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HomeMy WebLinkAbout1996-007989 - remodel PERMIT k� CITY OF ORONO PERMIT TYPE: 275� {;�"�, "arkway- P.O. Box 66 �;E i T I ;:T t�;('� Cry: �linnesota 55323 Permit Number: _ Date Issued: �'�`'''�'�'�'' (61� i 57 tf�,/�s'�=;'��,F: SITE ADI:;. :;�;�i F�i�;�lIE��J E_r=} .�� �' . ?: . �i . . _?�—�. �.�—;�°:::—:=::-,—•c.��_�€:��� DESCRIPTION: ���'L���:E: �x�:-,T t t�;i, i'��11 .t+�111'� i'�i'fiE?.f• �r��t: '•���+;��,.Jl�!�'.�t'��_41.1�.�_ ��+k l �.+�3.l i�� �:'���i'��: �',.���f.a L)�.�.����. �:;�i"!;�F.�'t,��,'F.j,�,�}l �y��E� �.il'•� i:k_'i���"4..�� �.S�,SI�J� r�,..���f^ !"tL f . �L•��d���.!4 i 1!"tL REMARKS: FEE SUMMARY: ��'�''-r�i IH?'�T.!_4�I �'r�;::; , t:yi ii:l E���� F��� ��'��. . 7� r i��� �=t�;:1�4? `��'�. �. . �_7'� '•=�1.,l3�C!-3=!1':�� �....____ _.��-.�_'�.''•_� �"���i.�1 F t r= '��.�; . _�. CONTRACTOR: — �;;�:r:.=i i c��-Et. -� '=,� . i_I�; OWNER: i P-i� �:��i=`�t�E�i E�°:� i�:�_���:,��i i;i�i ��.���;�x.� i;::�ty:�,r-.�`'� ��'_.;�'����: ����t�i�t��� �. �.t?E:� �,:i�11'1�'i!{'� ��'i �,'� .��t)�.�, F=�{=;�iZ�� L�? t•tl�ii,�t��w� t°iis� ��=;s�,��. }ii�:i=ft�l;i t���� ��_.°=�� t:i�,3 ;;':i ���:�'-��.!1 � ��..."�r�:-,:;i_)rr'� i�-�1.= �;i���:���;'_����id�� �-(�_�:��,Y �i�.�k�!_��=`��?''�� �'�i;i•i i`=�'_�I��+#�� i'�! t•1t���::+� Tt��� i;i:�� i i°�?=';=���t a'�.t•;!=tv T°�� - ,�i�'p ����J ��'� iai� ��'= �f_: ;1!! !� i ::�I�i�iF�` : }� —: i �-i: t�� i:`s it;iri E ''i�(_ � : �-! •�1 ! i:v 1 �r` i�l�: ����"__ :3.�" . €-3.4�.: �1 r..._.�.� . _.. .. ti L.-- -. . _.E4 _. �. � E . _.f t�. .-�. �R•1 . r' L_. _ ..� � ���F;i=Et�li t 1 II"1I1'�I i�lr��itv;=L=:; �yr.�i�� ��i F�T� �_��= i•i i t�a�l�'=�!+T� !:�,_!.i LC�i t�ii:� _��+�=�� �;�s;}�;_�z��•�i=�t��i:� , � � /1��r� APPLICANT-PERMITEE SIGN TURE ISSUED BY:SIGNATURE ' Total Fee: � ;;� "] 3�� DateReceived: � ' �� -'/_: Date Approved: Entered By: n Permit#: '�]�,� CITY OF ORONO - BUII..DING PERMIT APPLICATION AI,L INFORIVIATION�IUST BE SUB�TITTED IN FULL BEFORE PLA��i REVIEW WILL BE STARTED ------------------------------------------------------------------------------------------------------------------- THE APPLIC�vT IS: (circle one) OWNER OR ONTRACTO� JOB SITE ADDRESS: '3cs� �.a;.,J�b<� 1�,�,�� Z�� Ss��l NAiti1E OF OWNER: lZc��r��fl ���� �r3:��b� PHO�V"E: (home) y l(r f;r�c°� (work) �IAILII�'GADDRESS: "3c��� �„�;�� ��:�< CITY: L�;.,,�; La►.c� ZIP: S;>a 1 CONTRACTOR: TNE C,ra��,��:.�.�s �,,,.;����=���:°� ;,�: PHONE: ��a- S"t r�� MOBILE PHO�TE/PAGER: �;�;c�- :�•�3 ,:�:� F�.a�2 MAILINGADDRESS: ��GS c,-t� �2�& 1�� CITY:���o.;;..� ZIP: c53ti� STATE LICENSE: # ��;�-� ARCHITECT/ENGI�YEER: PHO�tE: MAII.ING ADDRESS: CITY: ZIP: N��; REGISTRATION # TYPE OF WORK: New Addition Accessory S�ucture Move Remodel/Alteration � L,and Alteration PROPOSEDWORK(describeindetail): 'I�v''�,a�� «.+s,,r,,a �c�c� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOvIS: GARAGE STALLS: ATT. DET. EST�IATED CONSTRUCTION VALUATION(escludingland): $ �3 c.=��� � � I hereby apply for a building permit and I acknowled�e 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 SIGNATURE: �) �.,r � •,.�!��.�,.��w DATE: � • Z! -.r� NOTE! Parade f 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 SLJBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is s[ored or to be stored shall be as set forth in this secdon. Subd.2. Information required 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'stace agency, polidcal subdivision,or sta[ewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any l�own consequence arising from his supplying or refusing to supply private or co�dendal data;and(d)che idenory of other persons or enrities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigadve dara, pursuan[to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or propertv tax refund instrucaons instead of on those forms. Subd. 3. Access to data by individual. Upon request ro a responsible authoriry,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 