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Home My WebLink About2000-P02450 - entrance monuments PERMIT �ITI�Y OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po2aso Crystal Bay, Minnesota 55323 Pe�mit Type: Accessory Structures (612) 249-4600 Date Issued: siioioo SITE ADDRESS: 1930 Shoreline Dr WAYZATA,MN 55391 P I D: 10-117-23-42-0005 DESCRIPTION: Proposed Use: Permit Class: Building Census Code 329 Permit Type: Accessory Structures Permit Sub-type(s): Entrance Monuments DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 23.50 Valuation: $ 400.00 � -�1..��G_i^� ` .J� TOTAL FEE: $ �2.�,��01 APPLICANT: ROBERT STIERNA OWNER: R C STIERNA& P A STIERNA 1930 SHORELINE DR 1930 SHORELINE DR 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. � i''� -- � . �� C�.�..� AP LI AN MIT SI 'F SUED BY SIGNATi1RE r,� Copies: City,Applicant,Assessor, Finance Page 1 . To'�al Fee: $ Date Received: Entered By: Permit#: CIT'Y OF ORONO - BLTII..DIVG PERI�IIT APPLICATION All information must be submitted in fiill before plan review will be started. (please print all inforn�ation) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR aos srrE annxEss: �q 3 O S/fa�-�.'� �,�.��= �n�� z�: SS 3 �i / NAME OF OWNER: p��f't�` �r��N� PHOYE: (home) qS1-y 7� -l`�S'-/ (work) %S� -�(76 -O S��'' 1�IAII.ING ADDRFSS: ( /� SIf�RcL�e= CTTY: 1�'/��-I�it-�iY�1- ZIP:_�:3�L CONT'RACTOR: S�-�=� pg�� CONTACT PERSON: MOBILE/PAGER: . MAII.ING ADDRESS: CTTY• ZIP: � .. STATE LICENSE: # ARCHITECT/ENGINEER: pA�� iAII.ING ADDRFSS: CITY: ZIP: NA11�: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move RemodeUAlteration Land Alteration PROPOSED WORK(describe in detain: (r G l��r�a �s�" �-�`�^'�' oti�"'�^^�� s�r� �- z � R.� �� .e�r �-n c-� arF P� � ,��-,,,.�►-�, STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROObiS: GARAGE STALLS: ATT. DET. . � ESTII�i IATED CO�TSTRUCTION VALUATION (excluding lancn: $ �� " I hereby apply for a buildin�permit and I acknowledge that the informadon above is complete and accurate; chat 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 ce with the approved plan. APPLICANT'S SIGNA � DA�: �0�`� � NOTE! Parade of Homes events require separate permit approval by Poliee Depcutment and � City Council 60 days prior to the event. Non permitted events will not be allowed. r . Sec.13.04 RIGFiTS OF SUBJECTS OF DATa Subd. 1. Type o[data. The righ[s of iadividuai on whom che data is scoced or ao be smred shall be as set focth in chis seccon. Subd.2. Information reqirired to be givea iadividual. r1n individual asYed to supply private or coafidendal data concecaing hi�self shall be iaformed of: (a)the purpose and iaunded use of che requesied dara wi�hin�he coliecdag 3cue agency,polidcal subdivision,or sarewide rystem: (b)whether he may tefuse or is legally tequired to supply tbe cequesud dara:(c)anY Imown coasequeace arisiag from his supptying or refusing w supplY private or conndendal data:and(d)the ideariry of a�er persoas or enrides auchorized by siar_or federal(aw to reteive the daa. This requiremenc shall not apply when an indir•idual is asked to suppty ia�adgadve dam,pursuanc to secrion 13.82.subdivision 5,tn a law enfoczemea�officer. The commissioner of re�enu nav ola' the nodce rzauired under this subdivision in the individual income rax or provem mz cefur.d instrueaans inste�d of on chose forms. Subd.3. accas to data b�iadividual. lipon requesc to a czsponsible auchoriry,an individual shall be infarmed whecher he is the subject of sror_d daea on individuals,and whecher ic is c[us�ed as public,private or confidendal. Lpan his furthec request,aa individual who is the subjecc of stor.d private or public dam on individuals sha12 be shown che dan widiout any chac3e m him and:if he desires,shall be informed of rhe concent and meaning of rhat daca. After an individual has bem shown[he privare daea and iaformed of irs meaning,che dara need not be d'uclosed oo hira for siz months diemaher unless a dispute ar acrion pursuanc w�his secaon is pending or addidooal dara oa che individua!has been collected or cmared. 'Ihe responsible au[horiry shall provida copies of the privace or pubiic daca upon requesc by the individuai subjecc of ehe dara. The responsible aurhociry may cequire�he requesring person m pay the acaial coscs of malcing,cerrifying,and campiling�he copies. 