The URL can be used to link to this page

Home My WebLink About2001-P04107 - land alteration PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P04107 Crystal Bay, Minnesota 55323 Permit Type: User Defined Surc Building (952) 249-4600 Date Issued: 7/20/2001 SITE ADDRESS: 4045 Watertown Rd MAPLE PLAIN,MN 55359 PID: 31-118-23-41-0003 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: User Defined Surc Building Permit Sub-type(s): Land Alteration(0-500 cu y DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Valuation: $ 0.00 4-0'' Nic. Fee: $ 50.00 TOTAL FEE: $ 50.00 APPLICANT: Greg Kellenberger OWNER: D S&G S KELLENBERGER 4045 Watertown Road 4045 WATERTOWN RD Maple Plain,MN 55359 MAPLE PLAIN MN 55359 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. \z"---r/ -4,e,_02-,-,,,,,,_ (B4,0 APPLICANT PE ITEE SI NATURE ISSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 Total Fee: $ ----3-0 — Date Received: 7-/a- U/ Entered By: Permit#: .,4-6-- P 1 61 CITY OF ORONO - BUILDING PERMIT APPLICATION / All information must be submitted in full before plan review will be started. (please prim all information) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 404c Li ttLe \-) 0 ZIP: 5-1 C iL0 ,' \ NAME OF OWNER: l t�.\,( G ' d l_PHONE: (home) `j S z 4-76'`4011 *(work) q'5?__.- 9 7 it -tri)6,S— MAILING ADDRESS: 1-015 k,,,)1, i \--CITY: 0{41 -0 ZIP: S-'$ -s,---7 CONTRACTOR: C-01EC. }G LL.L l' .C..- C-)E2_, PHONE: CONTACT PERSON: - ow Na. -- _MOBILE/ $.: Cc, Z -7 2-1 3�9 MAILING ADDRESS: 5e'"►v‘s`-- CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move RemodeL'Alteration Land Alteration ]C PROPOSED WORK(describe in detail): ,A8i o- 1?�1:. 4 •_-;-o --5�^ �\.. c!�. d 4 C1\ al r SO' c .�. , c , 1; �' c, .,, � +0 0-- STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $. 10,.•..i. oJc.___ I hereby apply for a beil4ifig-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:C DATE: `7 - ) .2 _ 0 C Wi NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 • Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This 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 may place the notice reauired under this subdivision in the individual income tax or Property tax refund instructicns instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether 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 the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. 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 action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within 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 additional 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 public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 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. t..0 First Mi diet Last Address cl/ in 1IM LE N� v�Vs 5 5 _Co City State Zip Phone _40+6\ I understand my rights as stated above. /, ?,/oi Signature 7 6 4 l CHECK OFF LIST FOR ISSUANCE OF PERiMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 4 0`{S w Pc 2T ow 1\1 RAS PID: DESCRIPTION OF WORK: t, ZONING REVIEW BY: C;� -- DATE APPROVED: -7- q - c.) BUILDING REVIEW BY: U AJ ,4 DATE APPROVED: FEES TO BE CHARGED: 131°GSADisc ees Calculated By: PERMIT Yes c/ No PLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes No WA I ER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: N( Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes 04 No Date of Survey: 6.J I e Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: 1 0' 4- Adjacent Structures: Wetl d: Building Height: Def. Hgt. Peak gt. Lot Coverage: Grading: Staff Approval Date: —I-19` (7 J By: ox‘20 Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: AID Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 BUILDING REVIEW CHECK LIST UBC: CONSTRUCTION TYPE: Sq Footage $ Per Sq Ftg Basement x = 1st Floor x 2nd Floor x Garage x = x TOTAL Estimated Construction Value: $ Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) >( Final Grading/Filling Electrical (State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT): 8