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Home My WebLink About2003-P06129 - addn/remodel/repair �CIT'Y OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po6i29 Crystal Bay, Minnesota 55323 Pel'CYllt Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 3i26�2o03 SITE ADDRESS: 4775 Bayside Rd MAPLE PLAIN,MN 55359 P I D: 06-117-23-22-0019 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Pernut Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 23.50 Valuation: $ 500.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 24.50 APPLICANT: EVAN R MELINE OWNER: EVAN R MELINE 4775 BAYSIDE RD 4775 BAYSIDE 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 STWCT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � ,/� , C --- ��k�� A E TEE SIGNATURE 1 SUED I3Y SIGNATURE Copies: 1-File(Si�nitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessin�, i-Finance Page 1 Total Fee: $ Date Received:�'��' �U� Entered By: � Pernut#: r`�� ' CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � ------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) `QWNER 0�2 CONTRACTOR JOB SIT'E ADDRESS: �-�� Z�: �� ^ � NA1�iE OF OWNER: �� PHONE: (home)C(S �jC��' . (work) MAILING ADDRESS: � S CITY:�'y�,� ZIP:_'a�"`7_ CO\�TRACTOR: (�,v✓L��(/ PHONE:_ COti�T'ACT PERSON: MOBILE/PAGER: NLAILING ADDRESS: CITY: ZIP: ST�TE LICENSE: # ARCHITECT/ENGINEER: PH0�1E: MAII..ING ADDRESS: CITY: ZIP: N��.�; REGISTRATION# TYPE OF WORK: New Addition� Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� I�' �� STORIES: SQ. FEET OF EACH FLOOR: 1`'O. OF BEDROOVIS: � � GARAGE STALLS: ATT. DET. ESTLI-IATED CONSTRUCTION VALUATION (exclud.ing land): $I' Jd� I hereby apply for a buildin�permit and I acknowled�e 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 perm.it; and that the work wiR be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: .�"�� NOTE! Parade o Homes events require separate permit approval by Police Department and City Counci160 days prior to the event. Non permitted events will not be allowed. 5 Sec.13.04 RIGHTS OF SUB,TECTS 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 secdon. Subd.2. Information required to be given indiridual. An individual asked to supply private or confidenaal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or co�dential data;and(d)the idendry 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 taw enforcement officer. The commissioner of revenue mav lace the norice re uired under this subdivision in the individual income taz or ro ertv tax refund instrucrioru 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 whether it is classified as public,private or co�fidential. Upon his further request,an individua]who is the subject of stored private or public data on individuals shall be shown the data without any char;e to him and, if he desires,shall be informed of the content and meanin�of that data. After an individual has been shown the private data and informed of its meaning,che data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this secdon is pending or addirional 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 requesring person to pay the actual cosu of making,certifyin„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,excluding Saturdays,Sundays and legal hofidays,if immediate compliance is not possible. If he cannot compty with the request within that time, he shall so inform the individual,and may have an addiaonal five days within which to compty 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 daa conceming himself. To exercise this right,an individual shall nodfy in writing the responsibie authoriry describing the 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 noafy past recipients of inaccurate or incomplete dara,including recipienu named by the individual;or(b)noafy the individual that he believes the data [o be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�ative 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 �iry of Orono or any of its departments may require you to furnish certai.n 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. �� First • Middle Last Address ` ��`�� Y�►�+ �� - ry State Zip Phone C��y� I understand my rights as stated above. Signature 6 � � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 477 5 �'°�-r s�� PID: DESCRIPTION OF WORK: (�0 2cc-� ZO�tING REVIEW BY: DATE APPROVED: �-3-z�v3 BUILDING REV�W BY: DATE APPROVED: 