HomeMy WebLinkAbout1998-011014 - remodel part basement PERMIT
CITY OF ORONO PERMIT TYPE:
�'�50 Kelley Parkway- P.O. Box 66 '�'`-}``-���'��`
Crystal Bay, Minnesota 55323 Permit Number: ;��. �;��;�,
� (612) 473-7357 Date Issued: ; � j�-�(_f j�`-t;^�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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. �APPLICA EE SIG ATURE ISSUED BY:SIGNATURE
-�Total Fee: $ 3�.�..5� Date Received:
Entered By: Perm.it#: (`� f
CITY OF ORONO - BTJII,DING PERMIT APPLICATION
A.11 information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICAl�'T IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: ZGSo Pheas,u.�� ��. ZIp: S�G33 /
NAME OF OWNER: rrjlla��r� f�. �o//,-�'F PHONE: (home) y7/-D�7 8
(work) s 93-7 yds
MAII�INGADDRESS• z68o ���aswH �- �d. CITY: �'x«ls•�, ZIP: .�ti
CONTRACTOR: PHONE:
CONTACT PERSOl�': MOBILE/PAGER:
MAII.,ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/El\'GINEER: PHONE:
MAILPTG ADDRFSS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED WORK(describe in detai�: � M�w u,�Ns �o� 6a -��+�oo•� � Clostf
STORIES: SQ.F'EET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ ��0d° � .
I hereby apply for a building pemut 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: . v DATE: ���Z� `9�
NOTE! Parade q�'Homes events require separate permit approval by Police De�artment and
City Counci160 days prior to the event. Non permitted events will not be allowed.
�
Sec.13.04 RIGHTS OF S[lBJECTS OF DaTA
Subd. 1. Type of data. 'Ihe righcs of individual on whom che data is scored or ro be scorod shall be as sec forth in this section.
Subd.2. Intormation reqirired to be given individual. An individual uked w suppty privare ar confidendal dara concerning himseif shall
be informed of: (a)the purpou and in�ended use of the izquesied daa wi[hin the collecdng State ageacy,poliacal subdivision.or scatewide rystem;
(b)whecher he may refuu or is legally required to supply che requesced data:(c)any frnown caaaequence arising from his supplying or refusing to supply
priva�e or confidendal dara:and(d)the idendry of other persoas or cnddes authorized by state or fedecal law to rcceive the dara. 'Ibis requ'uement shall
not apply when an individua!is uked to supply invesdgadve data,pursuanc ro secdon 13.82,subdivision S, to a(aw enforcement officer.
The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income tax or orovectv tax refund
instrucdons instead of on chose forms.
Subd.3. Accas to data by iadividuaI. Upon requcsc ro a responsible aurhoriry,an individual shall be informed whether he is the subject
of scored data on individuals,and whecher i[is classified as pubiic,privace or confidential. Upon his further request,an individual who is the subject
of stored Qrivate or public data on individuals shall be shown che dare wichout any charge to him and;if he desires, shall be informed of the concenc
and meaning of�hat dara. After an individual has been shown che private dara and informed of icc meaniag,che dara need not be disclosed to him for
sic monrhs[hereafur unless a d'upute nr 2edon pursuanc co chis secdon is pcnding oc addidooal dard on the individual 6as been colleccPd or created.
The msponsible au�hority shall provide copies of the private or public data upon requesc by rhe individual subjecc of the daca. The responsible authoriry
may require[he�equesdng person to pay the actual cosu of making,cerdfying,and compiling the copies.
The responsible auehoricy shall comply immediately,if possible,wich any request made purruant to this subdivision,or wi[hin five days of
�he dam of che requese,excluding Samrdays,Sundays and legal holidays,if immediate comptiance is not possible. If he cannoc comply wirh the requesc
wirhin th3c dme,he shall so inform the individual,and may have an addidonal five days wi�hin which to compty wich ehe request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest ehe accuracy or completeness of pubiic or private
dara conceming himse(f. To exercise chis right,an individual shall noafy in wridng the respoasibie aurhoriry describing the nature of the disagreement.
