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Home My WebLink About2001-P04002 - shed 4 � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Poaoo2 Crystal Bay, Minnesota 55323 Permit Type: Accessory struc�res (952) 249-4600 Date Issued: 6�28i2ooi SITE ADDRESS: 4070 Dahl Rd Mound,MN 55364 PID: o�-tt7-23-tt-oo19 DESCRIPTION: UBC Occupancy U1 Construction Type VN Proposed Use: Residential Census Code 328 Permit Class: Building Permit Type: Accessory Structures Permit Sub-type(s): Shed DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 44.85 Valuation: $ 1,200.00 Plan Review Fee: $ 29.14 State Surcharge Fee: $ 0.60 TOTAL FEE: $ 74.59 APPLICANT: Thomas Dahlquist OWNER: Mr. &Mrs. Dahlquist 4070 Dahl Rd 4070 Dahl Rd Mound, MN Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEl�NT5 SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. °� � �_�- � � ��-- �'�/ ; � -�.--- - -��- -� APPLICANT PER [TEE SIGNATURE ISSUEDB IGNATURE ,� Copies: 1-File(SiQnitures Reauired). 1-Aoplicant, 1-Monthlv Reoorts. 1-Assessine, 1-Finance Page 1 �/ '��`� �7� �=�� .- �� _ � � � �� / �� ; �'�� ,��`� t Total Fee: $ / -�� Date Received: �, �- ��-' / Entered By: il_�% Permit#: �-��;,(�-.�- �j�til•,,..,�`, �� I��' I 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: 2�� U ��L ,�� ZIP: S�j �j 1� NAME OF OWNER: Tv.�.. d--/�- �-.�- m�f c� � PHONE: (home) �j/7o� :3C�/ d (work) �� 6 � �SS/ MAILING ADDRESS: �-�R- CITY: ZIP: CONTRACTOR � I� PHOivE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: /L/i� PHONE: l�IAILING ADDRESS: � CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration � Land Alteration�_ i�(�(`I�/ ,� / PROPOS WORK,.,describe in detai p¢�,, o- � c� r a- �� m� �( �� # � � c� �-, , (� �� (�C /s �-��'D�� s�.� � - -�,�__ STORIES: �� SQ. FEET OF EACH FLOOR �'—�� , C.�� NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 1�,�� ESTIMATED CONSTRUCTION VALUATION (excluding land): $_��U __�G c7 � �,��''`� � ��, � 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 SIGNATUl�:.-- DATE: �j l C� NOTE! Parade of Homes events require separate permit approval by Police Department antl City Council 60 days prior to the event. Non permitted events will not be allowed. 5 I Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom[he da[a is stored or to be stored shall be as se[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 col(ecting state agency,political subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested da[a;(c)any known consequence arising from his supp(ying or refusing ro suppty private or confidential data;and(d)the identiry of other persons or entiries authorized by state or federal law to receive the data. This requirement shall not apply when an individuai is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or prooertv 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 whe[her he is the subject of stored data on individuals,a�d whether it is classified as pub(ic,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 ro 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 thereafrer uriless 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[he individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,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, exduding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreemenL The responsible authority shall within 30 days either. (a)correct the data found ro 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. Da[a in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of[he administrative procedure act rela[ing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Righ[s 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�.mder M.S. 13.04(available upon request) to review private data on yourself. 