HomeMy WebLinkAbout1996-007945 - replace deck �
� PERMIT
` CITY OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �;i 1 j 4 fi T r,�i;
Crystal Bay, Minnesota 55323 Permit Number:
;ia'l j°_�i,�.�
(612)473-7357 Date Issued: �j��i ��_!�,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
AF'F`i;�iUE[} F`ER �:Ilf��I T I�_���I`=� �:�i� ��°:;i�L���T I���N #=�����, .
FEE SUMMARY:
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CONTRACTOR: — �����1 i����t• — '=,T . �I s.`: OWNER:
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APPLICA /PER ITEE ATURE ISSUED BY:SIGNATURE C� �
, � �` • '� CITY OF ORONO – BIIILDING PERMIT APPI,ICATION
Tota]. Fee: $ /��� � �-" �JJ _��"'No� Date Received:
�s11�r_,;-...�! � r� ��
.. 1 `/� . .��
Date Approved:
Entered By: � • �'2'` permit�: ��(`�5
�AUG 8 �995
ALL INFORMATION MIIST B$ SDBMITT� IN F'UL.L BEFORE PI.AN REVIEW WILL B$ STARTED
(See Check-aff List Encl.osed)
THE APPLICANT IS: (circle one) OWNER or ONTRACTOR
JOB SITE ADDRSSS: �,j S '� �vrvr ��].�� al� cl ZIP:
(work)
?;� oF owr7�t: Q;, ,, a � �.rt G u � [' `i PHoxE: (home) �/73� �S y9
MAILING ADDRESS� f,$" 31 �� �� r�Q �,1 � � ,a�✓/ CITY:�p �(.�D ZIP: ��.��3
CONTRACTOR: �2. f - �s� ��. � �o(��,e2 s ��� PHONE: rI S �"' �/.Z .Z �—.
MAILING ADDRESS:�� �;p I7 s" ��1�v �� /�U.�� CITY: /��}�t S'�' �1 ZIP: .�5�j���
ST�TS LICENSE: � 7 Ff S" �
ARCHITECT/ENGINEER: PHONE:
MATLING ADDRBSS: CITY: ZIP:
ri�: RSGISTRATION �
TYPE OF WORK: New Addition Accessory Strncture Move
Demo Re.*nodei/Alteration_� Renovate Land Alteration
PROPOSED WORR (describe in detail) : cT � `�4 N �! h' '���S r f �+�' �s �Je c: �`
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF B$DROOMS: GARAG$ STALLS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding Iand) : $ �p(1 O o o C�
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
t'�at the work will be in.�.�e�s�rdance with the approved plan. .
\
APPI�ICANT'S SI6NATQRE: . � ?2.�f DATE: �- �� .'�
�_
.. ,
. , . .
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minnetonka
DATA PRNACY 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
l.icense from the City of Orono or any of its departments may require
you to furnish certain private or confidentiaZ 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 Iicense requires Counci3. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva��
data on yourself.
6. Yaur ful3. name is required to process this appl.icatian or
�t �-
permit. / R t- C� /� �ri �a/P ,e .� .� 'UC.
�o� h- � �v i.►� /V! �� e �-
Fi t Middle Last
23 5^p r7s- �k �.� �V e � -
Address
�.4� c � � /�I � sr 5�3 v 3
City State Zip
�.�.3 " �� 1- -�_'_'
Phone
I understand my rights as stated above.
�.� .
Signat e
BUILDING&ZONING-473-7357 • ADMIlVISTRATION&FINAIVCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
I
� ,►
. . .
�.04 RIGSTS OF SIIBJECTS OF DATA � .
gubdivision L Type of date- The rights of individuals 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 in�v��' An.individual asked to
� ' su ly private or confidentiel data concerning amwi�in the collect g stat agency,
PP
purpose and intended use of the requested da
olitical subdivision, or statewide system; (b) whether he may refuse or is legally
p the requested date; (c) any known consequence arising from his
required to suQply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply P Stete or federal law to rice��e st gg�ve da a
other persons or entities authorized by
requirement shall not apply when an indt�viala en orcementuofflcer.
pursusnt to section 13.82, subdivision �,
The commissioner of revenue ma lace the notice re uired under this
subdivision in the individuel income tax or ro ert tax re und instructions instead o
on those orms. . - --- - " .
Subd. 3.
