HomeMy WebLinkAbout1993-004973 - add/remodel PERMIT
CI kY O� ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �'�1��'�}�,''`��
Permit Number: r.�i_;�°,:�, _
Crystal Bay, Minnesota 55323 Date Issued: C�:;�;'i�F.J��:�;
(612) 473-7357
SITE ADDRESS:
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REMARKS:
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FEE SUMMARY: under permit #4 90 4. Areas show as future.
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A PLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
�� � � CITY OF ORONO - BIIIZDING PERi�LZT APPI.ICATION
r
Total Fee: $ � � �' � / Date Received:,,? - aZ 3 �� 3
Date Approved: �' �lp - � .3
Entered By: ' ,1
—� Permit�: `7� 7 �j
�LL INFORMATION MIIST B$ SIIBMITZBD IN FDLL BEFORE PI,AN REVIEW WII,L BB STAR�ED
(See Check-off List Enclosed)
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T� APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SSTE ADDRSSS: �Y �v �vn� ��I�. ��vr� ZIP: �j .�35(0
(work)S93 � 7�i '1
NAI�: OF OWNER: �rov s�-�rr��te�S �v� PHONE: (home) �7 `�- �850
HA.II,ING ADDRESS:���O Lt�✓tc., L a�C� �l vc� CITY: 0 r-o v�o ZIP: ��3 S�
CONZ�CTOR: �/s� PHONS: ��� - ��'O
MAII,ING ADDR$SS: ��J�D L vr�y, ��,� /��✓c'� CITY:Q,-o►� ZIP:�3SCo
STATS LICENSE: �
ARCHITECT/ffi�TGINEER: ,�r=.�t,�I /�.4 C S z'l PHONE:
MATT•ING ADDR$SS: CITY: ZIP:
N�: RBGISTRATION �
TYPE OF WORR: New Addition,� Accessory Structure Mone
Demo Remodel/Alteration Renovate Land Alteration
PROPOSF.D WORR (describe in detail) : �, i3�,_ �� � -G) -�'*�^� _
STORIES: 2- SQ. FEBT OF EACS FI�OOR: � � �
HO. OF B�ROOMS:_� GARAGE ST�LI.S: ATT. DET. �� �
ESTIIKATED CONSTRIICTION DALIIATION (eaclnding land) : $ _ //vV . ��
2 hereby apply for a buiI.ding 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 penait; and
that the wcrk will be in cordan with the approved plan.
APPI.ICANT'S SIGNATQRE: ----- DATE: 2. ''Z 3�- �7.�j
� . .
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minnetonka
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:
l. The information you furnish will be used to determine your
qualification for the permit or Iicense 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 Iocal, state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or 3icense requires Counci3. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your full name is required to process this application or
permit.
�� �(
,lJo ,�L �/Ot
First Mi dle Last
,�YqC7 �on4 L4K-� �b�Vc.� ,
Address
( Jr-o n� �IJIf �.s..�5�0
City State Zip
l�� - 1�so
P one � �
I un rstand my rights as stated above.
natu e
BUILDING 8c ZONING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING _
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.. . ,
�.04 RIGHTS OF SIIBJECTS OF DATA .
Subdivision L Z`ype of dat�- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section. .
_. - _ to be given individosl. An.individual asked to
- Subd. 2. Information requirea
� .' supply private or confidentiel data concernin�gmWi�in the collecting state agency,
purpose and intended use cf the req t med �b� Whether he may refuse or is legally
political subdivision, or statewide sys �oWn consequence arising from his
required to supply the requested date; (�) �Y
su lying or refusing to supply private or confifederal le wo receive the data.1tThis.
PP state or
other persons or entities autWhen anbnaividuel is asked to supply investigative data,
requirement shall not apply
pursuent to section 13.B2, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lace the e��a�tructio uinsteadh°5
subdivision in the individuel income tax or ro ert tax r
on those orms. . - � -— - - .