3-�-s —�3 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes _� No pLAN REVIEW Yes , No � SEWER CONNECTTON STATE SURCHARGE Yes �/ No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZOti1'�1i G CHECK LIST Zoning District: Fire Department: Post Office: School District: Lot Area: Sq.fr. Acres Width Depth Survey Submitted: Yes ,� No Date of Survey: o�' f=►t� Proposed Setbacks: Front (Laic�: 1��1 Righ[Side: SZ�� Rear (�: �� Left Side: i bo� Adjacent Structures: �� Wetland: Buildin� HeiQht: Def. Hgt. ��/'� Peal:Hgt. " Lot Covera�e: N L/�- Grading: Staff Approval Date: � By: Council Approval Date: Septic: Staff Approval Date: By: Zonin� File: # � Resolution: # Resolution Date: Shoreland District: �� Av�. Setback: Bluff Setback: Lo[Coverage: ExistinQ Proposed a Hardcover: 0-75' 75-2�0' 250-500' 500-1000' Hardcover Variance Required: Yes No Da[e of Council Approval: RE�IARKS (in house)• 7 BUILDING REVIEW CHECK LIST �C� 12' 3 CONSTRUCTIONTYPE: tiL� Sq Foo[age $ Per Sq Ftg Basement x = lst Floor R = 2nd Floor x = Garage x = R - TOTAL Estimated Construction Value: $ Sc��, o 0 Inspections Required: �Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection �_Framing Fireplace Lawn Irrigation � (Masonry) Other d . (Mfg.) Well (State Permit) _�Final Grading/Filling Elecirical (State Permit) Other — ---------- RE�IA.RKS (IN HOUSE): --------------------------------------------------------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existin; New Access Approval: Date gy: ---------------------------------------------------------------------------------------------------------------------- REivIARKS (TO BE NOTED ON PERMI'I�: 8 s C�� .... , � � C1RON0 CtTY �F � BU1��''`dG P ��;�•. ;At.; �Fv►Ew ; _-----_ Mgo:C i Gn - -c,�:?�T i:G.__�— p'r;Et.� ,:3:,Z5 .V°` __ ;-� ,15:•.��<0`F� , �, �' • `�� '{' C �� ' `y + . � 1 1 T t .J1 I%\1�11 Gx :r f,r. .._�'.._D � .. . ".I:v �, gCt.�,!b`:C�G�19 y; �,;,i �r . f� ��' . cl CO�. Y "" ` .� . ? � . �i�.rr ;�� yylBNi. �� . .� ;: .:..� .� AT' AU..TI�JiES � F` , i i 7i" `��ti.`�C�,�i�`J`�TE � Kt��. '' -�� ` �� '�� ----------- � _ - ,�� ' � '`'�e. � �.. —�� ,� f ' a � i �� ______. _�____ _ _..r______ _ � � � . � . . ! � , I , , , r � � � ! � i � � i ( � � t ` ...,_6.�.._ � - ,�`, i . �..._, _._.____... .�-.._ �.._._..__I��-�.-�--�• - -�� ( � � s� i �� ` � � � �_ . CE i 7� j _, � ; � �--.__�_-- � � � , � t�' ��. � �_____. :'''�'.! � --- � ___�.__. _ �__._.�.._____ 1 �. �_ � . , I� � � i� �v��.�..I��i�. �� ur� . OF LOT 1 , BLOCK 1 , CHADWICK . HENNEPIN COUNTY, MINNESOTA ~ BA YSIDE ROAD � � N 89°45' 00" E 205.15 � � u• \ . � —�_ N / l""""."'�"'-"".-�-�-----µ•-,•___ - - -- - � �tA _85 _ _ _ -- - -- -I9oo -- - - �- - - - - - - i �ourcor A ' PRO00�lO. � � $ � I '''""'p , --�,,,, -�----- ...,.._""'" A eU�v�� DRAINAGF_ � o � � �`�6-- - � EASEMENT i I � o � ��` � `'��v� � PFR i�,�r ` �► � � I I is � ) i � � 45 ��o � 1 l ' � / 1 � ' ,�w � � � — � , � ° , g � I � ., . o + . � ____ � � \ 45 i � � � ,�� Q t pRoPoJfo �\�C'� \ � , i � � �� U � ,?C'u/,iF �� \ , \ i i p,tivFw�y � ��Q •\ ' \ � _ `` — �-� � � � Eler*. � � �� -�-� _ _ _ � � � . � , � CITY OF OR4N0 � �� s�30-e - �� ` � � � � � SfTE PLAN GRAD�NG P N i � `-.�� . � ` � � �APP�OV�D- , -" � /f�� i \ ,� � � � . � � �7 �P�RGVED WITH REVISlONS � i � \��, � ❑ Di,SAf'�R BY o ,�� '� � \ � `� �� QATE ` � ��/ � �N / 89,944 SQ. FT. ' �. � � d �r'`'�q G � (2.065 ACRES) � � ' ` �.`1 N ' "�F � � � � 3 � \� � L � •� � � � ' .o � � Z � / T"F � SF / � I � � a � _1 a°�A �v�� ti F N / N o � 1 \� ' / � / �� T 'P �IoloJie � �{ � � �oJ / a R I � 1�' _! / �^ INo�jf � /,\� 6 ti,\ / � o��I�rl�7f(,e �1 ...� � �� ► N 9 �� /� `i � a I , �� ` Nt7� �e�� / / ��`so � ' z.o \ 3 oiL �� /� / �a9� 1 I ! �z. ,� � � / z W / .� ,-�-- / � � i —o� � ) �I / / o o ti`°� / � � �� / �� / � �� 33.0 � � � ( �� S 88° W/ � i / � 1 � � � / / � \ � / � � � ti , � '�1� �:Fr"r:` / � � i //fR�,� � O � � / A �Ff�ri� � � vj O 1 ..� ` � , y � ��° 6/�fRf,; / � / , \ � 'po � r ' � / / a � � � � ^/ � o `y� � � � 1�� I 3 � �9� � � � �E AND � ; �I'• � � , \ / DR E p,SE�'EN'(5 � O �— ` \ � � � � s 78�� y � p / � , r N i � ' � i � � � � � � ! _ � � .. FMi�: � � � � � � � elevation, mean sea level dotum � � t elevation, mean sea level datum >ur line, mean sea level datum upon an assumed datum. FT. (2.065 ACRES) +v the boundaries of the above described property, �f a proposed house thereon. It does not purport ments or encroachments.