Access to data bY in�ivi�L Upon request to a responsible
authority, an individuel shall be informed Wh ublic pr'vateeor confident al.e Upon his
individuels, and Whether it is classified es p � ublic data on
further request, an individual who is the subject of e to�mrl�ae if he desires, shall
individuels shall be shown the data witho of�hat data. After an individual has been
6e informed of the content and meaning t� �ta need not be disclosed to
shown the private date and informed of its mesning, u��t to this section is
him for six months thereafter unless e disPute or aetion p
� ending or additionel data on the individuel h� 8 e or public datarupona equest by
• p require the
responsible authority shall provide copies of t e p �in the
the individual subject ofthe actuel�cos h of making,l certl 3'ingya�d comp g
requesting person to pay -
copies. it ssible, with any request
The responsible authority shell comply immediately, P�
ursuant to this subdivision, or within five days of the date of the request,
made p S�dB� �d legal holidays, if immediate complianae is not
excluding Saturdays,
possible. If h� cannot comply with the request within�ii�ntlWr�ch toh mply w�h the
individuel, and maY hs�e a� additionel five days
and le holidays•
request, excluding Saturdays, SundaYS �
Subd. 4. Pmcedia'e' when data is not accurate or complete. An individuel TnBy
himself. To
contest the accuracy or completeness of public orlpriwvrai� the�responsible authority
exercise this right, an individual shall notify 11
describing the nature of the disagreement. The responsible authoritq shall within 30
days either: (a) correct the data found to be ete dataeincludingrec pients name t bY
notify past recipients of inaccurate or mcomp
the individusl, or (b) notify the individual i��a ���tatementof disagreernent is
Data in dispute shall be disclosed only �f th
• included with the disclosed data• e�led pursuant to the
' The determination of the responsible authority may be aPP
provisions of the administretive procedure act relating te contested cases.
i
, CHECR OFF LIST FOR ISSIIANCE OF PERMITS
• � � � FOR OFFICE USE ONLY
ADDRFSS OR LEGAL: /S 3�S C:v/v C> C.�,¢�-C.' r'��.�'r'::� PID:
DESCRIPTION OF WORR: k��„'��
-------------- --- -- -------------
------------------- ---- ---' -------- ----� �� � �
ZONING REVIEW BY: f � �� DATE APPROVED: -
BIIILDING REVIEW BY: �- � �{,v-t--� DATE APPROVED: 5 "��
----------------------� ---------------------------------- --- ---------------
FEES TO BE CHARGED: `� Misc. Fees Calculated By:
PERMIT Yes �..� No
PLAN REVIEW Yes .� No SEWER CONNECTION
STATE SURCAARGE Yes ..�� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
-------------------------------------
ZONING CHECR Li�T Zonzng District: �.r'-j�
Fire Department- l',o,�.c. .c=; Post Office: (�-,�,���=' School. District: u�4'`�O
Lot Area: ���ivc�y:,�� •2i kc��5 Width: S'�.�S � � Depth: ��' � �
Survey Submitted: Yes � No Date of Survey: 2 Z-`75 _
Proposed Setbacks : . j �
�� (Lake) : Right Side: �'
Rear (Street) : � � � Left Side: ` U (
. a
Adjacent Structures: Wetland:
Bui].ding Height: Def . Hgt. Peak Hgt.
Avg. Setback: Lot Coverage:
Existing Proposed
�
Hardcover: 0-75 '
,� � � t�
75-250 ' � �=- r ' �
250-500 '
500-1000 '
Hardcover Variance Required: Yes� No Date of Council Approval:
Grading: Staff Approva7. Date: By: Council Approval. Date:
Septic: Staff Approval Date: BY=
Zoning File: # �L'�� � Resolution # : 5��� Resolution Date: r�'� �� �S
REMARRS (in house) :
BQILDING REVIEW CHECK LIST , . ,
.
IIBC: �� CONSTRIICTION TYPR: 'V�--
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
���,/
$stimated Construction Value: $ i U� v
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�Footing Mechanical Fire
�Framing Septic Water Connection
Sr.su�ation Firepl::ce S�wer Conn��ticn
Wa�l Board (Masonry) Lawn Irrigation
�Fina 1 (Mf g.) Other
Other Well (State Permit)
Electrical (State Permit)
----------------------------------------------------------------------------
REMARKS (IN HOIISE) :
-----------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY=
-------------------------------------------------------------------
REMARRS (TO BE NOTED ON PERMIT) :
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