Subd. 3. �
Access to �eta bY in�n�' tip°n request to a responsible
authority, an individusl shall be informed�he��c hP V8 eeor confidential.e UPon his
individuels; and whether it is classified p � ublic data on
turther request, an individuel who �s the subject of Se to himrland, if he desires, shall
individuels shall be Sh°wn the data witho of�hat date• After an individual hes been
�e informed of the content snd meaning t� �� need not be disclosed to
shown the private data and informed of its u���action pursuant to this secticn is
him for six months thereafter unless a d�SP �
� ending or additional data on the individu e h�gte or public datarupcn request by
� p require the
responsible authority shall provide copies o t P �ible authority may
the individusl subject oftrie ectual'costs of maldng, certifying, and compiling the
requesting person to pay -
copies. 1mmediatelY, if possible, with any request
The responsible authority shell comply ' of the date of the request,
made pursuant to this subdivisi�oad legel tholidaYs, if�immediate complianae is not
excluding Saturdays, 5��3'SWith the request within that time, he shall so inform the
possible. If he cannot comply within which to comply with the
individuel, and may have ar► additional five days
request, exeluding Saturdays, SundaYs and legal holideys•
te or complete. An individual may
Subd. 4. Procefiae when data is not accura �ms�{, To
contest the accuracy or completeness�of public or private � the�respensible authority
exereise this right, an individuel sha11 notify in writing
describing the nature of the disagr
eement. The respcnsible authority shall within 30
days either. (a) correct the data found to be lete dataeincludin6 ree�Pie ts namedt by ��
notify past recipients of inaccurate or incomp �
or (b) notif the individual that he believes the data to be ement is �`
the individuel; Y + �� �
if the individual s statement of disagr j
Data in dispute shall be disclosed only � � , /
• i n c l u d e d w i t h t he disclosed data• ealed ursuar►t to the'" '
' The determination of the responsi b le a u t h o r i t y to c o ntes ed cases. �� �
provisions of the administrative procedure act relating .,,� ,;�
���
,�V
e � i
� , � CHECR OFF LIST FOR ISSIIANCE OF PERMITS
- FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I �_t O (,e q�► C,1ltG� ��U� PID:
DESCRIPTION OF WORR: ZN� S��r Y�-!�✓� �'�"L�
--------------------- -- ---- ------ ----- ------------------3--
ZONING REVIEW BY: DATE APPROVSD: � `Z Y`f
BIIILDING REVIEW BY: DATS APPROVED: 2"Z�-�)3
gggg Tp gg Cg�Ggp; Misc. Fees Calculated By:
PERMIT Yes� No � -
PLAN REVIEW Yes� No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No /� PARR FEE
SAC � Yes No�� SITE INSPECTION
Number of SAC Units OTHER (specify)
----------------------------------------g---------_-------J------------------
ZONING CHECR LIST Zonin District Q�(C' _
Fire Department: � C Post Office: /�/C- School. District:
Lot Area: N� Width: Depth:
Survey Submitted: Yes � No Date of Survey: �- � � -- � 3
Proposed Setbacks: /
Front (Lake) : �.� Right Side: �.�
!d/
Rear (Street) : �O Left Side:
Adjacent Structures: � � + _ Wetland: � ��
!
BuiJ.ding Height: Def. Hgt. a3,�o� Peak Hgt. � �.�
Avg. Setback: �/�i�- Lot Coverage: � �a
Existing Proposed
Hardcover: 0-75'
�s—a5o � 3 2� � 3 ��
a50—soo� 1��� 1�y�
5oo—i000 �
Hardcover Variance Required: Yes No �-- Date of Council Approva�:�_
Grading: Staff Approval. Date: By: Council Approval Date:
Septi c: Staf f Approva]. Date: BY� /�� ro
Zoning File:# � Resolution #: Resolution Date:
REMARRS (in house) :
BQII.DING REVIEW CHECR LIST
� r r
IIgC� CONSTRIICTION TYPE: +
Sq Footage $ Per Sq Ftg
Basement x =
lst FT�oor x -
2nd Floor x �. -
Garage X - �
x = ,�,.�
/�J ���
TOTAL �t�i ���o/, � , ��L�
�a
$stimated Construction Value: $ ��� 7`7�
Inspections Required: Work Requirinq Separate Permits:
Site ' Plumbing Grading/Fi].7.ing
Footing Mechanical Fire
�Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
Final (Mfg.) Other
Other Well (State Permit)
�Electrical. (State Permit)
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REMARRS (IN HOIISB) :
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
------------------------------------------- ------------- --------- -- - -
RffiKARRS (TO BE NOTBD ON P$RMIT) : � s /
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