The nsponsible auchoriry shall within 30 days eieher: (a)correct the data found ro be inaccurdte or incomplcte and atumpc to nodfy past recipienu of
inaccurnce or incomple�e data,including recipien�c named by che individual;or(b)nodfy the individual thac he believes the data to be correct Dara
in dispu�e shall be disclosed only if the individual's statemenc of disagreement is included with[he disclosed data.
The decersninaaon of che rosponsible authoriry may be appealed pursuant to the provisions of the adminisaarive proceduro act relating to
contesud cases.
DATA PRIVACY ADVISORY
� In accordance with M.S. 13.04, Subd.2, "Ri,,Q.hts 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
confidencial information.
You aze notified thar.
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, stace or federal a�encies 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 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
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Ciry Sra�e Zip Phone
I understand my rig stated above.
Signamre
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C�-IECK OF'F' LZST FOR TSSUANCE OF PER�I�Z�TS
� FOR OFFICE USE ONLY
� ADDRFSS OR LEGAL: _ Z��d P�}-��S�rvr- � .
PID:
DESCRIPTION OF WOR�i: _�C'_����o-eti. 02.�,o-,� h�ft�Pvn�t - .
ZO�Z�tG REVIEti� BY: N 1/-� ~ - ~� DATE ApPROVED: -~-
BUII.,D .J�i 1G REVIE�'Y BY: � . DAT�APPROVED: // • zv: �'g
�'EES TO BE CHARGED: • �� � Misc. Fees Calculated By: N� �
PERMIT _Yes !/ No '
PLAN REVIEW Yes v" No SE�YF.�Z CONNECTION
STATE SUR`H�FLG�, Yes � No �AT�CO�INECITON
I7VYESTIGAZZON-FEE Yes No PARK FEE
SAC Yes No SITEINSPECITON
Number of SAC Units �`01'HER (specify)
ZO�TI3�TG CHECK LIST zoning District: /V b G<�YfYJG �Q � � ~
Fire Deparflnent: Post Office: _ School District: '
Lot Area: Sq.fr. Acres �Vidth Dep[h
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
- � _ _ __--�-
Flont {La.ke): , RiahE��de: -- �- - —
Rear (S[reet): Left Side:
Adjacent Structures: tiV tland:
Building Height: Def. Hgt. P k Hgt.
Lot Coverzge:
Gradin?: Stafi Approval Date: - . By: Council Approval Date:
Septic: Staff Approval Date: gy; • � .
Zonino File: � Resolution: � Resolution Date: •
Shoreland Dis�-icc: �
Avg. Setback: Bluff Se back: I,ot Coverage: � .
� ' E�s� Proposed �
Hardcover: 0-75'
75-250' . - '
250-SQO' . •
SQQ-lOQO'
Hardcoi•er Varia.nce Required: Yes No Date of Councii Approval:
�
RE1�Z4R.KS ('in house): �
� - _ . • .
' �� . 26 .
BUILDING REVIEti'V CHECK LIST . . . .
UBC: /�- —.3 CONSTRUCTION TYPE: �//v
� Sq Foota�e $ Per Sq Ft�
. Basemeat X _ - .
. . lst Floor . � . . X . . — � : .
2ad Floor • -� • .x -. . . ' . . � .'
Gara�e ' , X . ' � . . - •
x
TOTAL
Estimated Coastruction Value: � 1�po� `�- .
- - — 7rLspections Required: • Work Re uirin� p
Site q a Se arate Pecmits;
• ._p�Piumbing Fire . � �
Hardcover Removal Mechanical � � �
FQo��� tiVater Connection. .
S�P�I� Sewer Connection
_�, Frami�o Fireplace �� �, �
_p�,Insulation __ (Masonry) Ocher �ation
_�, Wall Board (1blfa. . . .
_� p�� � � ) Well (State Perm.it) . �
Other
Gradin�/Fi11in� _� Electrical (State Perm.it)
RE1l�IARTaS (IN HOUSE): � ---------~ -- —
------------------ �
------- DATE
REVIE'�Y BY OTHERS: ----- -
Access: Exiscin� New -
-----
• Access Approval: Date .
REl ----------------- ---_____�Y� � _ _
tiIAR�iS (�'O BE NOTED ON PERitiiXT); .
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