . .�%_' �_.------�sS=��..= �-:
CONTRACTOR: — F:;�=��� ; =:�,;t. — :�;� . �.T i: . OWNER:
���:`Y t�:a�i�,�°��r I t��= i=_�.�'��`:`_? �.?�,:=; _��_:� ::ETt��s°��T��t s�:4-��=fi�
ii_i;11f� E:'�;�:,7��,Et; !i[-i #t j,i's�; �, t:�:��'���1`l� __��:�.F��. F°L.�
����t� F'��:I�ii�. t:C�f ��_��. s�i:��t��i� i•,t� �W,:��C��
t h.�; -,�i °=t�.:3._.'=:s:=f'�
: }-{� t_:r,i�'sv���i���;:u_i i ;;�_}z;l�'�;`;'' i�-.'t-;it{ti;,`-:�'._� �-`t__�c`���1 '_�`�;�l�;T„ �:_! �'i�<;:,_- {-�i�, i�:`:�i. �;��":�}'.s{��i::;`�:ij'�:j�"`-
-`i"t--t-1'_ -=�� h-l�j�l(,,° ?—1,t3i .3�`'._: �i�l {�tt 1 !��{_ �S�{`+;;�:, S#`.� =r�i;;��: t t_S�l#'�I—'L i f if�1�.•� s:•s I L"i i-i4_'•__ t-��'3f �i�'
!!i;'i ti.i:i t '�``�i� 'iFVt_:�'.- F';:`-?!J ��- i t� �''S: `isi:i -:!i! �;:': E I t� ',',4i i:I,?4)t- 'rit=s:'•:}:�;` E'(t- v# '.- `
_. ._ _ �Li.. �51`-�t _ =�E!=i . _ _. . L.'•_ _ . F� _ _L• ( . __ . .- -. .� __. . _ .
L - � —
r - f
� ������7 �
APP CANTi NAT E , ISSUED BY:SIGNATURE
. � - �
' � CHECK OFF LIST FOR ISSUANCE OF PERNIITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �5 C�.fS� C/1.��,�
PID: :
DESCRIPTION OF WORK: C�VT�},�v(� �'yw�v c�,�,.��s � �•�c9 Cv,ers Gv�'
-------------------------------------------------- --------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: �"- 2-���i f3
BUILDING REVIEW BY: /v(/.�- DATE APPROVED:
------------------------------------------------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t/ No
PLAN REVIEW Yes �/ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
N� Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_ c� No Date of Survey: piv /r'/t.�'
Proposed Setbacks:
i
Front (Lake): 2 � Right Side: lpd�+-
Rear (Street): IOv�' Left Side: ( (J�'�
Adjacent Structures: ��<< Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
.1� Zoning File: # Resolution: # Resolution Date: _
V"
Shoreland District:
Avg. Setback: Bluff Setback: I,ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
w . , �
BUILDING REVIEW CHECK LIST
UBC: 1N�14 CONSTRUCTION TYPE: /��R
Sq Footage � Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
0�2..
Estimated Construction Value: $ I I QO
Inspections Required: �Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT�:
8
,, �
Tbtal Fee: $ Date Received:
Entered By: Pemnit#:
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 CONTRACTOR
JOB SIT'E ADDRESS: 1 c5 ��'�S%� ���(Z �, ZIP:
NAME OF OWNER: �C 5r �C:f/ � PHO�TE: (home)
(work) a�4 -`'l�-t`1 c1
MAILIl�'G ADDRESS: I l���O U I K ��J Es, 17R... CITY: ZIP: -.�53�/
��� cc��nsz.
co�cTox: ��c �,s �c,�r� rxorr�: ��y si�9 �
CONTACT PERSON: � rv� � MOBILE AGE • �` -�Q �(�(� ��,'j �;3
MAILING ADDRESS: C(� 3�� v�K►n�6 10� CITY: �. ZIP: 553�/
STATE LICENSE: #
ARCHIT'ECT/ENGINEER: PHONE:
MAILI�i tG ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �N-fi-2tl�r�t'� �6��m��n��S � ���
CU � � V-t- _
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET.
