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Home My WebLink About2000-P03330 � PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po333o Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (612) 249-4600 Date Issued: 11i3oi2o SITE ADDRESS: 3960 Bayside Rd MAPLE PLAIN,MN 55359 P I D: OS-117-23-22-0007 DESCRIPTION: Proposed Use: Census Code 434 Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 9�•25 Valuation: $ 4,000.00 State Surcharge Fee: $ 2.00 TOTAL FEE: $ 99.25 APPLICANT: RANDY BALFANY CONSTRUCTION OWNER: MICHAEL G FILBRANDT 3629 152ND LANE 38 ADDRESS UNASSIGNED ANDOVER,MN MN 00000 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. �� r)rr�i-�� ;�_�� -----� __ ; ^ __ �� , APPLI NT PE ITEE SI NATURE ISS ED BY SIGNATURE ��- Copies: City,Applicant,Assessor, Finance Page 1 � �� u Total Fee: $ Date Received: � � " ��' -��-� Entered By: ! ' Permit#: /�� .=; = -� �� b, 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 one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �'�� ' '� � � �� ZIP: � � , NAME OF OWNER: � � � � ` � � � � � PHONE: (home) `�� - � _� �- (work) MAILING ADDRESS: �`� -� , , . CITY: �� , � ZIP: �• > ��'` ��`; CONTRACTOR: i�' I� � � � � PHONE: �': �� . � ,. , � CONTACT PERSON: i�-, '�;. , MOBILE/PAGER: . - � MAILING ADDRESS: � � �� CITY: -1 ; � ZIP: f ,�, ,, STATE LICENSE: # � � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: l�JAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration � Land Alteration PROPOSED WORK(describe in detai�: l � � � �� r 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 accordance with the approved plan. APPLICANT'S SIGNATURE: - , - DA'TE: NOTE! Parade of Homes events require separate permit approval by Police Department and Ciry Council 60 days prior to the event. Non pernzitted events will not be allowed. `�i rT• Sec.13.04 RIGHTS OF SUBJECTS OF DaT� Subd. i. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forth in this secaon. Subd.2. Informatioa reqirired to be given individual. An individual asked to supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting"state ageacy, polirical subdivision,or sratewide system; (b)whether he may cefUse oY is legally required to supply the requested data:(c)any Irnown consequence arising fmm his supplying or refusing to supp(y private or confidendai data;and(d)the idenary of o[her persons or enrides authorized by state or federal law to receive the data. This requirement stiall not apply when an individual is asked to supply invesdgaave dara, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or proper[v tax refund instructions ins[ead of on those forms. Subd. 3. Access to data by individual. Upon reques[to a responsible authority,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 6is fucther request, an individual who is the subject of stored private or public data on individuals shall be shown the data wi�hout any charge to him and, if he desires, shall be informed of the content and meaning of[hat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hirn for six months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the acnial coscs of makine, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of the request,exc(uding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shail so infocm the individual,and may have an additional five days wirhin which to comply with the request,excluding Saturdays, Sundays and legal hotidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri��ate data concerning himself. To exercise this right,an individuat shall noafy in wriang the responsible authoriry describing[he nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy 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 correct. Data in dispute shali be disclosed only if the individual's statement of disagreement is included with the disclosed data. Tlie determination of the rzsponsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relacing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rishts 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 detemune your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut 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 permi[ 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. �\ � � ��1, -- ' � i'�� , i/ �`�� FiCst , vliddle Last : •—- � i �' y _ � _ ' i :'�. Addr�ss �/ --- . — / - ��, "� i,. i� 4 � .,'- ��: ,� �-��- -' - -- i� / . C�n, � State Zip Phone I understand my rights as stated above. �— _ � — 9ignature DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI�E SCHEDULED L• 1 - c�v 1=3a PERMIT NO. � �' "�� COMPLETED � �� ADDRESS 39�� '°`ti S1�-2 OWNER M�It� t=t�-6/1,b•r�p�' CONTRJR�`'�4 Q'ALF✓�Nt� TELEPHONENO. -7l�'3-`-t2'Z - lt"��4tZ - ;23�- 61(Po � DESCRIPTION �� '"`� � ly 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COM�IAENTS: � ' W ', � �. G�S S� �l�C) `� Ct' �LGI,s a � � O � � O � W � Q � Z W � W � � �WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE W W ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. , pHOTO TAKEN INSPECTOR WILL RETURN CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContrac or on site: Inspector. �� White Copyllnspector's File Canary CopylSite Notice