HomeMy WebLinkAbout2001-P04179 - minor alterations � �
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po41�9
Lrystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600
Date Issued: giioi2ooi
SITE ADDRESS: 300 Big Island
EXCELSIOR,MN 55331
PID: 23-117-23-32-0027
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 32.65
Valuation: $ 800.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 3315
APPLICANT: Dan Kellogg OWNER: JO�[N D URAN
300 Big Island 160 BIG ISLAND
Excelsior, MN 55331 EXCELSIOR MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERM[SSION 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 REQU[REMENTS.
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APPLI ANT PERMITEE S A URE IS ED EY SIGNATURE
Copies: 1-File (Signitures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
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Total Fee: � Date Received: �,'�� -��
Entered By: ��vv� Permit#: ��
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
A.11 information must be submitted in full before plan review �vill be started.
� (please print al[ information)
THE A,PPLICANT IS: (circle one)� OWNE�_OR CONTRACTOR
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JOB SITE ADDRESS: =����� �i� � ! ,�-(U✓��-'� ZIP• -, �
NAME OF OWNER ���v� !�� j ��-- �-- �PHO�tE: (home) (�"�� 7`) --'`�� ' � � `�`�Gi
(work) � � �
1�IA_II�i1tG A.DDRESS: '� L'�3 c� r,�c ( r31 v� . CIT'Y: �=,��, �r, �,- ZIP: � 5 3 ; !
CONTRACTOR: � '�'� � �' .�' PHONE: ` ` ` .
CONTACT PERSON: /� t� 1IOBILE/PAGER: -
MAILING ADDRESS• � CI'I'Y: ` _ ZIP• �
STATE LICENSE: #
ARCHIT'ECT/ENG�'EER: ?� � - S�i�� ,� «j PHO\�:
NIAILL`TG ADDRESS: CITY: ZIP:
�,T�y�; REGISZ'RATION# �
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED`VORK(describe in detai�: ��`� c�,- � �-' i� �c�����c-� � �'�' � �, �.� i�( �
�� C --' (�i a� r t.� f ��. � r�� , ,� �;;� , ((�'1 �, t ��� _� :��-� �'�'- �� ✓1� ) i,�,!S�'` �i��'���'"f' � � t�
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�—�� �S c, r-� � a,- r L�.'. �
STORIES: � SQ. FEET OF EACH FLOOR: X'�� �'
NO. OF B�DROOII�IS:��_ GARAGE STALLS: ATT�. ----- � DET. . - - -- . . ..,
, ,f { ; ; `='=
EST11�i IATED CO�STRUCTION VALUATIO\ (excludi.ng land): 5 t.
I hereby apply for a buildin�pernut 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 Ciry and with
the State Buildin? 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 SIGNAT'URE: �i. e,.� ����_�� DATE: � ._ � (� — U i
, �
14'OTE! Parade of Homes events require separate permit approval by Police Depgrlment and
City Council 60 days prior to the event. 1Von permitted events will not be allowed.
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S�c.13.Q-� RIGHTS OF SL'BJECTS OF D:�T�
Subd. 1. T}-p=of data. "Ihe ri¢h�s of individual on whom t�e data is sto:�or[o be scored shall be as set forth in this secaoo.
Subd.2. Information reqirired to be givea indiridual. r1n ir.�i�-idual uY�to suppty priva�,or confideadal data concerning himseif s5a11
Ee inform-_d of: (a) [he purrose and incended use of the ceques�ed dam w:�in the collecdng'stam agency,polidcal subdivision,or satewide sysr`m;
(b)whe�`�er he may r_fuse oT is legally requir.d to supply the rquested dati:(c)any]co•Nn eoasequeace arising from his supplying or reFusing co suoply
pri-+ace or conndend:1 da�a;ar.d(d)che idendry of o�her persoas or eaaces a��uorizcd by scate or federal law to rceive the data..This rcquiremeac s6at1
r.o�apply whzn an ir,dividua( is asked to supp[y invesdgadve daa,Qurs�:-c to seccoa 13.82, subdivision 5,to a law enforcemea�o�cer.
The commissioner of rvenu� nav place the norce rauircd erd-r[his subdivision in the individual_ir.come tax_or orooern taz refund
inscructions inscead of on t}:ose forms.
Subd. 3. �ccess to data by indi�idual. Upon reques�to a r_s:oasible ae�:^..oriry,an iadividual shall be informed whe�her he is th�subjcct
of scored daea on ir:dividuals,and whecher ic is classificd as public,priva�or con@d�nrial. Upon his further requesc, aa individual who is the subjeu
of s�orcd private or public data on individcals shall be shown[he data wi�out any c�.3rge to him and,-if he desires, shall be informed of the content
ar.d maan.ing of[hac daca. After an individu�l has been shown che priva��aa and iL:"or�cd of ics meaning,che dac�need not be disclosed ro him for
six mor.;hs �t:ereaRer unless a dispuce or acaon pursuanc to chis secdon is�:ading o;addidooal da�on the individual has been collec�ed or creac�d.
The responsibl�au�horiry sha11 provide copies of the privaee or public da�a i::on reqi:s-by che ir.dividv 1 slbjecc oF the data. Tne;esponsiblz aurhoriry
may requir� [he requesring person to pay ehe acmal eoscs of m�kin2,cer.;:ing,az:d compiling the copies.
The responsible auchoriry shall compty ir.i,�nedia�aty,if possicle,wich any r_quesc mada pursuant to this subdivision, or wichin five days of
th:dac_of the requesc,etcluding Saturdays,Sundays and legal holidays,ii ir..media�e compliance is not possib(e. If he canno[comp(y wi�h the r_qu:sc
wichin cha�dme,he shail so inform che individual,and may have an addi�c�1 five da,s wi�`�in which to comply wich the request,exciuding San:rdays,
Sur.days and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or complereness of public or pri�•ate
dara conccrning himself. To exer:ise chis right,an individuai shall nodFr ia wrian��-rsponsible authoriry d=scribing the na[ure of the disagr_=meac.
The responsib(e auchoriry sh�ll wichin 30 days ei�hec: (a)comce t'r.e da�icund to ba inaccurate or incomple�e and ar.�mp�to nodfy pasc rcipiertcs of
;aaccurzce or incomple�e da;a, inciuding recipie��s named by che ir.divi��I;or(b) �odfy the individual tha�he bzli�ves the data to be coaec� Da�a
i1 dispue shsil be disclosed only if che individual's statemen�of disa;r:a�enc is L.c:��ded with the disclosed data.
T1te decerminarion of the rosponsible authoriry may bt appe�='_pursuac:to [he provisions of the admitusaarive procedure act rela�n� to
con�es::d eases.
DATA PRIV�CY AD�ZSORY
In accordance wit:z M.S. 13.04, Subd.Z, "Riahts of subjects o�daca", we would like to inform you thac your reauesc
for a per�it or license from che Ciry oE Orono or any oi is deps.i.encs may require you to furnish cenain priva�e or
confidential information.
You are notified that:
1, The informacion you furnish wili be used to de;ermine �'our qualification for the permit or license requested.
?. You may refuse to supply da�a, buc refusal riay require that the Ciry deay the permit or license.
3. 'Ihe informatioa may be shared wich ocher Iec�, state or federal a�encies to the ex�ent necessary to process
the permic or iicense.
4. If your requested pecmit or license requires Council ac�ion to approve, some informa�ion may become
. public.
j. You have certain rishts under N1.S. 13.0� (a•:ailable upon request) to review private iiata on yourself.
6, �'our full name is required to process this applicacion or permic.
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I underscand my ri�hts as stated above.
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