HomeMy WebLinkAbout1997-008959 - 2nd floor deck . � 1 PERMIT
CITY OF ORONO PERMIT TYPE:
' 2750 Kelley Parkway- P.O. Box 66 _�:r��-`;�="��=
Crystal Bay, Minnesota 55323 Permit Number: '�,:^:_;�..�i-,:�°
Date Issued: - -
(612) 473-7357 - - ,
SITE ADDRESS:
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REMARKS:
FEE SUMMARY: I
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CONTRACTOR: OWNER: _... :-�;F.,�:� ; ;- ;;:,-;; _..
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� Total Fee: $ /� 7� a � Date Received: �' � —q �
Entered By: ,Q� Permit#: �'95,�
CITY OF ORONO - BUII.DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all_ ' rmation)
THE APPLICANT IS: (circle one OWNER R CONTRACTOR
JOB SITE ADDRESS: � D �� (.o M A l.r�10 A Q v� Z�: �,6`3�`�
NAME OF OWNER: R6f3ECtT �rl CJ E fZso N PHONE: (home) �1� ��� l�Z�
(work)
MAII.ING ADDRESS: I U34� t,aMn► L��►nA A v c CITY: oRar�o Z�: S" 3 l �
CONTRACTOR: SE L� PHONE:
CONTACT PERSON: MOBILE/PAGER:�
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
TJAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure ✓
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: TU T i U� l.CJ A S�Gor�10 ��� 12 1(�t C.1S
A S '�E R ��K E i c.�-1
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ ��3U `
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 ac rdance with the approved plan.
APPLICANT'S SIGNATURE: . ifJ�� DATE: l ���
NOTE! 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.
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Sec.13.04 RIGHTS OF SLJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual 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 individual. An individual asked to supply private or co�dential data conceming himself shall
� be informed of: (a)the purpose and intended use of the requested data within the collecring State agency,poliacal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or enriries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve daa,pursuant to secdon 13.82, subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv tax refund
instmctions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsib(e authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is class�ed as public,private or confidential. Upon tus 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 hun and, if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this secdon is pending or additional data on the individual has been collected or created.
The responsible authoriry shall pmvide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual 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 icnmediate 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 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 private
data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 fumish 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 permit or license.
3. The information may be shared with other local, state or federal agencies to the extent 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 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.
�v��R� ���?' AN ��Qsorl .
p��i Middle Last
103�' �ot�►A �IriO� �U�
Address
�Re�Na 1�`1N S�3��{ �f ?� ���� -
C��y State Zip Phone
I understand my ri as stated above.
�����%�evv
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
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FOR OF ICE USE NLY
ADDRESS OR LEGAL: %C'_3� �rzr�� � ��_�C_��., l,�-i-��
PID: G��'- /� 7 - d 3 � 3 ��.� 5�
DESCRIPTION OF WORK: �,� �_x-
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ZONING REVIEW BY: ��Q�,,.,.Q,,._ DATE APPROVED: s- � -9 7
BUILDING REVIEW BY: ,,._ DATE APPROVED: 5--�-�7
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SUR:I-�ARG� Yes ,� No WATERCONNECTION
INVESTIGA'I'ION FEE Yes No PARK FEE
SAC Y�s No SITEINSPLCTION
Number of SAC Units OTHER (specify) •
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ZONING CHECK LIST Zoning Dis±rict: L 2-16
Fire Department: �a v.�✓J Post Office: �y(y��h School District: (,��s�-�aN�
Lot Area: Sq.ft. No Grf,sude Acres Width Depth
Survey Submitted: Yes c No Date of Survey: S
Proposed Setbacks:
�tet�t (Lake): Ztn � Right Side: 3S� �
� � -1--
Rear (Street): i o 3 �' Left Side: 3Z
Adjacent Structures: �}r—ry�c:�,-t-�.'� Wetland: /U(�
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
�.�. Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: #� Resolution Date:
Shoreland Dist:ict: y�pS
, Avg. Setback: t9. K Bluff Setback: N/A- Lot Coverage: �/�
Existing Proposed
Hardcover: 0-75'
75-250' /• .'��d i�•`f b
250-500'
500-1000'
Hardcover Variance Required: Yes No OC Date of Council Approval:
REMARKS (in house):
� 26
BUILDING REVIEW CHECK LIST
UBC: R• 3 CONSTRUCTION TYPE: yN
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floar x =
Garage x =
x =
TOTAL
oa
Estimated Construction Value: $ y,q 30'—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
�( Footing Septic Sewer Connection
oC Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
� Final Grading/Filling Electrical (State Permit)
Other
-----s�:
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REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS(TO BE NOTED ON PERMIT):
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' HARDCOVER CALC N_�'ORKSHEET +a,.r , � � .- 4
, SETBACK ZONE: (CIRCLE ONE) 0-75' 75-254'' 250-500' S00-1000'
— '�..J / �6 c�
EXISTING HARDCOVER IN ZONE
A. House C� t'% x .;��' = S.F.
Length Width
R = S.F.
x = S.F.
- X = S.F.
B. Garage x — _ S.F.
C. Driveway x = -- S.F.
R = S.F.
D. Sidewalk x = �,j C S.F.
X — S.F.
E. Patio/Deck x = -- S.F.
X — S.F.
F. Landscape x = %._�� S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - /y 6 5.,� S.F. A
TOTAL PROPERTY AREA IN ZONE - 1 3, 3t 2 .�r; S.F. B
A /1�� — B J7 7.�v x ioo = �--� %
�y:�g
PROPOSED HARDCOVER IN ZONE "I
A. House 6C> X v77 = i ��`� S.F.
Length W idth
� X — S.F.
X = S.F.
X = S.F. I
B. Garage x = ._.__._. S.F.
C. Driveway x = _---�— S.F.
X = S.F.
D. Sidewalk x = �.�U S.F.
R = S.F.
E. Patio/Deck x = '�y-3 S.F.
R — S.F.
F. Landscape x = � $�L� S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - �(`�'� � S.F. A
TOTAL PROPERTY AREA IN ZONE - /3, 3�Z �`�7�"� S.F. B
a ,2y6r — B 1 � ���� xioo = �3- ssd %
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