HomeMy WebLinkAbout2006-P06312 - land alteration PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P06312
Crystal Bay, Minne�,ota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued:
2/9/2006
SITE ADDRESS: 1825 Shadywood Rd Unit#
Wayzata, MN 55391
P��� 17-117-23-24-0001
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu yc
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Berm infront of house at 5'property line!
FEE SUMMARY: Permit Fee: $ 50.00 valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Ronald&Sabrina Ruud OWNER: Ronald&Sabrina Ruud
1825 Shadywood Rd 1825 Shadywood Rd
Wayzata,MN 55391 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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� PLICANT PERMITEE SIGNATURE ISSUED BY S NATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: ~$ Date Received: �"�3-D 7
Entered ]3y: �4.� � Y-�� Permit#: �063 /2-
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CITY OF ORONO - B�;�'QG PERMIT APPLICATIOl`�T
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., yn,,, f ` 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
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JOB SITE ADDRESS: � � ���==, �f y:' ��;��.t)�(��eti `�C�i ZIP: �;,�,;�-', I
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NAIv� O��' OWN�:R: '�:_��n °�,�_��.t��, PHONE: (home) `�� } -�.4�<��f
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(work) �t'<�- �'� ': - �(����
MAII.ING ADDRESS: I ����, �'�`{_�z��,a�,�o ,'� <:`�' CITY: ���P�,�' ��������, ZIP: ���?'�f !
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CONTRACTOR , f,��.���,<.;. � J; ! l��x��:)_�j�' PHONE: , : � . _ �� ;
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CONTACT PERSON: ^� , � ,r,��� MOBILE/PAGER:
MAILING ADDRESS• - `:k CITY• '�,�i t,. .,, ' � ZIP: ��i �
, � � -Y- _
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
�I:�ILING ADDRESS: CITY: ZIP:
l�JAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration r'� %�Il I V1G��
Pn`�'P�SE'�VVORIi�c�esi,�'ibe ii2 ueiczil}: �u � <� `� ic.�n�' �.,� ,';� (` � , ;��� . �
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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 �.c�o�dance with the approved plan.
APPLICANT'S SIGNATURE:���.� ��" l_� r ,j� DAT'E: � �`���'� �Ln �.J���
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NOTE! ParadeQf Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.i3.04 RIGHTS OF S[JB,TECTS OF DATA _
Subd. 1. Type of data. The righa of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be givea individual. An individual asked to supply privau or confidential data conceming himself shall
be informed of: (a)the purpose and inunded use of the requesred dara wi[hin the collecting State agency,political subdivision,or statewide rystem;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence azising from his supplying or refusing to supply
private or confidenaal data;and(d)the idendty of orher persons or enriaes authorized by state or federal law to receive the data. This requirement shall
not appty when an individual is asked to supply invesrigadve dara, pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or Dropem taz refund
instructions 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 wherher 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 rhe data wirhout any charge W him and,-if he desires,shall be informed of the content
and meaning of that dara. 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 acdon pursuant to this secdon is pending or addidonai data un the individua!has been colleeted or created.
The responsible authority shall provide copies of the private or public dara upon request by the individuai subject of the data. The responsible authoriry
may require the requesdng person to pay the acrual coscs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possibte, with any request made pursuant to this subdivision,or wi[hin five days of
the date of the request,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 addidonal five days within which to comply with the request,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 pubtic or private
data conceming himself. To exercise this right,an individual shall nodfy in wricing the responsble authoriry describing che nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to noafy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correcc. Data
in dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible au[horiry may be appealed pursuant to the provisions of the administradve 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 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 ta the extent necessary to process
the pernut 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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Fi�� iddle Last
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Address Z js3ry ) S� — -1����/��
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C�� State Zip Phone
I understand m stated a ve.
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
. FOR OFFICE USE ONLY
ADDRE.SS OR LEGAL: t 43 Z S s l�ti w o oc� �o/ar+r� �
PID: '
DESCRIPTION OF WORK: Q�Z41,� = (,4,�u� ,C�,,.L,�..orJ
ZO.�tPIi G REVIEW BY: DATE APPROVED: S-7�v -0-3
BUII..DING REVIEW BY: N �/-� DAT'E APPROVED:
. . c.c-5s ��c sr�o c.�d•� y^,i�j w�fl c..�.�1 M�.�-.�L �./>r
FEES TO BE CHARGED: Misc. Fees Calculated By: �
PER1vIIT Yes r/ No
PLAl�T REVIEW Yes No SEWER CONNECTTOI�'
STATE SURCHARGE Yes No WATERCONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPEC TION
Number of SAC-Units OTHER (specify)
ZONING CH�CK LIST Zoning District:
Fire Department: Post Office: School District: �
Lot Area: Sq.ft. Acres � Width Depth
Survey Submitted: Yes_� No Date of Survey: �/`' F�(�tr
Proposed Setbacks: �
Front(Lake): Right Side: (����► / t.��
. (j�.� A-r ST.
Rear(Street): LeR Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Grading: Staff Approval Date: S. 20- c�3 By: �c�_ Council Approval Date: �
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland Disuict: 4�S
Avg. Setback: .v/� Bluff Setback: N//� Loc Coverage:
Ezistin; Proposed
Hazdcover: 0-75'
75-250' �v.C ,
250-500'
500-1000'
Hudcover Variance Required: Yes No_� Date of Council Approval:
REMARI�S(in house)• _
7
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BUILDING REVIEW Ci�Cg LIST '
�C' � CONSTRUCTION TYPE: —
_ Sq Footage $Per Sq Ftg
� Basement . . x _
lst Floor � x . . . _
2nd floor x _ �.
Garage x _
x =
TOTAL
Estimated Construction Value: $_Lq,�,,� ��R�,�� ��r►�„�02
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Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ' Se uc
- Fr�g P � Sewer Connection �
Fireplace Lawn Irrigation
Insulation (Masunry) Other
Wall Board � (Mfg.) Well(State Permit)
�F�� Grading/Filling Electrical(State Permit)
Other
RE1�Z�iRI�.4(IN HOUSE):
REV�W BY OTHERS• DATE: - ------------- _
Access: Ezisting New .
Access Approval: Date �
By:
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REMARSS (TO BE NOTED ON PEItivIIT�;
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