HomeMy WebLinkAbout1998-010859 - 12x16 shed = PERMIT
CITY OF ORONO PERMIT TYPE: _ � - - -
2750 Kelley Parkway- P.O. Box 66 '`''.--='�"�
Crystal Bay> Minnesota 55323 Permit Number: �:�i 4_�=��:�°�
(612) 473-7357 Date Issued: i i:i::�i :_;;�'-;;�:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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CONTRACTOR: OWNER: -~ ���`�`� ?��'''=. -
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APPUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE 'C.�t-_�
y Total Fee: $ ���� Date Received: �� — 1�� � C j ;�
Entered By: Pernut#: /'C'�5 �
CIT OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
; � .,(please�r'�t all information)
---------C�_�,_,�-`-C_--L__-���c;-�=-�---�-------------------------------------------------------------
THE APPLICANT IS: (circle one) �WNER�R CONTRACTOR
�
JOB SITE ADDRESS: �Z�S��' �,�.' � 4-� �- 1�-���� �— E y�� Z�: -S� ��' �
NAME OF OWNER L f�I Z-��-, � C.._�v�` L�y '�(Zt�' IL�HONE: (home) �f ?3�- 7 3��
(work) 7�{ 2 -Z�; C��
MAILING ADDRESS: S CITY: ZIP:
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
l�JAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure �
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: t�ti��� `s`-�^
� L' � � x � 1 � <<� �� -
STORIES: � ,f,SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: L% GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ���-- � I ��� -
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 perinit and work is not to start without a
permit; and that the work will be in accordance with the a roved plan.
� � �� '� . �� � DATE: �� _ I � ._�� ��
APPLICANT S SIGNATURE�C,�- �..G�- r -
NOTE! Parade Qf 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 RIGIiTS OF SUB.TECTS OF D�TA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set for[h in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data concerning himseif shall
be informed of: (a)the purpose and intended use of the requesied data within the collecting"state ageacy, polidcal subdivisio�,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data:(c)any lrnown cocvsequence arising from his supplying or refusing to supply
privace or confidenrial data;and(d)the iden�iry of ocher persons or endaes authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgaave dara, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund
instruc[ions ins�ead 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 subject
of stored data on individuals, and whe[her it is ciassified 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 chat data. After an individual has been shown che private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter uriless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual 6as been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of[he data. The responsible authoriry
may require the requesting person to pay the acmal costs of making, certifying,and compiling the copies.
The responsible auchoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of
the date of the request,excluding Sa�urdays,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 pri��ate
data concerning himself. To exercise this rieht,an individual shall noafy in wriang the responsible authoriry describing the nantre of the disagreement.
The responsible authority shail within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to noafy past recipients of
inaccurate or incomplete data, including recipienLs 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[he disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the adminisaadve procedure act relaang to
contested cases.
DAT� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 Ciry deny the pemut or license.
3. The information may be sbared with other local, state or federal agencies to the extent necessary to process
the pemut or license.
4. If your requested pernut 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.
(, Your full name is required to process this application or permit.
� -, `�����i� �L �
r� �� �; � (
First vliddle � Last
c�<�5�` �.,�� �-�. (��ti '� �`�- �C �--.�
Address � _ �—, �� � ��^�
1.,�.i/��� 6� � ��"� !v �.'� \ � �
Ciry State Zip Phone
I understand y rights as stated above.
i �' I �/
Signature
CHECK OFF LIST �'OR TSSUANCE OF PER.i1�ZITS
� FOR OFFICE USE ONLY
ADDRFSS ORLEGAL: _ 9�3U c�. �'�t�pa� ��,� � .
PID: ,�- /1 � - �-� ti�( �� � I �
DESCRIPTION OF WORK: _ syL—n � z x t v �
— ------------------------
ZONING REVIEtiV BY: � � DA.TE APPROVED: � -U-�S �
BUIZD .1 ivG REVIEti'V BY• DATE APPROVED: q - Zi..4 S
FEES TO BE CHAKGED: - � � Misc. Fees Calculated By: ~ �
PERMIT Yes �/' No '
PLAN REVIEW Yes ✓' No SEWF�Z COYNECiTON
STATE SUR`H�1RG� Yes ,� No ti�ATER CO�NECITON
INVESTIGA'I'ION-FEE Yes No PARK FEE
SAC Yes No SITEI�tSPEC"ITON
Number of SAC Units OTHER (specify)
__--------------------- ------ ----
ZONING CAECK LIST zoning Districr. _ (�.-1 /� �
Fire Deparmlenr. W�,q�-� Post Office: �,q�,�,,4-� School District:
Lot Area: Sq.ft._ ivU Cf,�.�v�,,Q Acres tiVidth — Depth —
Survey Submitted: Yes o� No Date of Survey: 8 - ?.m-S�
Proposed Setbacks:
Front (�ee): . �"'1' Right Side: �{2.O� �
Rear (�rect): 5 5 � Left Side: I� �
Adjacent Structures: C� -�C- SVetland: Zf `
Building Heioht: Def. Hgt. O•(C Pea.k Hat. (��/� J
Lot Coverage: d��C
Grading: Staff Approval Date: _ �/� . By: — Council Approval Date: '�"
Septic: Staff Approval Da[e: /�!�/�- gy; s• .
Zoning File: � 22`►s' Resolution: #- 397� Resolution Date:� 1 U- 13 -� � �
Shoreland Dis�icc: _ yPS
Avg. Setback: _ N I/-� Bluff Setback: _ N /�+ L.ot Coverage: CJ.��
' ' Existing Proposed
Hardcover: 0-?5'
75-250' . �, I L �
250-500' •
SOQ-1000'
Hardcover Vaziance Required: Yes No p< Date of Council Approval:
. �
REl�Z4R�S ('in house):
� ___ . . .
: ��i � 26
, ��:� . .
BUILDING REVIEti� CAECK LIST . : .
UBC: _ U- ( CONSTRUCTTON TYPE: �(� -
� Sq Foota�e $ Per Sq Ftg
. Basemeat X . � .
.. . 1st Floor . . . z � � — - . -
2nd Floor � � . .x .. _ . � .. '
Gara�e — ' . . .
. x .
x
TOTAL
Estimated Construction Value: � � p o D�= •
-- Inspections Required: • Work Requiri.ng Separate Permits:
Site Plumbin� �
Hardcover Removal Fire . _ . _
Mechanical Water Connection
Footin� Se tic� � �
Framing P Sewer Connection "
Insulation Fueplace Lawn Irrigation
Wall Board �aSO�Y) Other � �
—�F�� . (11'if�•) Well (State Permit) � �
Other Gradin�lFillin� Electrical (State Perm.it)
. REiI�A.RhS (lN HOUSE): '�_�---------- � -- -
----------------- �
--------- DATE
REVIE'�V BY OT --�-� --�-
HERS: . ----------
Access: Ezisci.ng Ne�v -
----_—
• Access Approval: Date • ,�-�"
-------------------------------- �Y:
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