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Home My WebLink About2007-P11622 - addn/remodel/repair PERMIT CITY C�F ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11622 Crystal Bay, Minnesota 55323 Pe�mlt Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: 10/26/2007 SITE ADDRESS: 4680 Creekwood Tr Un�t# Maple Plain,MN 55359 PID: 30-118-23-33-0005 DESCRIPTION: Proposed Use: Residential Census Code 437 Permit Class: Building Permit T e: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair YP DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Interior Remodel-Master Bath,Replace Exising Mech Equipment FEE SUMMARY: Permit Fee: $ 431.65 Valuation: $ 29,000.00 State Surcharge Fee: $ 14.50 TOTAL FEE: $ 446.15 APPLICANT: Thomas Bren Homes OWNER: Dale&Jonmari Olsen 2073 Wayzata Blvd.W. 4680 Creekwood Tr Wayzata,MN 55391 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 OR�DINANCES AND STATE OF MINNESOTA BU(LDING CODE REQUIREMENTS. i , u-- ��_- �-� ��-�� C� � APPLICANT PGRMI'1'EE SIGNATURE ISSUED BY SIGNA'I'URE Copies: 1-File(Sigiiatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � . PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P11622 � Crystal Bay, Minnesota 55323 Permit Type: Minor Altexafi"on�f i.�;��,� ;�� );i (952) 249-4600 Date Issued: 10/26/2007 SITE ADDRESS: 4680 Creekwood Tr Unit# Maple Plain, MN 55359 P�� 30-118-23-33-0005 DESCRIPTION: li Pro osed Use: � �-� �� p Residential ,�� Census Code O/S-Building �. Permit Class: Building ,/ `,�{�I Minor!#�lt�erations -�� Permit Sub-type(s): Addn/Remodel/Repair Permit Type: � -� �� C DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Interior remodel-master bath,replace existing mech equipment FEE SUMMARY: Permit Fee: $ 431.65 valuation: $ 29,000.00 �� r�� l'�'�� . �, � ��f'(�I �'?x (��t�� _�..`-� �� ' 1 State Surcharge Fee: $ 14.50 ��' � TOTAL FEE: $ 446.15 APPLICANT: Thomas Bren Homes OWNER: Dale&Jonmari Olsen '`--�'.7 �''��'. �"��'�-"'-. '=' � 4680 Creekwood Tr �_.�. � --� w �v�y Zc��tt;(`��r'�� Wayzata, MN 55391 Maple Plain,NIN 55359 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFfED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. '� _ � I l r �� PLI('A MITEE SIG\'ATl E ISSUED[3Y SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 2 Total Fee: $ ��,(� Date Received: � (� � � � �� Entered By: _�,�,� Permit#: � � (��Z--. CITY OF ORONO - BUILDING PERMIT APPLICATION All informaYion must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ -- v"`�� THE APPLICANT IS: (circle one) OWNER OR ONTRAC� JOB SITE ADDRESS: ��j(1 G'�ziz�.f;tJ�l:J� T2 . ZIP: j S �S `�! Will this be� Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yes �NO If yes, a special even[permit is regui�•ed with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be i•eyuired unless applicant demonstrates su�cient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: �24L�� ,�vn�ivt,4�Ej QL s,_.ti( PHONE: (home) �S"Z� �� S Z�� (work) MAILINGADDRESS: �('�v Ckaz,r-iJ��J 77L: CITY: wt,�'c� P��'N ZIP: SS3.�'9 CONTRACTOR: �7�,�,f-� �B,�h,�/ //�i�hs, �,�,�;. PHONE: �,S�Z �7S (,�77 CONTACT PERSON: Ti�[ �n.- T'o.�r MOBILE/PAGER: '"`"' ��z-z s2-2�yti MAILING ADDRESS:Za73 �,/ w�yz�-T.�-- /;��'d CITY: t��ec� �.Ft=� ZIP: S-�3 s�� STATE LICENSE: # Zv 1 Z� �� EXPIRATION DATE: 3-� 3� —c�� ARCHITECT/ENGINEER: �'� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) y�� Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detai�: i�vl-�/1iu�2. i2,��ro,��z � sy�� g�T�- No �'�r. ��G�4-G iz �?�/ST/�'t j �?�I�G/� �@G�i��.� Kc i� �5 �W;�(p,Q p rJ S c�Cc STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ G� ,� 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 tlle 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. ,n APPLICANT'S SIGNATURE: ��G�� DATE: rU �G a � j/j l v �� Sec.13A4 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 dataconceming himselfshall be informed of: (a)the purpose and intended use ofthe 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 shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,[o a]aw enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or properry 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 thereafler unless a dispute or action pursuant to this section is pending or additionai 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 ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible [f 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 conceming himself. To exercise this right,an individual shal I notify in writing the responsible authority 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 notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bel ieves 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 PRNACY 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. c�.�/!iZ� �� /�d N'j� First Middle Last Address City State Zip Phonc I understand my rights as stated above. � C��'�"_.' l° �Cv o� Signature % ✓ Reset Form 32 , . *� i � I -----...__.._--•_...,_._�_ ._.___._-------- ------------ ._._._.._______ _. __,.._.__._..__._.__._.� 1�10[nat 8TM HOifIC3 T1lC : ---=___.,__..__....�,.. a , v �(173 W.W�IZ3La Blvd.#�0 . , � , . Long Lake MN 55356 � . � � � � U�� i�f/+'�n/ ��LS�^�r I � �I ';� ; , ��o cr��.�a�'� � , ' i ' ` _ ; i,� ; i Q/�-o�a� �.�.r �5�359 � ii ' �, ' � i , y 1 � ' /G �� } � ; j _/ .}, + _ � � � . �� . ; � ��, � ,_ � ; � _,r.Y �. : _L,� � ' " � i ` � \..�� f _, ___'_ 6 � � � � � x : � ...._. � � � � � , % �i' 1 � ' �.. -, ; �� .�' : � ` ? .. + ` ---- -- - - ---. q � � . ,* ; ; � ti i i� . �r� i / • � � � ' . . �` ` � f 4 i ��----�4 � _ � I I 1 � 1 ' � � ___��...f...�1 .��.w.� � ___ . .. ._..} { 1� • � I • � � II / _ � I 1 1 s �;: ' �---= J�r�/ S %/�G ; � � s ; . ___ Y � � i j .. � � I � �: � � ' � , �' - - ---� ---._-- - ', � - --- ---- � _. .. ' �� ':_ _ _ j � � �� . , ; ;; �- , , ; ��_� __ � - - - i i ; . --;____---- __ _____ . _._-----------._� ___.___._.- , , . 'I�omas Bten.Honeea Inc �073 W.Wayzata Blvd.#�SO Long Lake MN SS356 _,, _ . - -_ _ ,! �,/�. .,, � Q�I'L�i � ✓�NM�/ C�L S��'�/ ��l,�"r ��'.',, �_ ` Cf��U �2��,��7�va � �`�� ' �3 O/�..-GNv /yii�! �'S 3S`� , � , � .. t,,` ;ij � \� �� -r:.- __.._._ —%~�/' �v G� �� -�-- . . . � _ ` _._ -. _�.. __-.�....:_. —-_... � � .. . _ �� ._ �, _,.....,...,,�. - �-�= i _ _ _ _ / � , 1 � � �u�� / • � � � . � ` � � ' / , � / � � /, , � \ � `1 / a r a i I I ♦ , ' � / � / y � _ v i / �—^ � ��' 1 1 .. . � . ` - . �