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Home My WebLink About1997-009472 - fill for house const � PERMIT � CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 - _ =-�- Crystal Bay, Minnesota 55323 Permit Number: ,_ (612) 473-7357 Date Issued: SITE ADDRESS: w.: �r,,��-,;-.i-,,.. _.. - . _ ;.:;..�.�.4��r_�.:s' :�'�•��-_ DESCRIPTION: ... ..._ , «..�.�.. { i':. :.:.._ -... i : ; �.E i}' F�{ i.]:"ei.. '.. _ .. . . .. � �__ . _.. . . ._ _ _ 4._;�'�r'••i��; :�t._i%=sz`�—'1!y%_`='v REMARKS: FEE SUMMARY: I CONTRACTOR: OWNER: ' � � � ; �::�� - ::�t_:—:— —{V:, `-`J '.. '._.. ,.._ . � .. .. ..... ._ . ._..___ :t, _ .. " ._:'� •" r. ' �'n iy.:iiii�' f i� �j� _ 1�{ 'si. { i ' .�r'�l�, eil��k�i�+' ' i�j_ . �' ? . ..._ .: f�_.__��_.��iS:4'"'t_ . .t...-5.�...-.W . i F-»._:•�i ._«... _ . ._ .. ..�. ._ _ _ .... . . .. . .. . ._... . . .. ..._. ._�. .... .. . .._ . _._. .__ , . .. _. ...__"' ' ' .. ' _ �� . r c., E i...!� f i : - ..,. _�� y:3 ;:� _��1 i ��l..i ; t" .f_. ,.. r.< . { ,e < < � ' .,..' '... . , » . {- .. ' 'w,• ii _. . . .. , ...�__. . _ .. _ . ..., e. _. . .. . . . . . . . ... . i i i ' ' t�.•� r 1 V _ �� 5 �'.. L t t� � � d. f i,' �..� 2 4 t.. _, ... .. ,_.w'i.�' . . _.. _ _ _.... _. ._� _ �f_;... f,r._�.t », ., , f t.. ��> > . � . ... -� . _. _ _.. �`.. . — � �C�J APPUCANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE ` � Total Fee: $ �7 C'. �-�% Date Received: Entered By: �;:�,, Permit#: `�'�-f �7?�� CITY OF ORONO - BUII�DING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------- -----�------------------------------------------------- --------- - THE APPLICANT IS: (circle one) Q�E$�0�2 CONTRACTOR JOB SITE ADDRESS: ��f'��' �/��z��;�y��-�fi L =�' ZIP: NAME OF OWNER• /J�./'c'�1 T ��.�cr�jL�' PHONE: ome �� 7��L/L/�� ) �„_, f�erk�.Y� .-7��- � "y�J MAII�ING ADDRESS: �.5�>r'c�,rr�' �c� CITY: l ��,� /`,�- ZIP•�" ��3�'� CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAII.,ING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration /.; PROPO�D WORI�(describe in detai�:,�2-��-�� ,�,�c-�,j� fc� �,�,� _�- /��-��,e.,t�� T z 1. /� �/'� �`i.�:� %'�~'/�f�-��c �� S:�f�' STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ i; // I hereby apply for a b�riic�mg permit and I aclrnowledge 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 accqF�ance with the approved plan. � �/�� Jf1 �� n � APPLICANT'S SIGNATURE:i l L'=� DATE: � �%�� NO?'E! 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 RIGHTS OF SiTB.TECTS OF DATA Subd. 1. Type of data. The righcs 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 confidenaal data concerning himself shall be informed of: (a)the purpose and in[ended use of the requested data within the collecang'state agency,poliacal subdivision,or sratewide system; (b)whether he may refuse ot is legally required to supply che requested dara;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenriry of other persoas or endcies authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the noace reauired under this subdivision in the individual income tax or propem taz refund instrucdons inscead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subjecc of stored data on individuals,and wherher it is classified as public,private or co�denaal. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data withouc any charge to him and,�if he desires, shall be informed of the content and meaning of that data. Aher an individual has been shown the privace data and informed of iu meaaing,che data need not be disclosed to him for six mon[hs thereafter unless a dispuu or acdon pursuant to this section 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 accual costs of making, certifying,and compiling the copies. The responsible authoriry shall comply immediately, if possible,with 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 request within that time,he shall so inform the individual,and may have an addiaonal five days wirhin which to comply with the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest[he accuracy or completeness of public or pri��ate data concerning himself. To exercise this righc,an individual shall nodfy in wridng che responsible authoriry describing the nature of the disagreemeoc. