HomeMy WebLinkAbout1998-010978 - porch PERMIT
CITY OF ORONO PERMIT TYPE: — -
t 2750.Kelley Parkway- P.O. Box 66 F'`�''�='�`�`��`
Cr stal Ba , Minnesota 55323 Permit Number: i�+1 ;����i���i
y y Date Issued:
(612) 473-7357 � j .::`��j':���
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURF, SUED BY:SIGNATURE
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' Total Fee: $ Date Received:
Entered By: � Pernut#: � L I 7 �j�'
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � `7'��d /�Ole� �'"��- �ZIP:
1� /
NAME OF OWNER: �(�-L.Sc:��— PHONE: (home)
(wark)
MAILING ADDRESS: ��--v►-�2._ CITY: ZIP:
CONTR�ICTOR: � Z �l�n-S ., PHONE: �`�3—��
CONTA�T PERSON: L MOBILE/PAGER: �`7—`�' �'�3
MAILI\GADDRESS:,� �C.��x�l1�.t..C�-P CITY: /,./�. ZIP: ��3��
STATE LICENSE: # ����/�"' �
ARCHITECT/ENGINEER: ��'�'y��— PHONE:
MAILI:�1G ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK (describe in detain: ���� La� � �� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /���
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 acco dance with the approved plan.
APPLICANT'S SIGNATURE: "' � — DATE: ��Ul� ��
NOTE! Parade of Homes events require separate permit approval by Police Deparlment 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 SUBJECTS 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 secdon.
Subd.2. Information required to be given individual. M individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intecded use of the requested data within the collecring state agency,polidcal 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 suppiying or
refusing to supply private or confidendal daha;and(d)the idendry of other persons or enriaes authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav nlace the norice rewired under this subdivision in the individual income tax or orocem tax refund
instrucrions instead 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 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 d�e data without any charge to him 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 its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or acuon pursuant to this secrion is pending or additional data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or Ewblic 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 tnade pursuant to this subdivision,or within five days
of the date of the ree(uest,excluding Saturdays,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 compty with the requesc,
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
privare dala concerning himself. To exercise this right,an individual shall notify in writing the responsibie authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify
past recipients of inaccurate or incomplete daha,including recipients named by the individual;or(b)nodfy 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 determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relaang
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�ity 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 permit or license.
3. The information may be shared with other local, state or federal agencies to the eztent 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.
���� � ���z
First Middle Last
`�� �'/t��(� ►�t� 6�-
Ad ess / , fL� ��'/(/— ��J�/ �� / �
L�f�l�-i (�
City State Zip Phone
I understand my�hts s stated above.
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Signature
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' CHECK OFF LIST FOR ISSUANCE OF PER'�IITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ��{5� ��p 2-Z-}-( St�v�z� 1�2 t u L.
PID:
DESCRIPTION OF WORK: 0 2CJ�-�
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ZONING REVIEW BY: � DATE APPROVED: ( �- S- S�3
BUILDING REVIEW BY: DATE APPROVED: ! ( -5-�j�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �� No �
PLAN REVIEW Yes _ ,/' No SEWER CONNECT`ION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes �� No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
�----=�------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning Disuict: L.,le-1 L
Fire Department: � = Post Office: W�q.�,,� School District: pRpn�o
Lot Area: Sq.ft. -1�9'i O Acres .t$ Width .�� Depth //L(1,�,s�v�a-.�(
Survey Submitted: Yes� No Date of Survey: I !- ►2.-�6
Proposed Setbacks: � �
Front (Lake): G S � 1�f0 Right Side: �,'Z
Rear (Street): �(90� �= Left Side: I�� �'
Adjacent Structures: {�-r'ty�.Gl-4ti✓� Wetland: N ��
Building Height: Def. Hgt. (�.(� Peak Hgt. U` -<<
Lot Coverage: Z.�.ZS
Grading: Staff Approval Date: /��� By: — Council Approval Date: --
Septic: Staff Approval Date: N �� By: —
Zoning File: # 2 y Z Resolution: # Resolution Date: ��"Z6-�i$
Shoreland District:
Avg. Setba : y/�yL�� Bluff Setback: /�/�� L.ot Coveraae: �i�- Z�
Existing Proposed �
Hardcover: 0-75'
75-250' 3 b•t b 3?.y3
250-500'
500-1000'
Hardcover Variance Required: Yes C No ' Date of Council Approval: �o uo-s�
REMARKS (in house): ��p R.�� 5�2.�'�� W�� PPf1�W�,< <
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BUILDING REVIEW CHECK LIST
UBC: �Z• 3 CONSTRUCTTON TYPE: �/�J
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
o�-u-� /� x .z.z.►S = 3'-t S�;Y o
TOTAL
Estimated Construction Value: $ 3i�( ����
Inspections Required: Work Requiring Separate Permits:
Site Plumbine Fire
Hardcover Removal Mechanical Water Connection
D�Footing Septic Sewer Connection
o�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
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): P�- Go�,�o �-rt o,�rs �� cl�t��
� • ' �
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