'ihe respansible authoriry shall compty immedia[ely,if possible,wieh any reqaest made pursuant to this subdivision,or wichin five days of the dace of che reqaes4 excluding Satucdays,Sundays and legal holidays,if immediace compliacce is no�possible. If he cannoc comply with[he requesc wirhin�hac titne,he shall so inform ehe iadividual,md may have an addidonal five days wirhia which to campty wich ehe cequest,excluding Saturdays. Sundays and legal holidays. Subd.4. Procedure when data is not accurate or comp(ete. An individual may contest che accuracy or completeness of public or pri�ate• data conceming himself. To exercise chis righc,an individuai shall nodfy in wriung ehe responsible auchoriry describing rhe aacu:e af the disagreemea�. .. The responsible auchoriry shall wichin 30 days ei�':er. (a)cocrect ehe daca found ro be inaccucare or incomple�e aad aaempt to nodfy pasc recipiencc of inaccuraa or incomplete dan,inciuding cecipiena named by che individual:or(b)notify d:e individual chac he believes rhe daca to be correct Data in dispuce shall be disc:osed only if the individual's sracement of disagreement is included wich[he disciosed daa. The dearminadon af the rrsponsible auehoriry may be appealed pursuant w the provisions of rhe adminisaarive procedure act mlacing to contes�ed cases. DATA PRIVACY t1DVISORY Ia accordance wich M.S. 13.04, Subd.2, "Rishcs of subjecu of data",we would like to inform you that your requesc for a permit or license from the City of Orono or any of its deparcments may require you to fumish certain private or confidencial 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. ;. The informacion may be shared with ocher local, stace or federal a�encies to the e:ccenc necessary to process the permit or license. 4, If your requested permit or license requires Council action to approve, some information may become public. �. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. 6, Your full name is required to process this applica[ion or perm.it. Arn �tiddle Last Addreu • �iry gtace Zip Phaae I undentand my ri;hts as scated above. Signaatte .� CHECK OFF LIST FOR ISSUANCE OF PERMITS " FOR OFFICE USE ONLY ADDRESS OR LEGAL: �� 3 c� s�Rx,c,.,.+� �Q�.�-e PID• DESCRIPTION OF WORK: r—_-,�r�-r�cv ,�y�•orv�,�a� — L�S� 7��s� ZO�TG REVIEW BY: DATE APPROVED: s-�o •� BUII.DING REVIEW BY: DATE APPROVED: S-�o -o� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes r/ No PLAN REVIEW Yes � No SEOV'F.R CONNECTION STATE SURCHARGE Yes ►�' No WATERCONNEG"TION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC�Units OTHER (specify) ZOti�G CH�CB LIST Zoning Districr. � C N-�tr-�P Fire Department: Post Office: School District: � Lot Area: Sq.ft. Acres idth Depth Survey Submitted: Yes �� No Date of Survey: D�/ r'i � Proposed Setbacks: � . � Front(Lake): � -� Right Side: Ca./C Reaz(Street): C9-ic Left Side: b� Adjacent Structures: — Wetland: _ Building Height: Def. Hgt. � Peak Hgt. � Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Da[e: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hazdcover: 0-75' 75-250' 250-500' 500-1000' Hudcover Variance Required: Yes No Date of Council Approval: REv1ARKS(in�house): _ 7 t a BUII.DING REVIEW CHECK LIST �C� � CONSTRUCTION TYPE: — Sq Footage $Per Sq Ftg Basement x = lst Floor x = 2nd F1oor x = Garage x = x = TOTAL Estimated Construction Value: $ `-I O o.d o Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connecdon Footing � Septic Sewer Connection - � Fr�B Fireplace Lawn Irrigation Insuladon (Masonry) Other Wall Boazd (Mfg.) Well(State Permit) ��F� Grading/Filling Electrical(State Permit) Other REMARI�.S(IN HOUSE): . REVIEW BY.OTHERS: DATE: Access: Ezisting New Access Approval: Date gy; ----_______��_ �________�------------------------ --_ RENLARKS (TO BE NOTED ON PERMI�: 8 � � �� , � �( � , / ��,�� ,_ � � L �fl�1 j�- i_.._..� � _.____ � 2 ` - ^_=____-� --:-1�-� � , � C11� �f 4�0�10 �- ti _�_ — -.—.�LK.1__: .._._._ ...p.�. �TE PUN GRADING rLAN _ _ _ __ _ � A�'PROVED-c�c� w�N�ww,� ❑ A�PPROYtD WlTN REYISIONS ❑ DISAP�' � � oY ._._ � � - ._ SZto -�o , '` � I , � 2� �� , � � � � , � r i i) �^� � - �Yl- �I � _ f / nl M� W� 69 - , ; � �` � t � -�, BS 935. . 3'�iti�`; , -�,..�-.---� � E�. p �g5� \ `'=�--.�. ► :' NSE N �p�SE � S�pE � �ll N . � � • . . � � � . j/ '' � , . . 1 . . � � �c��,j�'S.A O��' ''� � `1 , ,, � � ��• 9 DppR c� � , �. i ,' �-- S\�E.� �(Q �� '' , � �� . 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