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipienrs of inaccurate or incomplete data, inciuding recipien[s named by the individual;or(b)nodfy 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 decerminarion of the responsible authoriry may be appealed pursuant to the provisions of the adminisaadve procedure act reladng 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 permit or license from the City of Orono or any of its departments may require you to furnish certain priva[e or confidential information. You are notified that: 1. T'he information you fumish will be used to detemune 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 shazed with other local, state or federal a�encies to the extent necessary to process the permit or license. 4. If your requesterl 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. �� . !'�1ti?� ,�,L G:%y.c '� r ,�7 C.Z%�'l First� - Middle Last -�� " `C"�r �;L�'� �� Addr�,ss � � - � / 3/i � �J r',l"1G C� � ��/L"' �.��C�`"� �( � 7� � CityY State Zip Phone I understand m ' hts as stated above. � � Signa �e � CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: z'-i�5 tJ�;rv�.��y ��t, PID: DFSCRIPTION OF WORK: _ ,=�l� a-tio� "' r�r� r�� _------------------------------------�_� , -------- ZO'VING REVIEW BY: ��(��,,,�,,` DATE APPROVED: � 4 ) BUII.DING REV�ti� BY: ` DATE APPROVED: FEES TO BE CHARGED: Misc. Fees Calculated By: � Y PERNIIT Yes ,� No PLAN REV�W Yes No SEWF.R CONNECTION STATE SUR`HAI�Cr� Yes No WATER CONNECITON INVESTIGAT'ION-FEE Yes No PARK FEE SAC Yes No SITEINSPECTTON Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: Fire Department: Post O�ce: School District: I.ot Area: Sq.fr. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Righ[Side: Rear (Street): Left Side: Adjacent Structures: Wefland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: � Grading: Staff Approval Date: By: Council Approval Date: � Septic: Staff Approval Date: By: Zonino File: # Resolution: # Resoiution Date: � Shoreland Dist�-ict: Avg. Setback: Bluff Setback: Lot Coverage: � Ezisting Proposed Hazdcover: 0-75' 75-250' � 250-500' . 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): • 26 BUII,DING RE`VIEW CHECK LIST - �rBc: ,,�U/,� covs�xUc�o�r�E: N�,r►- � Sq Footage $ Per Sq Ftg Basement x = lst Floor x _ . . . 2nd F1oor x _ Gazage x _ z = TOTAL Estimated Construction Value: $ - Inspections Required: - Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Boazd (Mfg.) Well (State Permit) �� Grading/Fillino Electrical (State Permit) O[her REiIZARKS (IN HOUSE): ----___w�----- __�__ ------------ ----------------- --------------- RE'VIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By. REMARKS(TO BE NOT'ED ON PERil�1I1�; ��____�__� - 27 . _ � , ;;, , � , �C I . � . . ;. . ./,�LIN�DoDY `" ,(1/6, . � `� � � � ; � ; � � � � f � r �� ,r' 2 �b ,1 � / , � �. ` � �� ,�� : .. ,_ . , �� . c : .� ( u i� ( p�� 3 // / ��i ! / �� ti� E '�1 a� � l o i Sk �t1. �. 1 1q4� ,+ � `� 1`ti� �F L Q.�- �ao °i � �� S 3i ° 3 f S ao ��.� � --- --------- ---------- oQ �° QP .� ; , , r99,.e� � LO �` `,. , +�,s� � , , , , �/� Q�� a�"�ti°t� � � `\ `'�ti f � � �P ° � •<� `\1 x � Q'v.�� ,ti aot�° . �� '�• J` � � -- �c. �`� F� ti _ � 0 a �-----�- �,�,'� � / -,�1So�e.��k , � /int \ \ � �,� �� / ��9�6,,� `y j _ _ _q,�6 ; — — — � t (� ��..�'• � �''r"�� h � i ° 4j�� 1�, �: <::f�: � ` � % 1 D i� 0' � � � i � ,: o � f h � � e i� 0! � � ! � � ! � �i�� iT€ t L��1 � G�i.��1NG PLAN %� � � � �A�'P��`v`'�'=��i <�oa w��c y�,og o�- � �V �Y,�t ;�yl F-'.s tiJ��3 � 11.1� i L� A F'r'}�,)'',+'�.`ti`f �'r i ,1 �.� °� � ' � � ' ❑ DtSAc��'!��--a-- � � /�.� �Y -� �`; �, .�" 1 a � �J�4TE_------c''� o - 5 , � . � �' ^� �,� n,� P ,. �� '' ,��v3,�c +t_ �_L a .s�c9 /�s s r-f-o 'A-'J / �---- - q3 ° ' �PP�°_ -�„ � 5� � � _ � < � ,� i9.o � '�R.o �s.o � o�c-�-� ��-e �� ,, �� ', . 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