wi[hout any charge to him aud,'if he desires, shall be informed of the content and meaning of tha[dara. After an individual has been shown the private data and informed of its meaning, the data need no[be disclosed to him for six months thereafrer unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or creaced. The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,cemfying, 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,exduding 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 addiaooal five days within which to comply with the request,excluding Sarurdays, Sundays and legal hotidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccucate or incomplete and attempt to noafy pas[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 determinacion of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relacing 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 private or confidential information. You are notified 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 pemut or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the pernut or license. 4. If your requested permit or license requires Councii 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 fuil name is required to process this application or permit. 7 tiY7:+ D� �a First Middle ast l��� c�.� f�� 1�� - Address ,�r,w w� r,�w ��'3�`� c-1?1--1�'I C�h, State Zip Phone I understand my rights as stated above. � �u .,� � a/'� � �� — Signature ' � CHECK OFF LIST FOR ISSUAI�iCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3US I F►4RV 1�—W �AN�= PID: DESCRIP'ITION OF WORK: � �C��. -------------------------- ZONING REVIEW BY: DATE APPROVED: �� 22-`r� BUII.DING REVIEW BY: DATE APPROVED: S � zz -S� --------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW Yes .� No SEWER CONNECTION STATE SURCHARGE Yes � No WATER CONNECITON INVESTIGATION FEE Yes No � PARK FEE SAC Yes No � SITE INSPECTION Number of SAC Units OTHER (specify) ----------------------------- ZOivING CHECK LIST Zoning Distnct: LQ-���" Shoreland District : �� Fire Department: ost Office• h 1 L�ct: (� Lot Area: Sq .fr. Acres Width \ Dep[h Survey Submitted: Yes L No Date of Survey: O� �%�� `('Z'� -7� Proposed Setbacks: � � }, Front (Lake): yc�c� d-- Right Side: � - i � Rear (Street): IV�� Left Side: Z � Adjacent Structures: /4T17'�- U-{�� Wetland: l �D� f Building Height: Def. Hgt. Peak H° • Av�. Setback: Bluff Se ack: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' O.� No C��;��. _d_ 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: Grading: Staff Approval Date: By: Council Approval Date: NI� Septic: Staff Approval Date: BY� Zoning File: # Resolution: # Resolution Date: RF.MARKS (in house): BUII..DING REVIEW CHECK LIST usc: �Z- � CONSTRUCTION T'YPE: 1/� Sq Foota�e S Per Sq Ftg Basement x = lst Floor x = 2nd Fioor x = Garage x = x = TOTAL Estimated Construction Value: $ 23,,�dt�p— Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection _�e Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) �Final Gradin�/Filling Electrical (Sta[e Permit) Other REMARKS (IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By� RENIARKS(TO BE NOTED ON PERI�IIT): 27 � . . ..:; - ,i . . �- .:. � �,.,-: . .. .. - _ _ . . �� : _ . .. . . ._ __- _._-- _ .._... _ _ _ .. . . . �.. �. y �. � . . ... . , ...,. i . :. . . . _—'_'_'- _ __. . . . .j„. , _ . . . . . . . . . . . . . . , . . . . , . .. , . .. _ . . . . . . .. . . _ , ., , ... . . . . . ;.��..�.. . '.. ' ... -......" . �., . . � . . . . - . . . '�. . .� :� . ..� . . . . . . . ' L t. � . ' . � � . � � �.. ' . � � -. � � . . . . . ... 5 3' _ • � . .. . , . . � "_r.: ..� ` _ . . . . � . � . � . . . . i � . . . _ . i .. .. . . ' ' . __. .' ._ . ... .. . � . .. • . . _ ,.. . . . . . . . � .. . . �.� . � . ' �,.1 . ' ' . . � � . ' �.. . ._ . . _. . . . . . . ,. . _ .. .. . . . . . . . . . _ . . . . " _ . . ... � .. . . .�- . - : . . . _ .. .� . 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