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HomeMy WebLinkAbout1994-005980 - siding/door PERMIT PERMIT TYPE: CI'�Y OF ORONO 2750 Kelley Parkway • P.O. Box 815 '='„ I :I I'dC� Orono, Minnesota 55356 0815 Permit Number: ;t; ' ;=;t� (612) 473-7357 Date Issued: ti:;,` _�:`'psi SITE ADDRESS: R40 OL D LONG LAKE RD CH F' . I .N . •c-11;=-_::-41-t�; ;ti1. DESCRIPTION: °r;I D I tG:DUf iR Build.'”ill; DP,rrrii t. Typ '=F--ADD/REMODEL +(C4i It�ill'� t1 orl•:. Type RE-_'IDL. ttom' . Ocrlad='_ill'=y F:-:=: C.:tInst•ru t•iori Type VN 41 LII- 1213.(„2/y-. .--- REMARKS: I MIA;i++-'L l:.i REMARKS. '-' ''" " 1 -113.10.'17LV %s? rc i #r!= "xi // //L'../L��!!}}L617 11+6'+VV 1vJVI V( V�JV " 01 :1- + FEE SUMMARY: VALUATION _ 22220 tit? ' n 01 bb, 'T+td CHECK r BaseFee $108. 00 RECEIPT-'ii.; f" L°jit3 !1117!7}1 ! -.; Plan Review .?{; i't_; # t}t1•},•,t: i•t�ui i_rs= -a +: { - nL'vvv rl% 4vvi 11v1 r 14 -i S1urch=trg ,t. i 3/ ' i'',,=. TO{t.a I Fee $182 . 45 CONTRACTOR: R: - App I i C ctllt• - 840 ORONO X173-7_937 TNS � QRSHEREBY . QUESTS-- RM168 O 1 THE REAL-- IMPROVEMENTS .. ,F'�� ETEC? AI+ AGREES 0 D ALL <« IN S RIt T CD S.T =11 :E* t . Al, G T URONO'ORO I N ES A NATE F 3'' , *" 4. {9 !! �:" R€ � NT . ,, - X �� SLSf%J " --- 4eie CV�ms/�J ••PLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE C.-it •44 + CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ /u ./S Date Received: .s5 -?f - 7 7 Date Approved: Entered By: */""/:7. ) Permit#:a:5-c)Ye) ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) THE APPLICANT IS: (circle one) !•^ 1110 .r CONTRACTOR JOB SITE ADDRESS: gr-K0 0/e 64' LA:- £Ge- ZIP: .„1.)--:5--3/ / (work) 'J NAME OF OWNER: f��.�1i' aG ez:-.� PHONE: (home) `r4 77-17 MAILING ADDRESS:lrc /1 /4 !r ,,„i6: CITY: Z{f,AtU z.44 ziy. ZIP: 17;37/ J CONTRACTOR: 61, ),2,c_ PHONE: 1/7.3J - 773 7 MAILING ADDRESS: 2' e D/eil .1,7. j#,, G' CITY: f‘,/.72./.% ZIP: „5---127y STATE LICENSE: # ARCHITECT/ENGINEER: jloA:/✓ PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration ) Renovate Land Alteration PROPOSED WORK (describe in detail) : 4/Fhtl JX 7- e64, 2c- ic7 ..5; ;17,-, .- .4s ,C tie,„ 4,J, Q p.0 2 n.c/ ARL STORIES: / SQ. FEET OF EACH FLOOR: /..spa -,J EP-441) - 14..5yt•49-4 NO. OF BEDROOMS: ?3 GARAGE STALLS: ATT. 2- DET. `� 6o _ 71- `4,4 /47r ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ IS aa . " 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 accordance with the approved plan. APPLICANT'S SIGNATURE: 41,' - DATE: .a .27 -1,4 CITY of ORONO CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices OF ORONO 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: 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 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 to review private data on yourself. 6. Your full name is required to process this application or permit. 44711v . k?"4:6- First Middle Last 1 Address 0 City 7 State Zip '93 ' 7 .27 Phone I understand my rights as stated above. 4/ .I - gn -'-ure • BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS 473-7359 ASSESSING 4 513.04 RIGHTS OF SUBJECTS OF DATA . • Subdivision 1. Type of data. The rights of individuals on whom the data is stored or to be stored shall be as set forth in this section. to be given individual. An.individual asked to • Subd. 2. Information required himself shall be informed of: (a) the • • supply private or confidential data concerning purpose and intended use of the requested data within the collecting state nvy, tem; (b) whether he may from legally political subsupplynthe requested dator statewide a;a; (c) any known consequence arising his required to supply and (d) the identity of supplying or refusing to supply private or confidential data; otheror entities tities authorized by state or federal law to receive the data. This. p 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 ma 'placelce tax the re notice und iiistructid