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Home My WebLink About2003-P06376 - land alteration PERMIT C I TY O F O RO N O Permit Number: 275(1 Kell�y Parkway - PO Box 66 Po63�6 Crystal Bay, Minnesota 55323 Per-mit Type: User Defined (952) 249-4600 Date Issued: 6i3i2oo3 SITE ADDRESS: 1973 Fagerness Point Rd Wayzata,MN 55391 PID: 18-117-23-14-0008 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: User Defined Permit Sub-type(s): Land Alteration(SOl+cu yd� DETAILS: Approved per resolution#: Separate pemuts required: NOTICES/REMARKS: Major Alteration-Ok'd by Bruce Vang FEE SUMMARY: Permit Fee: $ 75.00 Valuation: $ 0.00 Misc.Fee: $ 75.00 TOTAL FEE: $ 150.00 APPLICANT: Land Images OWNER: Kevin&Janet Manley 12255 120th St S 1973 Fagerness Point Rd Hastings,MN 55033 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. ., �" `- ��. ;� C �'�'�! (��l�-� APPLICANT MI' ISSUE BYSIGNATURE Copies: 1-File(SiQnitures Repuired), 1-Applicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1 � . . �� 4= � Total Fee: $ �/ Date Received: Entered By: f , (� � . Pernut#: � t � CITY OF ORONO � BUII..DING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------------------------------------------------- THE APPLICAi�1T IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: f�' 7� ��tSS ��. I� ZIP:_ �S"39�' NAI�iE OF OWNER: �,,,K .�,T,�,�' �J�„/c„ PHONE: (home) . (work) (��i-ys�/ � '�'��3 MAII�ING ADDRESS: ��,.,-�.rcrs � CITY: di-�,.r� ZIP: 5�.�9/ /�� CO\�'RACTOR: 1��P-�-ra�,�t� .��c : PHONE:_ �-�1 • y.3�` SIr�S/ COr�T'ACT PERSON: 1 y ��y,-r,��, NIOBILE/PAGER: �S�-3C'�g� �'�'y� iVLAII�ING ADDRESS: ��Z�� 1^.Z..��'�' ��:S�.CITY: �' ZIP: ��3 ST�TE LICENSE: # ARCHIT'ECTIENGIlVEER: PHONE: MAILI�i 1G ADDRESS: CITY: ZIP: 1�,.4.�IE: REGISTRATION# '� , -� . �,�. TYPE OF `VORK: New Addition Accessory Structure ,Q�� Move Remodel/Alteration Land Alteration_�_ �� /� 1 1 � PROPOSED WORK(describe in detai�: !-�.5 - -P•f' Ct�t�,t+t ��I c�l f�`0 p�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: � � GARAGE STALLS: ATT. DET. ESTL�IATED CONSTRUCTION VALUATIOv (exclud.ing 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 Buildin; Code; that I understand this is not a permit and work is not to start without a permit; and that the work wiII be in accordan e with the approved plan. APPLICANT'S SIGNATURE: �``� — �-( �A�E: NOTE! Parade of Homes events require separate perinit approval by Police Department and City Council 60 days prior to the event. Non permiited events wi11 not be allowed. �� i ,-r' -1 � 5 . � Sec.13.04 RIGHTS OF SLIB,TECTS OF D?�TA , � 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 secuon. Subd.2. Informa2ion required to be given indiridual. An individual asked ro supply private or confidencial data concerning himself shall be informed of: (a)the purpose and intended use of the requested data wichin the collecdng state agency,polirical subdivision, or sratewide rystem;(b)whzther he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing co suppiy private or confidenoal dara;and(d)the idenury of other persons or entiries aurhorized by srate or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav lace the norice re uired under this subdivision in the individual income taz or ro ertv taz refund instrucdons instead of on those forms. Subd. 3. Access to data by indiridual. 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�dendal. 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 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 iu meaning,the data need not be disclosed to him for six months thereafrer unless a dispute or acdon 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 requesc by the individual subject of the data. The responsible au[horiry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediacely,if possible,with a.�y request made pursuant to this subdivision,or withia five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wichin that time, he shall so inform the individual,and may have an addirional 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 dara conceming himself. To exerzise this right,an individual shall noofy in writing the responsible authoriry describing the nature of the disagreement. The responsibie authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or inconplete and attempt to nodfy past recipients of inaccurate or incomplete data,including recipients 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 adminiscradve procedure act relatin� ro contesred 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 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 pemut 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 da[a on yourself. 6. Your full name is required to process this application or permit. �cti��z- First M�ddle Last Address C�ry Srate Zip Phone I understand my rights as stated above. �- � �� 6 � � CHECK OFF LIST FOR ISSUANCE OF PERNIITS , FOR OFFICE USE ONLY - ADDRESS OR LEGAL: PID: DESCRIPTION OF WORK: Z0�1ING REVIrW BY: DATE APPROVED: BUII,DING REVIEW BY: DATE APPROVED: FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes No pLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ----------------------------------------------------------------------------------------------------------------------- ZOti�ING CHECK LIST zoning District: Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Widch Depth Survey Submitted: Yes No Date of Survey: Proposed Se[backs: Front (Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Wetland: BuildinJ HeiQht: Def. Hgt. Peak Hgt. Lo[ Covera�e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: Av�. Setback: Bluff Setback: I.otCoverage: Existing Proposed Hardco�:er: 0-75' 75-2�0' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RENIARKS (in house): _ 7 BUILDING REVIEW CHECK LIST � �C� CONSTRUC'ITON TYPE: Sq Footage $ Per Sq Ftg Basement x _ lst Floor R _ 2nd Floor R = Garage x = R = TOTAL Estimated Construction Value: $ Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) Final Grading/Filling Electrical (State Permit) Other REi�IARBS (IN HOUSE): �-------�- ----------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existing Ne�✓ Access Approval: Date gy: --------------------------------------------------------------------� REil�1ARKS (TO BE NOTED ON PER'�IIT�: 8