HomeMy WebLinkAbout1992-004768 - deck addition . PERMI'��
r OF ORONO "� °� QERMIT TYPE: �.;��j������;�
�wn Rd. South • P.O. Box 66 Permit Number: i;i;�.?�„_
3ay, Minnesota 55323 Date Issued: � �;'i_3�.:'��'
�0�2) 473-7357
SITE ADDRESS:
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REMARKS:
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APPLICANTiPERMITEE SIGNATURE ISSUEO 9Y:SIGNATURE .�4�
\i
�
CITY OF ORONO -�• BQI7.�DING PERMIT APPLICATION
Total Fee: $ � �r � � Date Received:
Date Approved:
Entered By: ���Ld d
Permit�: �{7�P0
AT•T• INFORMATION MIIST BS SIIBMITTED IN FI]LL BEFORE PLAN REVIEW WII,L BB STARTED
(See Check-off List Enclosed)
------------------------------�----------------------------------��------------
THE APPLICANT IS: (circle one ' OWNER or CONTRACTOR
. � /
JOB SI TE ADDR$SS: /���� . c��.DY�.�. 2� J Z IP: `� � 3C�fJ�`
(work) ���-/Z/�
NA1�II� OF OWNER: � ���9c� PHONE: (home) �,��'�G(y'�
MATLING ADDRESS: � CITY: R ZIP: cgiS����
CONTRACTOR: �i'di�YLSL PHONE:
MAII�ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure Mave
Demo Remodel/Alteration�_ Renovate Land Alteration
PROPOSED WORK (describe in detail) : � � '� -ll.c��c—
c �
� �. �i -f' �.., � �
STORIES:�_ SQ. FEE'1' OF EACH FLOOR:�� (,�� _
NO. OF BEDROOMS: � GARAGE STALLS: ATT.�_ DET.
ESTIMATED CONSTRIICTION VALIIATION (escluding land) : $ �l ��
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 SIGNATORE. DATE:
' CHECR OFF. LIST FOR ISSUANCE OF PERMITS
FOR OFF�CE USE ONLY
ADDRESS OR LEGAL: �3�,�� �, �(,t� ���' PID:
DESCRIPTION OF WORK:��� {��IC� t �.�
----- --------------------------------
-------------- --- - - ---
ZONING REVIEW BY: ���,� DATE APPROVED: , ;J �/ `���
/
BIIILDING REVIEW BY: � DATE APPROVED: � " �
------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ��� No
PLAN REVIEW Yes �= No SEWER CONNECTION
STATE SURCHARGE Yes l' No WATER CONNECTION
INVESTIGATION FEE Yes No �/ PARK FEE
SAC Yes No �/ SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------
ZONING CHECR LIST Zoning District: L� li
Fire Department: ��� Post Office: /J//,��,,.,� Schoo� District: /'� �
Lot Area: J �, � �'� Width: �(�j) � � Depth:
Survey Submitted: Yes� No Date of Survey:
Proposed Setbacks : , ,
� (Lake) /���A Right Side: � �3,� -
�
Re�-� (Street) : �C� � Left Side:�'�,�� ��"�_`
Adjacent Structures : f� {� �%r Wetland: j�%�r�
-�
Bui�ding Height: Def . Hgt. iv��I Peak Hgt. /�� ���
Avg. Setback: /�'/�1� Lot Coverage: �
Existing Proposed
Hardcover: 0-75 '
75-250 ' L�' i 5��
250-500 ' �
500-1000 '
Hardcover Variance Required: Yes NoL�_ Date of Council Approval:
Grading: Staff Approval Date: � � By:� Coun�il Approval Date:
Septic: Staff Approva� Date: % �y:
/
Zoning File: # Resolution #: Resolution Date:
REMARRS (in house) :
r
r
BDILDING REVIEW CHECR I�IST � , �
� ��
IIBC: �� /1� 3 CONSTRIICTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement x =
lst F].00r x =
2nd Fl.00r x =
Garage x =
�e,t� ss x��, x �D c� _
TOTAL
$stimated Construction Value: $ ���
Inspections Required: Work Requiring Separate Permits:
Site P7.umbing Grading/Fi1.7�ing
�Footing Mechanical Fire
�Framing Septic Water Connection
Insu�ation Fireplace Sewer Connection
Wa�� Board (Masonry) Lawn Irrigation
p�Fina]. (Mfg.) Other
Other WeIJ. (State Permit)
Electrica�. (State Permit)
-------------------------------------------------------------------------------
�_FMARKS (IN HOIISE) :
-------------------------------------------------------------------------------
REVIEfii BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REIrlARRS (TO BE NOTED ON PERMIT) :
. ' , .
�� .
�I'1'Y Of ORO�iTO
Post Office Box 66•Crystal Bay,Minn�ota 55323•Municipal Offices
•
F � - � � 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 Iike 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 refusa]. may require that
the City deny the permit or license.
3. The information may be shared with other local, s�ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Council actian
to approve, some information may become pubZic.
5. You have certain rights under M.S. 13.04 to review private
data on yourself.
6. Your full name is required to process this application or
permit.
� O �dO� �...� r �
First Middle Last
�� � k� �� ��Z ,
Address
f/��.� �%�. �s 3 G�°
City State Zip
���� ��� �
Phone
I unde and my rights as stated above.