under his . subdivision in the individual income tax or roa rton those orms. — Subd. 3. Access to data by individual. Upon request to a responsible authorityy,, an individual shall be informed whether hprivatethe or confidential.stored Upon his individuals, and whether it is classified as p data ons to him and, if he desires, shall further request, an individual who is the subject of stored private or�du� has been individuals shall be shown the data withouofan���� After an individual Se informed of the content and meaning the data need not be disclosed to shown the private data and informed of its ��action pursuant to this section is _ him for six months thereafter unless a dispute or additional data on the individual ha.va been collected lie datarupereated. e request he pending the by the individualble authority subject shall provide copies The responsible authority may requireithe the of the data. certifying, and compiling requesting person to pay the actual costs of making, Yi g, copies. immediately, if possible, with any request The responsible authority shall comply ' request, made pursuant to this subdivision, or within five aysi of the date of the is the excluding Saturdays, Sundays and legal holidays, he if ot possible. If he cannot comply with the request withinihat which shall so inform with th the • p have an additional five days individual,eand may Saturdays, Sundays and legal holidays. request, excluding _ Subd. 4. Procedure when data is not accurate or complete. An individual To mcay the accuracy or completeness of public or private data concerning the responsible authority exercise this right, an individual shall notify in writing authority shall within 30 describing the nature of the disagreement. The responsible to days either: (a) correct the data found to be inaccurate� incomplete iients namedt by notify past recipients of inaccurate or incomplete the individual; or (b) notify the individual that he believes the data to be come is Data in dispute shall be disclosed only if the individual's statement of disagreementto the • included with the disclosed data. appealed pursuant The determination of the responsible authority may provisions of the administrative procedure act relating to contested cases. by CHECK OFF LIST FOR ISSUANCE OF PERMITS l FOR OFFICE USE ONLY ADDRESS OR LEGAL: O L 0 Uo l CPC PID: DESCRIPTION OF WORK: S t 01 re‘5 + O OO( ZONING REVIEW BY: N IA DATE APPROVED: BUILDING REVIEW BY: 4i0PAIew--- DATE APPROVED: 3 -i V--(Y FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes L No PLAN REVIEW Yes t/' No SEWER CONNECTION STATE SURCHARGE Yes & No WATER CONNECTION INVESTIGATION FEE Yes No f PARK FEE SAC Yes No 1 - SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: Fire Department: Post Office: School District: Lot Area: Width: Depth: . Survey Submitt= d: Yes No Da a of S rvey: Proposed Setba ks. Front (La e) : R' ght Si•e: Rear (Str -et) : eft Sid : Adjacent •truc'ures: Wetlan. : Building Heigh : De . Hgt. Pea Hgt. Avg. Setback: Lo Cover- ge: E isting •ropos- • Hardcover: 0-7 ' ' 75-251 ' 250-501 ' 500-100 h ' Hardcover Vari• nce Requi ed: Yes io Date of Council Appr.val: Grading: Staff Approval D=t- : By: Council Approval Date:___.__ Septic: Staff approval Da .- By: Zoning File:# Resolution #: Resolution Date: REMARKS (in ho -e) : I BUILDING REVIEW CHECK LIST UBC: R -3 .---- VN CONSTRUCTION.TYPE: Sq Footage $ Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage ` . x = x = TOTAL Estimated Construction Value: $ FSS S O O- Inspections Required: Work Requiring Separate Permits: Site ' Plumbing Grading/Filling Footing Mechanical Fire Framing Septic Water Connection InsulationFireplace Sewer Connection Wall Board (Masonry) Lawn Irrigation _Final (Mfg.) Other Other Well (State Permit) Electrical (State Permit) REMARKS (IN HOUSE) : REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT) :