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Home My WebLink About2004-A8213 - Building PermitTotal Fee: Entered By: Date Received: 4 '�3 a / 3 Permit #: - - CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle orae) OWNER OR CONTRACTOR JOB SITE ADDRESS: C � P � ZIP: Will this be a Pa •ade of Homes, Remodelers Showcase Home or other Display Home? El Yes MNo If yes, a special event permit is required with Police Departinent and City Council approval- 60 days prior to the event. -Non permitted events will not nbe allowed. NAME OF OWNER: D�1�-[ �� Q t-\kv F- PHONE,; ---(home A- (work) Nnnnn Z > '6000 MAILING ADDRESS: 750 (� + LA0 l0 j (2-OCITY: KO ZIP: CONTRACTOR: PHONE:69 i -2-) -7273 -7/3-7 CONTACT PERSON: ( MOBILE/PAGER: SJR MAILING ADDRESS: kk-u - V CITY: C-A-GA40 ZIP: c�;;ks-Z_ STATE LICENSE: # -- .2€J ARCHITECT/ENGINEER:��5�jNE�Z� MAILING ADDRESS: I 0 - %4 L�-P:E CITY: MPL5 ZIP: NAME: E C, - LA, N REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration Land Alteration ,10� , PROPOSED WORK (describe in detail): _ Z -� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. '2 DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 1000 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: DATE: See.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 required under this subdivision in the individual income tax or property tax refund instructions 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 requestwithin 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. Middle Address As -f � W /,J F 2-':�--71 3 City my rights as stated above. Signature State Zip NelsonDesignGroup,lnc. 1012 Marquette Avenue Minneapolis, Minnesota 55403 Phone: 612-334-5995 Fax: 612-338-6645 Date: ay RECEivE To: D Fax number. NOV 2 2 2004 Pages to follow (including this one): CITY OF ORONO Re: 130141P& lot.7� tr 0071"r 14V,, C*.,rl or vrzDi-rV r-1.77 771 jz-d5,0e-yCj- aiJ ;V&l C,.,fsle PeiAJ7" ntc i" -c PL'ty'/5 -r' /Z.^yyh/L(L-r-Z 24 -0 'i tom. S 31 -3j o C- 0 30 60 90 SCALE IN FEET ,013 = EXISTING SPOT ELEVATION. X(998.0) = PROPOSED SPOT ELEVATION = DIRECTION SURFACE DRAINAGE EXIST HOUSE CALCS OHW-75SB 75-250 S8 250SB+ 7750SF 0.17 AC 18 1 20SF/0.4 1 AC 6650SF/O. 1 5AC7Z ,0% ALLOWED X25%=4530SF HC ALLOWD X30%=1995SF HC ALLOWED 175 — NTS EXIST HC EXIST HC EXIST HC DECK 385SF 4;,'J'DRIVE CI.- HOUSE=55SF HOUSE=3325SF 18.35%, SHED =150SF /SHAREDI ASPHALT DECK=225SF DRIVE= 870SF TOTAL=280SF/3.6% WALK = 215SF TOTAL=1020SF 15.3% — Y ACCESS oVEWA C� DRIVE= 3055SF 0 sHKRED Dp E NQ TOTAL=6980SF 38.5% T CO p6KT ROAD vioEa"�� > TO 'A INFORMATION PROVIDES' EAKME�t INFOR x N, EXIST U-) DECK HOUSE 0 _j Z 0 >\ UM Q 0 LLf z cr: V to < 44 U_ CL < 01 "30 65 j (0 LLI r,2. *q r� - n A _): 1 41 ff A 3 B----/ lb (17 to j *95 940 -;7 sz� q5 0jrj _j 111W 11/' 68 7 0.5 ril tIN \\ NOUS(;p 04, LO # 214 PROPERTY DESCRIPTION 942 0 L4 t.1% A tract of land in See. 20r -T. 117, R. 23, described as 0 t 284 U1 follows; Beginning at the rno s t N I y corner of Lot 54, Spring aPark, thence westerly in a straight line through a point which is X4g00 LA 15 feet North from the NW corner of Lot 52, Spring Park, extended 130- to the shore of Lake- Mntka; thence Nly along the shore of said �4 9 0 co, Lake to its intersection with a line parallel with and 100 feet Nly, measured at right angles, from the 1st above described course of -this description; thence Ely, along said paral lel I "CP 71 line,to a point in the centerline of vacated Ivy Place in said (b_55Plat of Spring Park, said centerline being a I ine parallel with * P (�0;5 3.60 and 25 feet at right angles NWly from the Mly I ine of Lot 56, Ar0 l Spring Park; thence SWly along said parallel line also being the centerline of vacated Ivy Place to its intersection with the extension of the Sly line of Lot 55, Spring Park; thence SEly, k 3 65 along the extension of said SEly line the point of beginning. The southerly I ine of said Tract being marked by two JLMs ADDRESS 3061 CASCO POINT ROAD PID 20-117-23-34-0017 NOTES '`'VERIFY ALL LOCATIONS UTILITY LOCATIONS ARE APPROXIMATE TSAN MH THIS SURVEY IS SUBJECT TO CHANGE PER ANY TITLE OR EASEMENT INFORMATION ELEV = 941.5 BOUNDARY INFORMATION PER ISRAELSON &ASSOC SURVEY DATED MARCH 10,1987 ALL VISABLE HARDCOVER IS SHOWN, ALL MAY 'NOT BE SHOWN DUE TO SNOWCOVER QO,- (j) Q) z� (j) v �' W W CL W IS 14 CX 0 CL Z,�,- 00 ar;0 0 M < a- un, =-JW U>J S V)U) ~5 � 00O C:) .1- O 04 O N (n 9 0 Cl W LL_ W (n Z > ce ce C13 Uj cr m �— < < W Cr vL%..r\-LL.JJI VC.ufN — .Juv%j.i VR! V C=' O / Ul) Y TOTAL=280SF/3.6% WALK = 215SF TOTAL= 1020SF / 15.3% DRIVE= 3055SF — �''4 N E—SH,,KF TOTAL=6980SF / 38.5 / / �: Tb CA CO / . � � EA EMS \ Q I` i 650 gA ► a �e Nil UA \ .•*jam '// ..--� Q' / ,.. _,,,-''r 'q L 940 �'cv 0 pip • or ,. r' '` ; ,r' ;: .8 4 .rf C J K s00 .., �X �Z00 -- Zo Cp I O�� : o Y\ F'ROPEFTY DESCRIPTION A tract of Iand in Sec. 20,- T. 117, R. 23,