��
EST �MATED CONSTRUCTION VALUATION (excluding land): $ � �� J`
I hereby apply for a building permit and I aclmowledge 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 BuildinJ Code; that I understa 's is not a permit and work is not to start without a
permit; and that the work will e in a ord , ce with a roved plan.
APPLICANT'S SIGNATURE: DATE: � " 2� ` g�
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
� �.
Sec.13.04 RIGHTS OF SiJB.TECTS OF DaTA
Subd. 1. Type of data. The rieh�of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd.2. Information reqirired to be given individual. An individual asked to supply privare or confidzaaal dara coacerning himself shall
be informed of: (a) the purpose and incended use of the requesr�dara within[he collecang'stac�ageacy, polirical subdivisioa,or scacewide sysmm;
(b)whecher he may refuse or is legafly requir.d ro supp(y the requested data:(c)any Irnovm coacequence arisin3 from his supplying or refusing to supply
� priva[e or conndendal dam;and(d)�he idenary of other persoas or enaazs aurhorized by stace or federal law to receive the data. This requiremen[st�all
not apply when an individual is asked to supply invesrigarive dara, pursuan�ro section 13.82, sutdivision 5, co a law enforcemenc ofricer. -
The commissioner of re�enu riav place the nodce r�ouired under this subdivision in �he individual income tax or propern tax refund
ins;tucrions inscead of on�hose forms.
Subd. 3. Access to data by iadi�idual. Upon reques[to a responsible authoriry,an individual shall be informed wherher he is the subject
of stored data on individuals,and whe[her it is classified as public, private or conFidendal. Upon his fitrther request,an individual who is the subject
of stored private or public data on individuals shall be shown[he data wichout any charge to him and, if he desires, shali be informed of che contenc
and meaning of chat data. Aftzr an individu�l has been shown che priva�data and informed of iu meaning, che data need not be disclosed to hirn for
six monrhs chereafter unless a dispute or acaon pursuan�to this secaon is pznding or addirional data on the individual has beea coltecu,d or crearEd.
The responsib(e authoriry shall provide copies of the privace or public data upon requese by the individual subjecc of the data. The responsible authoriry
may require the requesring per5on to pay the ac�ual cos�s of making, cerafying, and compiling the copies.
The responsible authoriry shall compiy immediacely, if possible, wich any reques[made pursuanc to this subdivision, or wi[hin five days of
the da�e of[he requesc,exciuding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc
wi[hin[hat time,he shall so inform the individual,and may have an addirional five days wirhin which to comply wi[h the requesc,excluding Sacurdays,
Sundays and legal holidays.
Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this rieht,an individual shall noa"ry in wricing che responsible au[horiry describing che nantre of the disagreement.
The responsible au�horiry shall within 30 days either. (a)correct the data found ro be inaccurate or incomple�e and attempc to nodfy past recipients of
inaccurate or incomplete data, including recipien�s named by the individual; or(b)nodfy [he individual thac he believes[he data to be cocrect. Data
in dispute shall be disclosed only if the individual'S statement of disagreement is includzd with[he disclosed data.
The determinarion of the responsible authoriry may be appzatzd pursuant to the provisions of the adauniscrarive procedure act retaang to
concesced cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you tha[your request
for a permit or license from the Ciry 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 will be used to deternune your qualifica[ion fo:the permit or license requested.
2 You may refuse to supply da[a, but refusal may require that the City deny the perm.i[ or license.
3. The information may be shared wich ocher local, state or federal agencies to the ex�ent 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 cenain riQhts 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 perm.i�.
First Middle Last
Address
Ciry State Zip Phoae
I understand my ri�hcs as sta�ed above.
Signanire