Sig ture .
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSlNG
f.__-�------ - �
. .
�.p,4 RIGHTS OF SIIBJEC'I'S OF DATA � -
gubdivision L Type of data- The rights of individusls on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information re�quired to be given individuel. An.individuel esked to
� ' supply private or confidentiel data concerning himself shalt be informe�ate agency,
purpose and intended use of the requested data within the coll T� or � e��y
po li t i c a l s u b d i v i s i o n, o r s t a t e w ide s y stem; (b) whether he ma„
1 the requested data; (c) any k ncwn c o n s e q u e n c e a r i s i n g f r o m his
required to supp y
supplying or re fusi n g t o s u p p l y p r i v a t e o r confidentiel data; and (d) the identity o
other persons or entities authorized by state or federal law to re�e��ee th e�ve da t a
requiremen t s h a ll n o t a p p l y w h e n a n i n d i v i dual is esked to supply g
pursua�►t to section 13.82, subdivision 5, to a law enforcement o f fice r.
The commissioner of revenue ma o ert t� re°una instructio�in�teadh�s
subdivision in the individual income tax �r r
on those orms. . --- -� - - .
A�� � �� by ����, Upon request to e responsible
Subd. 3.
authority, an individuel shall be informed whether h��gteeoriconfidential.e IIpon his
�dividusls; and whether it is classified as publia, P ublic ciata on
further request, an individuel v�►hc is the subject of st t�e�mri�ae�he �r�� shall
individusls shall be shown the data ntitho of�hat dat�a. After an individusl hes been
�e informed of the content and meaning t� �� ne�d not be disclosed to
shown the private date and infocmed of Its m teaninBgc�on p��t to this section is
him for six months thereafter unless a �P been ccllected or created. The
� pending or additional data on the individuel t►� �li� �ta upon request by
� responsible authority shall provide copies of the prlo�i�Ier authority may require the
the individual subject of the data. The resp �d comp�ing the
requesting person to pay the actual costs of making,
certifying,
copies. ' immediatelY, if pcssible, with any request
The responsible authority she]1 comply � of the date of the request,
made pursuant to this subdivision, or witlzin five ��immediate compliance is not
excluding Saturdays, Sundays and legal holideys,
ossible. If he cannot comply with the request within that time, he shall so i��th the
p hsve en additionel five dsYs within which to comply
individuel, and may 5��� �d legal holidays•
request, exeluding Saturdays:
te or oomplete. An indiv�dual may
Subd. 4. Procedure when data is not ace��'8 �innseif. To
contest the accuracy or completeness�of public o inri�vaMtt�t�COn��ble authority
exercise this right, an indivi� s� notify nsible euthority shall within 30
describing the nature of the disagreemenL The resP°
days either. (s) correct the data found to bQ lete datae includir►g pee�pl�� namedt by
notify past recipients of inaecurate or incomP
the individuel; or (b) notify the individuel that he believes the data to �ement is
Data in dispute sha]l be d i s c lose d o n l y i f t h e i ndividuai's statement of disagr
• included with the disclosed data• � aQpealed pursuant to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested ceses-
,„ ' , ,
HARDCOVFR CALCULATION W�ORKSHE T
SETBACK ZONE: �CIRCLE ONE) �-75 75—�5�� 25�-5��' S��-1���'
EXISTING HARDCOVER IN ZONE
--------------------------
A� � HOUSE °� ' X � _ �I�SF� S.F�
• LENGTH WIDTH
x = ' S.F.
X = S.F�
� X = S�F�
X = S�F�
B� GARAGE �� X � _ '7`'j Q S�F�
C. DR I VEYVAY
g x a'� = 11 � s.F,
I � X �`S = L�b � S�F�
D�. SIDEWALK �`��� X = S�F�
X = S�F�
X = S.F�
E� ATIO/
�ECK
� x D = �C9� S.F�
F.LANDSCAPE X = S.F.
AREAS
UNDERLAIN ��ea�
BY X = S�F�
PLASTIC� . '
SHEETING
x = S�F�
x = S�F�
G� OTHER X � = S�F�
TOTAL HARDCOVER IN ZONE — � S�F� �
TOTAL PROPERTY AREA IN ZONE — S�F� �
n ���� : a X ioo = �� ��
19
. �
HARDCOUFR CALCULATION W SHEET
SETBACK ZONE: �CIRCLE oNE) 0-75' 75-250' 250-500' S00-1000�
EXISTING HARDCOVER IN ZONE
--------------------------
A� HOUSE X = S�F�
LENGTH WIDTH
X = S,F�
X = S� F�
X = S�F�
X = S� F�
B. GARAGE X = S�F�
C� DRIVEWAY X = S.F�
X = S� F�
D� SIDEWALK X = S, F.
J
'� I ' = S� F�
X = S,F�
E� PATIO�
DECK
X = S.F.
F� LANDSCAPE X = S,F�
AREAS
UNDERLAIN
BY X = S�F�
PLASTIC
SHEETING
X = S�F.
X = S.F�
G� OTHER X = S.F�
TOTAL HARDCOVER IN ZONE - S� F� a
TOTAL PROPERTY AREA IN ZONE - S� F� a
n : B X loa = -�- i
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