6. Your full name is required to process this appiication or permit. First Middle Last Address Ciry State Zip Phone I understand my rights as st bove. � _ -- _ �/� C� Signa 6 � CHECIi OFF LIST FOR ISSUA._�TCE OF PERtinTS � FOR OFFICE USE ONL.Y . ' . ADDRESS OR LEGAL: L{0 l O ��+►-��. �� — PID: . DESCR�TI4N OF�ORK: i1�'�(��2 � ��tt - G3�,�� s i-t-v� � - ZOr'L\�G REVTEti�+BY: �,,,,__ D�TE APPROV�D: �- 27-�I BUILDIti'G REV�SY BY: D�.TE APPROY�: 6 �Z�-�.► FEES TO BE CTi4RGED: Misc. Fees Calcula[ed By: pEgMI'r Yes c/' No �� pl,p,N REVIEW Yes _� No S��WER CONNECI'ION STATE SURCHARGE Yes ✓ No ��A1�RCONNEC'TION 1i�,rVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECITON Number of SAC�Units OTHER (specify) ZOti1-,IG CI�CK LIST Zoning Districc: G2- �C3 . Fire Departmenc: (Ytn�v�.a/� Post Ofnce: Yy.o�.w� Sc�col Discrict: � ��e5 �r/1� ' Lot Area: Sq.ft. No Gf�.t Acres — � Wid:h — DeP� r Surve;� Sub.:.itted: Yes_� No oc Dace of Survey: �91.- rvvc r �x c�a.�p rf�r•�J ��l. s rtt:YJ s .< �Z.o s.�. �' Proposed Setoacks: { Front (Lake): S�� Ri;ht Side: � (o � Rear (Screet): Left Side: AdjacencStructures: I�O� �` �Vetland: NI � � . Building Hei�ht: Def. H�t. p •(L Pea.�H?t. d.IL Lot Covera�e: — Gradin�: Stafi Approval Date: --- By: Council Approval Date: Septic: Staff Approval Date: By: Zoain�File: n � Resolution: � Resolutioa Date: � Shoreland District: u-e� Av�. Se[back:� I'lJ �} Blufi Se�back: I,otCo�'era�e: E��? Proposed Hardcover: 0-7�' 7�-250' �. � . ti0-SQO' 500-I000' Hardcover Vari�ce Required: Yes No Dat� of Council Aoproval: REI�LA_R��S (in house). 7 BUII.DING REVIE�V CHECK LIST ' UBC: U ' � - CONSTRUCTION TYPE: �( V� Sq Foota�e � Per Sq Ftg Sasement x — lst Floor x = 2ad FIoor z = Gara�e z = � � z = � �^� � �'�� 1��' TOTAL � ��'- � .�j�, ; �x' � �� '� Estimated Consfruction Value: $ �,�� '� ��(; � �� J( �i� .c a� C.'�-e`� � InspectiorLs Required: �VorI�Requiring Separate Permits: jf + i��f� Site Plumbing ' Fire ? �.,x�' � j,7,e- c;1� t�u-^��'`-�`"`�_ Hardcover Removal Mechanical Water Connection �� ( Footin� Septic Sewer Connection _ o� Framin� Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Pemut) _�Final Grading/Filling Eleccrical (State Permit) Other RE�LARKS (IN HOUSE): � REVIEW BY OTHERS: ' DATE: Access: Existin� New Access Approval: Date By: RE1�L4R.KS (TO BE NOTED ON PERMI'1�: 8 , :� ' ��irs� ,��i ;��y` � � �d �...`�:9�� t�'�� l� d �./ � � � ��/v � l C' L(/�Li D h �� /�- �D�/C'��'� �(/lG � /UJ/ ��G/ �' � �lZ� �lJ�`�P` /OC'6��'aN L'�`� �GQ✓� /�� ^h�LJ�— �;C� �� C(H c.�C '=C� i L'+.r� /%cr G/-� _ � s s � � � r��i��P� �c�� ,.� ��e �v,ti �� i�- � �,._,�C � � Q cc c��-4'�,-cs— �r/�l � ��P�7 . . � /( �� , � , � �fl�/UG L'-�' /I�i) G E'i Sfl S'��v�1i ''S`o�p .v�l�/G �'��AJ �.�oy�, M� j��G� 9S-Z- �/ j_ i�c�v � !j i � _ _ I� i� � i4 _ i' ,t � � _ . , . {�� _ � y �� ,� !; ;�, ��! !� , , ��, � � aRONO COPY � , � t „ � �� o�� . � -. -� � � � ; � � --, � � oi � � � J ` � I o i �> 1 � � ' � � >> I � !� I o_ � �-� _ � i � , �� C1TY OF ORONO � � � � � S!TE PLAN GRADihdG PLAPJ� c -a � �-%Z' ��`"� �-Ar'-?'0`Jr�—Sc�b � � � `� /� , � �1�� ,�.- � ,,� o � /'�,.�5 � �N�ecr��C � p'. �%r�� .� H REVISIONS � � , � �, =� L�S;4��r��0�� D P � �;' — � ; D�T� • L� -� � � , � � IL � I � �� ` �, I ___�` G t (`' � � I �r' l �` � •� 1 \ �( J � � . �. ,� I 1 j I I ' I \ / \ 1 I \ � / \ R % /-?�/G� � c�°I� 1 � � � / ,r� � � �